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BDS3 BAMS Diseases of Human Systems > Paediatrics - Pregnancy and Perinatal Health > Flashcards

Paediatrics - Pregnancy and Perinatal Health Flashcards

1
Q

What are fertility issues linked to

A 
age
smoking
BMI
exercise
drugs
folate
alcohol
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2
Q

What does low levels of folic acid put an unborn child at risk of

A

spina bifida

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3
Q

Describe the stages of early pregnancy

A

ovulation happens and then fertilization happens while the oocyte is in the fallopian tube
the embryo/zygote spends first week of life transitioning own the fallopian tube before implanting onto the uterus at approximately day 8 or 9
lots of development has taken place by this stage
once the embryo has implanted there are development changes and beginning of maturity

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4
Q

What are the 3 trimesters

A

first is 12 weeks
second is 12-28 weeks
third is 28-40 weeks

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5
Q

What are the changes that occur across the diff trimesters

A

1st - structures of embryos forming and differentiating
2nd - more specialization and further differentiation
3rd - all that happens is growth and changes necessary for successful birth

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6
Q

What are the maternal changes in pregnancy

A 
physical changes
hormonal changes
hematological changes
CV changes
coagulation changes
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7
Q

What are the hematological changes

A

large blood volume produced to protect from death from blood loss at birth

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8
Q

What are the hormonal changes in pregnancy

A

increased estrogen and progestogen

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9
Q

What does the increased estrogen and progestogen do

A

act on kidney to increase renin secretion
increased salt and water retention
increased plasma volume by 45%

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10
Q

Why does plasma volume increase

A

protects against hemorrhage at birth

dilution effect makes Hb fall from 15-12g/dL

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11
Q

How do hormonal changes cause diabetes

A

reduce insulin sensitivity

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12
Q

Why does the lower esophageal sphincter relax

A

increase abdominal pressure gives increased GORD

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13
Q

What are the hematological changes in pregnancy

A

increased production of RC< WC, platelets
20% increase in RC mass
increased platelet consumption makes platelets normal to low

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14
Q

What is the issue with increased WC in pregnancy

A

increased WC makes diagnosing infection difficult

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15
Q

What are the CV changes

A

relaxation of vascular smooth muscle

vascular compression by uterus

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16
Q

What is the effect of relaxation of vascular smooth muscle

A

reduced peripheral resistance
reduced systolic and diastolic BP
compensatory increase in HR by 25%

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17
Q

What is the effect of vascular compression by the uterus

A

compresses vena cava and aorta
results in difficult with venous return when supine so ensure there is a pillow under one side or sit slightly to the side so no pressure on vessels

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18
Q

What are the coagulation changes in pregnancy

A

clotting factors production increases
fibrinolysis increases
increased system sensitivity with increased DVT risk

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19
Q

What should pregnant women not eat

A 
raw/slightly cooked meat and raw fish
raw eggs
non pasteurized milk and milk cheeze
spicy grilled and fried food
marlin, tuna and shark
liver and other entrals and internal organs of a slaughtered animal during the first 3 months
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20
Q

Why should they avoid raw /slightly cooked meat and raw fish

A

danger of infection with toxoplasmosis

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21
Q

Why should they avoid raw eggs

A

salmonella

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22
Q

Why should they avoid non pasteurized milk and milk cheese

A

listeria

23
Q

Why should they avoid spicy, grilled and fried food

A

dyspesia and GORD

24
Q

Why should they avoid tuna etc

A

mercury

25
Q

What does development start

A

at 4 weeks

zygote becomes embryo

26
Q

What happens in week 6

A

start of embryonic circulation

weeks 6-10 embryonic development and growth

27
Q

When do embryo stages stop

A

week 10
it is a fetus from 10-14 weeks
features and limbs become developed and active

28
Q

When is miscarriage rate highest

A

first trimester

29
Q

From week 14-18 what happens

A

hair, nails, toenails and eyelids start to form and movement may be felt

30
Q

What happens weeks 18-20

A

toes and fingers formed and hearing starts to respond

31
Q

What happens weeks 20-26

A

final development of vision and senses

brain development and body fat increase

32
Q

What are foetal changes from week 27

A

growth and NS maturation

33
Q

What is placenta

A

interlinking mesh of VS so maternal and fetal circulation do not mix but are in close proximity and nutrients can diffuse

some infections and toxins can diffuse through fetus

34
Q

What are the stages of labour

A

induction
first stage
second stage
third stage

35
Q

What is looked at in screening pregnancy in first trimester

A

establish dates of pregnancy
determine the number of fetuses and identify placental structures
to diagnose an ectopic pregnancy or miscarriage
to examine the uterus and the other pelvis anatomy
in some cases to detect foetal abnormalities

36
Q

What are the mothers screened for

A

chronic diseases

infectious disease

37
Q

What are the fetus screened for

A

genetic and developmental abnormalities

38
Q

What are chronic diseases that are screened for

A

hypertension

diabetes

39
Q

What are infections that are screened for

A

rubella
syphilis
hep C
HIV

40
Q

What is screen for at weeks 18-20

A

confirm pregnancy dates
determine number of fetuses and examine placental structures
assist in prenatal tests such as amniocentesis
examine the foveal anatomy for presence of abnormalities
to check the amount of amniotic fluid
examine blood flow patterns
to observe foetal behavior and activity
to examine the placenta
to measure the length of the cervix
to monitor foetal growth

41
Q

Whta is FAST

A

foetal abnormalitiy screening programme

42
Q

What is screen for in FAST in see 1

A 
neucheal translucency (ultrasound)
maternal hCG (blood) 
PAPP-P blood

looking for chromosome abnormality from combined result

43
Q

What do we test in the fetus in second trimester

A

alpha foetus protein

44
Q

What is the abnormality follow up after AFP

A

CVS and amniocentesis - genetic changes

ultra sound - spina bifida

45
Q

What are the birth testing

A

physical exam
hearing test
blood spot

46
Q

Whats tested in bloods put

A 
PKU
hypothyroidism
CF
sickle cell
mCADD
47
Q

What does the APGAR score consist of

A 
activity
pulse
grimace
appearance 
respiration rate 
done at 1 min and 5 min
48
Q

What does activity look at

A

muscle tone

49
Q

What should pulse be

A

> 100/min

50
Q

What does grimace test

A

reflex irritability

51
Q

What does appearance look at

A

colour

52
Q

What are considerations of pregnancy in dentistry

A 
cost of dental care
drugs in pregnancy
pregnancy gingivitis
periodontal health in pregnancy
position of mother
53
Q

Why is pregnancy gingivitis a thing

A

hormone levels change

immune response heightened to plaque

BDS3 BAMS Diseases of Human Systems (11 decks)

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