Perinatal Medicine Flashcards
Effect of smoking on pregnany
Low birth weight
IUGR
Increased risk SIDS
(Correlated with #cigarettes smoked per day)
Effect of folic acid deficiency during pregnancy
Neural tube defects
Effect of alcohol during pregnancy
FAS
- cardiac abnormalities
- facies (saddle nose, maxillary hypoplasia, absent philtrum, thin upper lip)
- growth restriction
- developmental delay
Features of fetal alcohol syndrome
- cardiac abnormalities
- facies (saddle nose, maxillary hypoplasia, absent philtrum, thin upper lip)
- growth restriction
- developmental delay
Three primary features of congenital rubella
Cataracts
Cardiac problems
Deafness
Effect of warfarin during pregnancy
Interference with cartilage formation (e.g. nasal hypoplasia)
Cerebral haemorrhages
Microcephaly
Effect of vitamin A/retinoids during pregnancy
Increased spontaneous abortions, abnormal facies
Effect of opioid abuse during pregancy
Prematurity
IUGR
Opiate withdrawal - jittery, sneezing, seizures, etc.
Signs of opiate withdrawal in neonate
Jittery, sneezing, poor feeding, D&V, weight loss, seizures
Effect of cocaine abuse during pregnancy
Preterm delivery
Placental abruption
Cerebral infarction
Maternal infections that can damage fetus
Rubella CMV VZV Toxoplasmosis Listeria Parvovirus Syphilis
What is the extent of fetal damage (rubella) associated with?
Gestational age
<8 weeks worst
<20 weeks bad
Commonest congenial infection
CMV
% of fetuses with CMV +ve mothers who get infected
40%
Features of toxoplasmosis in fetus
Retinopathy
Cerebral calcification
Hydrocephalus
–> long term neuro disability
Non-immune mother exposed to chickenpox (mx)
VZIG asap (given up to 10 days after contact)
Non-immune mother with chickenpox infection (mx)
Avoid any contact (until all lesions crusted over)
If over 20/40 gestation Aciclovir (500mg 5/day 7 days)
If under 20/40 - hospital admission for IV aciclovir
Refer to FMU
Non-immune mother with chickenpox infection at delivery (mx)
Avoid elective birth until AFTER 7 days after infection (allow maternal IGs to passive transfer)
If birth within 7 days - VZIG immediately to fetus
+ IV aciclovir
Vitamin K deficiency can result in?
Haemorrhagic disease of the newborn