Preconception Care: Common Medical Problems Flashcards
Define gravidity and parity
Gravidity is the number of times a woman has been pregnant.
Parity is the total number of times a woman has given birth.
Discuss the TPAL acronym’s use in assessing pregnancy outcome and recite what the TPAL stands for
TPAL - Term, Preterm, Abortions, and Live births
(>37wks, <37wks, <20wks, live)
Recognize the terms: last menstrual period (LMP), estimated date of delivery/estimated date of confinement (EDD/EDC), and gestational age (GA)
LMP - Last Mentrual Period.
- Used to determine the gestational age.
EDD/ EDC- Estimated date of delivery/ estimated date of confinement
- When the mother is expected to deliver.
GA - The gestational age of a fetus in units of weeks and days, counting from the first day of the maternal last menstrual period.
The common term used during pregnancy to describe how far along the pregnancy is
Recall the purpose of preconception care and outline its key elements
Goal - to optimise medical problems to decrease maternal and fetal morbidity and mortality.
Identify the most suitable time for women to start taking folic acid supplements
3 months before conception
It’s best to take folic acid for at least 14 weeks before you become pregnant when you’re trying for a baby. You should continue taking it for at least the first 12 weeks of pregnancy.
Explain the rationale behind taking folic acid during the preconception period and discuss the recommended dose
Prevent neural tube defects in the unborn child.
Recommended dose: 400 micrograms (normal women)
4mg in women with any previous history of pregnancy with neural tube defects or if taking medications that lower folic acid absorption.
Describe the changes in mean blood pressure during pregnancy
Maternal blood pressure may be lower than her pre-pregnancy baseline during the first and second trimesters of pregnancy.
List the complications of hypertension in pregnancy
- increased risk of…
- preeclampsia
- preterm labor
- placental abruption
Identify the potential complications of diabetes mellitus in pregnancy
- Congenital malformations
- Pregnancy loss
- fetal macrosomia
- growth restriction
- diabetes ketoacidosis
- maternal and perinatal mortality
Describe the effects of pregnancy on maternal asthma symptoms
1/3 of the cases get worse, 1/3 get better, 1/3 stay the same.
Identify the adverse outcomes of tobacco use during pregnancy
- CO levels increase - Less oxygen is delivered to the fetus.
- Placental abruption: blood vessels of the placenta is affected and are caused to prematurely separate from the uterus.
- Preterm labor: placental abruption causes contractions which lead to labor.
- Preterm premature rupture of the membranes: leads to early delivery
- Fetal growth restrictions: lower oxygen levels as smoking affects the blood supply to the placenta which affects the growth of the baby.
smaller and weaker baby.
Explain the 5 A’s approach to smoking cessation
Stopping smoking 24 weeks before getting pregnant will result in the same pregnancy outcomes as someone who has never smoked.. so it is worth stopping!
Ask - if the mother is ready to stop smoking
Advise - inform the mother about the ill effects of smoking on both the mother and baby.
Assess - check for yourself if the mother is willing or able to stop smoking or make changes.
Assist - find ways that suit the mother and her ability to stop smoking.
Arrange - have regular check-ins and counseling sessions.
List the adverse outcomes of alcohol use during pregnancy
- Fetal Alcohol syndrome
- CNS abnormalities
- Fetal growth restriction
Describe the craniofacial features of fetal alcohol syndrome
- thin vermillion lip
- flat midface
- flat and long philtrum
- short palpebral fissures
- small head circumference
Recognize the central nervous system (CNS) abnormalities associated with fetal exposure to alcohol
- mental retardation - seen throughout the kid’s life
- growth restriction
