Preconceptional care Flashcards
most common deficiency causing miscarriage
iodine deficiency
criteria for discontinuation of anti-seizure meds
seizure-free for 2-5 yrs
single seizure type
normal neurologic exam and normal intelligence
normalized EEG w/ trt
OGTT sched for low-risk & high-risk DM grp
LR: OGTT at 24-28 wks
HR: immediate OGTT
cutoff FBS for GDM
> 92mg/dL - GDM
>126mg/dL - overt GDM
what supplement should be given to epileptic women?
4mg folic acid
what should be given to prevent recurrent pre-eclampsia?
low dose aspirin (80mg)
how long is the recommended delay for pregnancy after receiving live-attenuated vax?
1 month
general considerations for vax in pregnancy
never admin in buttocks
confirm completion of childhood/recent vax for MMR & Td before admin
maintain vax record
bigger needle for IM, smaller for SQ
simultaneous vax is not contraindicated
antibiotic trt or breastfeeding is not contraindicated
general contraindicated for vax in pregnancy
severe allergy
live attenuated vax
severe immune attenuation
mod-severe acute illness
defect with 1-2 per 1000 LB
NTD
recommendation for maternal AFP screening
offered in 2nd trimester
can be measured as early as 1st trimester
measured between 14-22 wks
low levels of AFP is seen in?
obesity GDM trisomies GTD fetal death overestimated gestational age
what are included in quad screen?
AFP
estriol
b-hCG
inhibin
detect NTD & certain trisomies, not applicable to multiple gestations
what are included in ultra screen?
nuchal translucency in utz
free b-hCG
PAPP-A
newest screening for aneuploidies
recommendation for ultra screen
done between 11-13 wks
still needs 2nd trim. MS-AFP for NTD detection
+: proceed to genetic counseling, high resolution utz, amniocentesis, chorionic villous sampling
may be offered to multiple gestations
complications of untreated PKU
spontaneous abortion mental retardation microcephaly congenital heart disease fetal-growth restriction
most common risk for aneuploidies and trisomy?
maternal age
age grp w/ inc risk for anemia, preterm birth, & preeclampsia
15-19 y/o
what is linked to molar pregnancy? paternal or maternal age?
paternal age
DES maternal cancer
breast cancer (12-17%) vaginal clear cell adenocarcinoma
DES daughter risk
cervicovaginal clear cell adenocarcinoma CIN congenital anomalies of reprod. tract subfertility early menopause breast Ca
DES transgenerational effect
slight inc of irreg menses, amenorrhea, preterm birth
inc in birth defect
inc risk of ADHD
modern DES
bisphenol-A
- xenoestrogen
effect of pre-pregnancy obesity
LGA baby inc CS preeclampsia GDM late fetal death (3-4x) early fetal death (2x)
effect of pre-pregnancy underweight
preterm birth
SGA baby
clinical significance of PROM
cord prolapse
intraamnionic infx
most sensitive biometric measurement in diagnosing IUGR w/ false - of <10%
reduced abdominal circumference
clinical feat of dysmaturity
actual loss of weight in utero
reduced SQ tissue
scaling & parchment-like skin
what can be given in preterm labor bet 24-34 wks?
steroid
major cause of premature birth, fetal death, & maternal morbidity
UTI
_thyroidism is associated w/ inc LBW while _thyroidism inc stillbirth
hyper: LBW
hypo: stillbirth
hexoaminidase A def
neurological motor & mental dysfuction w/ childhood death
tay-sachs ds
IKBKAP gene mutation
neurological do, poor feeding, abnormal sweating, pain & temp insensitivity, labile BP, & scoliosis
familial dysautonomia
aspartoacylase def
neurological do, dev’l delay, hypotonia, macrocephaly, seizure, blindness, GI reflux, childhood death
canavan ds
recessive mutation of any several genes
severe anemia, pancytopenia, dev’l delay, failure to thrive, childhood death
fanconi anemia
sphingomyelinase def
neurodegenerative ds, childhood death
niemann-pick ds type A
neurodegenerative lysosomal storage do, growth failure, psychomotor retardation, retinal degeneration
mucolipidosis IV
inc chromosomal breakage, susceptible to infx & malignancy, growth def, skin findings, mental retardation
bloom syndrome
b-glucosidase def
affects spleen, liver, bones
anemia, brusing & bleeding, hepatosplenomegaly, & osteoporosis
Gaucher ds type 1
