Pregnancy Flashcards
how long is pregnancy ?
40 weeks
what is the law on working when pregnant ?
- can carry on working up until day of delivery
- compulsory leave of 2 weeks form when baby is born ( some can take longer )
- 52 weeks maternity leave (starts from when u take leave )
- 39 week maternity pay
- can share leave between parents
what are the risk assessments in pregnant women ?
- lifting carrying
- chemicals/ drugs
- amalgam
- N20
what is pre conception screening ?
tests and assessments done before couples try to conceive
- as 45% of pregnancies are unexpected
why is smoking cessation important for pre conception?
- it increases risks of :
why is alcohol important to stop ?
fetal alcohol syndorme
miscarriage
what otter things are important to consider pre conception ?
recreational drugs
caffeine
prescribed drugs eg. some can cause abnormalities in babies (teratogenic )
what diet type of diet is needed for pregnant women?
- varied diet
- folic acid = reduces risk of neural tube defects
- vit d = if poor diet and not exposed to sunlight
what are foods to avoid during pregnancy ?
pate unpasteurised diary = listeria (miscarriage, still birth)
raw meat and eggs
- liver (excess vit a )
- some fish eg. tuna and swordfish due to mercury
- alcohol and caffeine
how is pregnancy care coordinated ? (antenatal)
- by GP first
- later care and delivery under care of midwifery
- specialist obstetric medical care if required
what are the screening test we do for pre - pregnancy and pregnancy ?
when do we check gestational age of baby ?
10 weeks
- give idea of due date
when do we check fetal anomaly scan?
18-20 weeks = picks up cleft lip plate, cardiac, lungs problems
what is amniocentesis?
- sample of amniotic fluid = contains dna of baby to check when theres high risk of Down syndrome
- small risk of miscarriage
how is the baby protected during pregnancy ?
- cervix retains baby in uterus
- amniotic sac protects baby from infection
- placenta nourishes baby
what happens during birth ?
- cervix dilates and uterus contracts
- amniotic sac broken
- placenta is delivered after baby
what hormones are involved in order to deliver a baby ?
- CRH
- oestrogen
- oxytocin
what are the local risk factors that can rupture amniotic sac to happen early or late?
- size of baby
- inflammation of cervix
- microbiome of mom
- stress
what are the different types of delivery ?
- spontaneous (natural)
- induced : physical cervical ripening or syntocinin
- assisted: forceps or vaccum
- caesarian: elective or emergency = this is done if baby is too big or baby heart rate drops or mother
what happens after birth ?
- delivery of placenta
- arrest of haemorrhage
- oxytocin will be given to cause uterus to contract and reduces haemorrhage
- suture perineal tears if required
- APGAR score (look at baby’s O2 sats and check if baby is crying)
- resuscitation as required eg. if baby needs to be warm or needs oxygen
- skin to skin contact to encourage bond
- breast feed to nourish
what major issue can happen postnatally ?
- puerperal sepsis = major cause of maternal death
- symptoms = 38deg+, pain (abdominal and chest) cough, tachycardia
list some pregnancy problems
- rhesus isoimmunisation
- hypertension (common)
- pre- eclampsia
- eclampsia
- heart murmur
- DVT
- gestational diabetes
what is rhesus isoimmunisation?
- mother is rhesus - blood group
- baby is rhesus + blood group
- mother WBC attach babys positive cells
why is Rhesus isoimmuunisation a problem ?
if mother has a second pregnancy where the baby is rhesus - she will have a profound immune response to baby blood
- causes problems for baby as there blood cells are getting attacked = haemolytic disease of newborn causing anaemia
how can we prevent rhesus isoimmunisation?
- rhesus typing of parents
- give anti- D immunoglobulin = coats D- antigens of baby RBC’s and disguises them from mothers immune system
what is pre -eclampsia and eclampsia ?
- uncontrolled hypertension
- raised intracranial pressure
- High BP
- kidney failure
- leads to convulsions and fits
- risk to mum and baby
what are the risk factors for pre eclampsia ?
- high BP
- DM
- obesity
- over 40
- previous eclampsia
how do we manage pre eclampsia ?
- prevention
- education
- monitor BP, blood glucose, protein in urine, diet, weight
- may have to give birth to baby to stop eclampsia
- manage with BP meds
why do heart murmurs happen in pregnancy?
- common
- increased circulatory vol due to extra metabolic needs for baby and mother and leads to flow murmur
- leads to anaemia
- increased heart rate
- not a risk factor for endocarditis
how does DVT occur in pregnancy?
- baby reduced blood flow to pelvis
- leading to clots in legs and turning into pulmonary embolism in heart
- managed with anticoagulants eg. heparin
- may occur up to 6 weeks after baby is born
how does gestation diabetes occur?
- develops during pregnancy due to extra metabolic demands and change in diet
- body is unable to produce enough insulin thus increases glucose
what are the risk factors of G. diabetes ?
- obesity
- 40+
- prev big baby
- prev G. diabets
- ethnicity
what are the complications of G. diabetes ?
- bigger baby
- pre eclampsia
- birthing difficulties
- premature birth
how can we prevent g. diabetes ?
- antenatal screening
- diet advice
what are some common symptoms during pregnancy ?
- morning sickness in ear 4-20 weeks, variable but common, nausea, vomiting, dehydration, weight loss
- tiredness
- urinary frequency = due to baby sitting on bladder
4, hypotension = when u lie flat baby compresses vena cava reducing venous return
how can we reduce hypotension?
- adjust position to Side when sleeping
- use a wedge
what are some dental effects in pregnancy?
- pregnancy gingivitis
- hyperemesis (erosion)
- epulis
- link between gingival inflammation and poor outcomes of pregnancy
- give OHI
- settles down after birth
