Pregnancy 2 - 235 Flashcards
When do cardiovascular changes to the pregnant mother begin and end during pregnancy?
Changes start at 6/40 and plateau in the 2nd trimester
What is the change in CO immediately postpartum?
80% increase
How does the progesterone effect affect vascular resistance during pregnancy?
It decreases it
How does the blood volume of the pregnant women change during pregnancy?
Non-pregnant volume ~2600mL
Pregnant volume ~5000mL
Pregnant women are in a pro-thrombotic state. True or false? What is the relevance of this?
True.
Protect from haemorrhage at delivery BUT increased risk of thromboembolism
What happens to the tidal volume and residual volume in a pregnant women?
Tidal volume increases by 30-40%
Residual volume decreases by 20%
What happens to GI motility during pregnancy?
Reduces to allow better absorption. Due to oestrogen and progesterone
Name 4 factors that can increase chance of multiple pregnancy
1) Increasing maternal age
2) FH
3) Race
4) Assisted conception
If you have a monochorionic twin pregnancy how often do you scan the mother?
Scan at 16 weeks to exclude TTTS and then every 2-3 weeks for growth
When is the anomaly scan in pregnancy?
20 weeks
Uncomplicated DCDA twins should be delivered at what gestation?
37-38 weeks
Uncomplicated MCDA twins should be delivered at what gestation?
36-37 weeks
What 4 things are necessary before commencing an operative vaginal delivery?
1) Adequate analgesia
2) Empty bladder
3) Full dilatation of the cervix
4) Head not palpable per abdomen
How long must nulliparous and multiparous women have had lack of progress in labour before an operative vaginal delivery is considered?
Nulli - 3 hours
Multi - 2 hours
Where is the ventouse cap fixed?
2-3 cm anterior to the posterior fontanelle (at the flexion point)
Name 3 absolute indications for c-section
1) Placenta praevia
2) Severe fetal compromise
3) Uncorrectable abdominal lie
4) Pelvic deformity
Give an example of some relative indications for c-section
Breech, DM, other nulliparous women, previous c-sections
What is the status of the cervical os in a threatened miscarriage? Incomplete?
Threatened - Closed
Incomplete - Open
Give 2 reasons for bleeding in early pregnancy
Miscarriage
Ectopic
Roughly how many pregnancies end in spontaneous miscarriage?
14-19%
Give some reasons for bleeding in late pregnancy and early labour
Abruption
Placenta praevia
Ruptured uterus
APH
How is miscarriage managed medically? (what drugs)
Mifepristone and misoprostol
What do you give to all rhesus -ve mothers if they have had a bleed
Anti - D prophylaxis
What would serial bHCGs be like in a ectopic and molar pregnancy?
Ectopic - suboptimal rise
Molar - very very high hCG
