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PHN > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

Foetal complications associated with maternal obesity (3)

A

Congenital anomalies e.g. NTDs
Macrosomia (BW greater than 4500g)
Mortality

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2
Q

Birth complications associated with maternal obesity (2)

A

Caesarean delivery

Shoulder dystocia

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3
Q

Define GDM

A

Glucose intolerance with onset during pregnancy

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4
Q

Define thromboembolism

A

Increased blood viscosity and upregulation of coagulation pathways

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5
Q

Define shoulder dystocia

A

Delivery beyond the foetal head is obstructed by impaction of the foetal shoulders

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6
Q

Define preeclampsia

A

Hypertension during pregnancy along with proteinuria

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7
Q

Maternal complications associated with maternal obesity (3)

A

GDM
HDP
Thrombeomblism

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8
Q

Why are demands for certain nutrients increased during pregnancy?(2)

A

Tissue deposition

Maintenance costs of pregnancy

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9
Q

What increases maintenance costs of pregnancy?(2)

A

Increased BMR

Increase energy cost of PA

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10
Q

What contributes to tissue deposition?(2)

A

Products of conception

Maternal tissues

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11
Q

Products of conceptions (3)

A

Foetus
Amniotic fluid
Placenta

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12
Q

Maternal tissues (4)

A

ECF
Uterus and breasts
Blood
Fat stores

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13
Q

What is the optimal amount of weight gain during pregnancy?

A

12.5 kg

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14
Q

Physiological adaptations to increase blood supply to the uterus (4)

A 
Increased:
Blood volume
Cardiac output 
GFR
Renal plasma flow
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15
Q

Why is an increased blood supply to the uterus needed?(2)

A

Nutrient supply to uterus

Sustain placental and foetal development

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16
Q

Which hormone drives fat storage in 1st and 2nd trimesters

A

Progesterone

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17
Q

Which hormone driving so fat mobilisation during the third trimester

A

Human placental lactogen

18
Q

How is nutrient supply to the foetus increase?(4)

A

Slower gastric emptying and intestinal transit
Increased absorption of some nutrients
Increased water absorption in colon
Increased insulin resistance

19
Q

Preeclampsia stage 1 (2)

A

Failure of spinal artery remodelling in placenta

Reduced perfusion of placenta

19
Q

Preeclampsia stage 2 (3)

A

Endothelial activation
Hypertension
Renal dysfunction

20
Q

Eclampsia

A

Maternal seizures

21
Q

Risks associated with GDM (6)

A 
Perinatal mortality 
Preeclampsia 
Caesarian delivery 
NTDs
Macrosomia 
Neonatal hypoglycaemia
22
Q

Reduction of energy expenditure during pregnancy (3)

A

Reduced fat storage
Reduced PA
Improved energetic efficiency of PA

23
Q

Adolescent pregnancy risks (4)

A

Low both weight
Preterm birth
Intrauterine growth retardation
IDA

24
Q

Interventions for adolescents (3)

A

Iron and calcium supplementation

Extra protein

25
Q

Underweight (3)

A

BMI under 19.8

Greater risk of preterm birth and low birth weight

26
Q

Overweight (4)

A

BMI over 26
Greater risk of diabetes and hypertension
Should not attempt to lose weight

27
Q

Alcohol (3)

A

Ethanol freely crosses the placenta

Heavy drinking has a teratogenic effect

28
Q

Fetal alcohol syndrome (3)

A

Facial dysmorphology
Growth restriction
CNS anomalies

29
Q

Effects of low alcohol intake (3)

A

No strong evidence to suggest a negative effect
Difficult to study due to ethics so it is unknown
Variation in alcohol metabolism means safe levels differ between people

30
Q

Effects of caffeine intakes over 300 mg (2)

A

Increased risk of spontaneous abortion

Foetal growth restriction

31
Q

Conclusions of FSA caffeine study (2)

A

Difficult to set level of caffeine whee there is no risk

May be an increased risk in association with over 200mg

32
Q

Which enzyme for caffeine metabolism is absent in placenta and foetus

A

Cytochrome p450 1A2

33
Q

Nausea and vomiting (5)

A

Begins in 6th week of pregnancy
Lasts for 6-8 weeks
Women who vomited 17% lower risk of premature delivery
30% lower risk of miscarriage
May be protective mechanism against toxins and teratogens

34
Q

Need for extra protein (3)

A

Protein synthesis increased for:
Foetal growth
Placentation
Maternal tissues

35
Q

Why is an extra 800 mg of iron required (4)

A

Foetal liver stores
Formation of placenta
Expansion of blood volume
Blood loss during delivery

36
Q

How are the extra iron requirements met?(3)

A

Increased iron absorption efficiency
Cessation of menstrual iron losses
Use of maternal stores

37
Q

How are extra protein requirements met (3)

A

Urinary nitrogen excretion decreases late in gestation
In order to conserve amino acids
Dietary protein utilisation increases

38
Q

Calcium requirements

A

Foetus required 30g

39
Q

How are calcium requirements met (4)

A

Maternal skeletal stores
Results in loss of bones mineral density
Increases intestinal absorption of dietary calcium
This protects maternal calcium homeostasis

40
Q

Vitamin D requirement (2)

A

10 micro grams a day

Required to maintain calcium homeostasis

PHN (18 decks)

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