Pregnancy Flashcards
What are the signs and symptoms of early pregnancy?
Morning sickness Hyperemesis gravidarum PV spotting/absence of periods Breast tenderness Tiredness Urinary frequency Ligamentous pain Headache
Blue discoloration of cervix and vagina
Darkening of nipples (increased melanin)
Softening of cervix and uterus
Palpable fundus from 12 weeks onwards
What hormones are raised in pregnancy?
Oestrogen, Progesterone, Human placental lactogen, beta-HCG Human Chorionic Gonadotropin, placental alkaline phosphatase
What are the common complains of pregnant women?
Heartburn, Constipation, Varicose veins, vaginal discharge, oedema, backache,
Why is the abdomen palpated at <24 weeks?
To check dates and to identify twins
Why is the abdomen palpated at >24 weeks?
To assess well-being by assessing size and liquor
Why is the abdomen palpated at >36 weeks?
To check lie, presentation and engagement.
If the presenting complain of the mother is antepartum haemorrhage, what important question must you ask?
Whether there is any pain. Painless antepartum haemorrhage can suggest Placenta Preavia whereas painful APH can suggest Placenta abruption.
What does “primipara/primip/primigravida” means?
Primipara/Primigravida refers to women who are pregnant for the first time.
How much Vitamin D is given if needed?
10mcg
Who will be advised to take Vitamin D supplements?
Women of South Asian, African, Caribbean or Middle Eastern family origin.
Women with limited exposure to sunlight.
Women whose diet contains no oily fish, eggs, meat or Vit D fortified food.
Women with BMI >30kg/m2.
Which food should pregnant women avoid? State the risks for consumption of each food.
Avoid fresh milk or ripened soft cheese, due to risk of listeriosis.
Avoid raw meat or eggs, due to risk of toxoplasmosis or salmonella.
Avoid unwashed vegetables, due to risk of listeriosis or toxoplasmosis.
Avoid vitamin A supplementation (above 700micrograms), as it can be teratogenic.
What is done at 25 weeks of gestation?
Symphyseal-fundus height measurement and ausculatation
What is antepartum haemorrhage?
Antepartum haemorrhage is bleeding from the genital tract after 24 weeks of gestation
What should be done if there is placenta praevia?
ABC - Large bore cannula and fluid replacement. Blood cross-matching.
If preterm, give steroids and observe. Deliver normally at 37/40 gestation if no further bleeds or if placenta is >4cm from cervical os.
If term, deliver by C-section.
Why is C-section usually done on the lower segment of the uterus?
The lower segment of the uterus is less muscular and less vascular. There is also less risk of tear and bleed if there is subsequent pregnancy.
Why is steroids given in preterm labor?
Steroids can help speed the development of infant’s lungs, by inducing surfactant production.
What are the observations of the uterus and fetal heart sound in placenta preavia as compared to in placenta abruption?
In placenta preavia, uterus is soft and non-tender, with fetal heart sounds heard.
In placenta abruption, uterus is “woody” hard and fetal heart sounds are muffled.
What is the cause of painful antenatal haemorrhage? Define this condition.
Placenta abruption, when part of or all of the placenta separates form the endometrium before delivery of the fetus.
What are the 2 types of placenta abruption?
Revealed abruption and concealed abruption
How is Haemolytic Disease of Newborns prevented?
By intramuscular injection of anti-Rhesus antibody preparation during the first pregnancy at 28 weeks gestation and again at 34 weeks.
What is measured when booking bloods in pregnancy?
FBC (to check for anaemia and thrombocytopenia)
Haematocrit (if Hb is low)
Infection screening (for Hep B (and Hep C if Hep B is positive), HIV and Syphilis)
Group and Save: (Blood group and Rhesus status, and atypical antibodies)
Describe how the estimated date of delivery is calculated.
Estimated date of delivery is calculated by adding 9 months and 1 week onto the 1st day of the LMP
At what stage of gestation would you expect a nulliparous woman to feel foetal movements?
At 18 to 20 weeks of gestation
What is the most common cause of PPH?
Uterine atony.
A uterus can become atonic due to prolonged labour, macrosomia, multiple pregnancy and retained placenta.
