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AB 3rd Year Repro > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

what is pre eclampsia?

A

hypertensive syndrome developed after 20wks gestation

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2
Q

what causes pre eclampsia?

A

failure of trophoblast invasion with causes arterial maladaptation

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3
Q

what does the placenta produce in pre eclampsia? what does this cause?

A

pro inflam proteins
vasoconstriction
salt retention
high BP

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4
Q

features of pre eclampsia?

A 
headache
vision change
N + V
oedema 
urine output change
RUQ pain 
SOB
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5
Q

Ix for pre eclampsia?

A

BP
urinalysis
CTG
umbilical artery doppler

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6
Q

if at high risk, what pre eclampsia Tx is given? when?

A

aspirin from 12 wks

betamethasone at 34-36wks

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7
Q

what are high risk factors for pre eclampsia?

A 
first preg
extremes of age
preg interval of >10yrs
BMI high
FHx
multi preg
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8
Q

Tx for pre eclampsia?

A

labetalol
nifedipine
hydralazine
methyldopa

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9
Q

what emergency can occur in pre eclampsia?

A

pre eclamptic toxaemia

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10
Q

what is eclampsia?

A

tonic clonic seizure and pre eclampsia

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11
Q

Tx for eclampsia?

A

IV labetalol/hydralazine
IV magnesium sulphate
IV diazepam (if persistent seizures)

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12
Q

what does rhesus negative mean?

A

D antigen not found on surface of RBC

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13
Q

what causes sensitisation in a RhD -ve mother?

A

leak of babies (RhD +ve RBC) into circulation, causing anti D antibodies produced

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14
Q

what causes haemolytic disease of newborn?

A

RhD -ve sensitised mother has damage, causing anti D to cross placenta and haemolyse RhD +ve babies RBC

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15
Q

what happens to the baby in haemolytic disease of new born?

A

haemolysis
decreased oxygen delivery
-> haemolytic anaemia

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16
Q

features of haemolytic disease of new born?

A

jaundice
CCF
hepatosplenomegaly

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17
Q

what type of jaundice occurs in haemolytic disease of new born?

A

pre hepatic

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18
Q

Ix for haemolytic disease of new born?

A

maternal blood type
maternal serum Rh antibody
coombs test

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19
Q

Tx for haemolytic disease of new born?

A

anti D immunoglob
28 and 34 wks
or 72hrs after an incident

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20
Q

what are dizygotic and monozygotic twins?

A

di - two sperm, two ova

mono - one sperm, one ova

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21
Q

for twins, what sacs can they be in? what are they called?

A

dichorionic - separate
monochorionic diamniotic - same sac but separate
monochorionic monoamniotic - same sac

22
Q

what affect does hyperglycaemia have on the fetus?

A

macrosomia
hypoxic
metabolic reprogramming (obesity/diabetes)

23
Q

risk factors for gestational diabetes?

A 
>40
FHx
obesity
previous big baby/still birth
PCOS
24
Q

when is gestational diabetes recognised as not T2DM?

A

diagnosed during pregnancy, not at booking

25
Q

Ix for gestational diabetes?

A

GTT at 28 weeks

fasting ≥ 5.1, 2hr ≥ 8.5

26
Q

tx for gestational diabetes?

A

diet and exercise

insulin therapy

27
Q

follow up for gestational diabetes?

A

fasting glucose 6wks PP

28
Q

complications of gestational diabetes?

A 
pre eclampsia
polyhydramnios
macrosomia
shoulder dystocia
neonatal hypos
29
Q

if diabetic during pregnancy, what should you take?

A

5mg folic acid

30
Q

what are the two types of IUGR? what causes them?

A

symmetrical - affected in early preg

disproportional - insult in late preg

31
Q

when is
1st
2nd
3rd trimester from?

A

1 - 13 wks
2 - 28 wks
3 - 40wks

32
Q

when is a baby a neonate?

A

0-27 days

33
Q

what should be used for VTE prophylaxis in pregnant women?

A

LMWH

34
Q

what diabetes drug should be avoided in pregnancy?

A

SU (switch to insulin)

35
Q

when does ‘baby blues’ most commonly occur?

A

3-10 days after birth

36
Q

features of baby blues?

A 
tearful
irritable
anxious
poor sleep
confused
37
Q

Tx of baby blues?

A

self limiting
support
reassure

38
Q

features of puerperal psychosis?

A

irrational ideas
mania
delusions
hallucinations

39
Q

antidepressants safe in pregnancy and breast feeding?

A

sertraline
fluoxetine
paroxetine

40
Q

features of floppy baby syndrome? what causes it?

A

hypothermia
hypotonia
respiratory depression
withdrawal

benzos cause it

41
Q

can lithium be used in pregnancy/breastfeeding?

A

yes but monitor

NOT IN BREASTFEEDING

42
Q

when is usual onset of PND?

A

2-6wks

43
Q

features of PND?

A 
irritable
anxious
lacks enjoyment
poor sleep
wt loss
lasts for weeks
44
Q

if a pregnant women requires a smear, what advice is given?

A

rescheduled to 12 wks post delivery

45
Q

what is sheehan’s syndrome? why does it happen?

A

post partum hypopituitarism

ischaemia due to blood loss in pregnancy

46
Q

what emergency can occur in pre eclampsia?

A

HELLP

47
Q

Ix for HELLP?

A

FBC
U and Es
LFTs

48
Q

what vitamin should be taken during pregnancy?

A

Vit D

49
Q

when is folic acid useful? why?

A

only up until 4 wks

neural tube closes

50
Q

Tx for HELLP?

A

magnesium sulphate
IV dexamethasone
blood product replacement
DELIVERY OF FETUS

AB 3rd Year Repro (27 decks)

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