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REPRODUCTION > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

What are some of the causes of bleeding in early pregnancy?

A 
Implantation bleeding 
Chorionic haematoma 
Miscarriage 
Ectopic pregnancy 
Molar pregnancy 
Infection
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2
Q

Describe implantation bleeding

A

Occurs when a fertilised egg implants into the uterine wall

Bleeding is limited and light brownish in colour

Occasionally mistaken as a period

Management; watchful waiting - usually settles

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3
Q

What is the primary symptom of miscarriage?

A

BLEEDING

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4
Q

What are some of the possible symptoms of miscarriage?

A

Bleeding

Period-like cramping pain

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5
Q

What are some of the possible causes of miscarriage?

A

Embryonic abnormality

Immunological conditions e.g APS

Infections e.g CMV/ rubella/ toxoplasmosis e.t.c

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6
Q

What are the different types of miscarriage?

A 
Threatened miscarriage 
Inevitable miscarriage 
Incomplete miscarriage 
Complete miscarriage 
Early fetal demise
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7
Q

What is early fetal demise?

A

Pregnancy in-situ

No heartbeat

*can wait a couple of days to see if the fetus regains a heartbeat, the mother however may miscarry in this time

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8
Q

What is the management of miscarriage?

A

Emotional support

Haemodynamic stabilising

Anti D (for rhesus -ve mothers)

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9
Q

What are some of the causes of recurrent miscarriage (3+ pregnancy losses)

A

Antiphospholipid syndrome

Thrombophilia

Uterine abnormalities

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10
Q

What is the primary symptom of ectopic pregnancy?

A

PAIN

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11
Q

What are some of the possible symptoms of ectopic pregnancy?

A

Pain

Bleeding

Dizziness/ collapse

SOB (caused by internal bleeding)

*Peritonism causes rigidity and rebound tenderness

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12
Q

What might an ultrasound scan show in cases of ectopic pregnancy?

A

Empty uterus

Pseudo sac

Mass

Free fluid

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13
Q

What diagnosis should you always consider in early pregnancy presenting with pain?

A

Ectopic pregnancy

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14
Q

What is molar pregnancy?

A

Non-viable fertilised egg in the womb

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15
Q

What is the difference between a complete and partial mole?

A

COMPLETE MOLE
Egg without DNA
Only paternal DNA
No fetus

PARTIAL MOLE
Egg
1 reduplicated or 2 sperm- forms a triploidy with the egg May have a fetus attached

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16
Q

What are some of the causes of molar pregnancy?

A

Gestational trophoblastic disease

Nonviable fertilised egg

Overgrowth of placental tissue with chorionic villi swollen with fluid

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17
Q

How might a molar pregnancy present?

A

Hyperemesis

Bleeding and passage of “grape-like” tissue

Shortness of breath

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18
Q

What is the typical ultrasound appearance of a molar pregnancy?

A

‘Snow storm appearance’

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19
Q

What is a chorionic haematoma?

A

Pooling of blood between the endometrium and the embryo due to separation

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20
Q

How does a chorionic haematoma present?

A

Bleeding

Cramping

Threatened miscarriage

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21
Q

What is hyperemesis gravidarum?

A

Excessive vomiting in pregnancy which alters QOL

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22
Q

What effects can hyperemesis gravidarum have on the body?

A

Dehydration

Electrolyte and nutritional misbalance

Weight loss

Altered liver function

Emotional instability

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23
Q

How is hyperemesis gravidarum managed?

A

Rehydration and electrolyte replacements

Nutritional and vitamin supplements e.g thiamine and pabrinex

NG feeding

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24
Q

What is the first line anti-emetic for hyperemesis gravidarum?

A

Cyclizine

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25
Q

What is the second line anti-emetic for hyperemesis gravidarum?

A

Ondansetron

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26
Q

HCG doubles by 50% in 48 hours with viable or inviable pregnancies?

A

Viable pregnancies

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27
Q

When is considered term?

A

37-42 weeks

90% of babies will be delivered in this time

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28
Q

When do women deliver with reference to their due date?

A

4% deliver on the date

60% deliver within the date

90% deliver within term

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29
Q

What screening should be done for the mother throughout pregnancy?

A

Diabetic eye screening and gestational diabetes

BBV and infections

Maternal anaemia

Pre-eclampsia

Urinalysis

Mental health

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30
Q

What screening should be done for the fetus during pregnancy?

A

Neural tube defects

Haemoglobin disorders

Growth

Aneuploidy

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31
Q

Screening for aneuploidy in pregnancy is done to detect which conditions?

A

Down’s syndrome (trisomy 21)

Edward’s syndrome (trisomy 18)

Patau syndrome (trisomy 13)

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32
Q

How is Down’s syndrome screened for in pregnancy?

A

1st TRIMESTER

  • Nuchal thickness (US) (11-14 weeks, <3.5mm is normal)
  • HCG and PAPP-A

2nd TRIMESTER

  • Blood samples (at 15- 20 weeks)
  • HCG and AFP (Low AFP in Down’s)
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33
Q

What is placental praevia?

A

When the placenta is low lying in the womb and covers all or part of the cervix

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34
Q

What are pre eclampsia and eclampsia?

A

Pre-eclampsia = pregnancy induced hypertension and proteinuria

Eclampsia = extreme pre-eclampsia

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35
Q

What are the risk factors for pre-eclampsia?

A

Previous pre-eclampsia

pre-existing hypertension, diabetes , autoimmune disease , renal disease

FH of pre-eclampsia

Obesity

Women with multiple gestation (twins or multiple birth)

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36
Q

What are some of the proposed causes of pre-eclampsia?

A

Secretion of placental hormones

Immune response to the fetus

Insufficient blood supply to the placenta- causes ischaemia

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37
Q

What are some of the treatment options for eclampsia?

A

Vasodilators

Caesarean section

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38
Q

What effects do progesterone and oestrogen have on contractility of the uterus?

A

Progesterone inhibits contractility

Oestrogen stimulates contractility

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39
Q

Where is oxytocin secreted from and what is its role?`

A

Posterior pituitary

Increases contractions

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40
Q

What is the name of the contractions which increase towards the end of pregnancy?

A

Braxton Hicks contractions

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41
Q

What are the risks of pregnancy to the mother if she is obese?

A

Miscarriage

Pre-eclampsia

Gestational diabetes

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42
Q

What are the risks of pregnancy to the fetus if the mother is obese?

A

Still birth

Macrosomnia

Long term obesity

Diabetes

Metabolic and congenital abnormalities

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43
Q

How many extra calories are recommended in pregnancy and breastfeeding?

A

300 extra calories in the last 3 months of pregnancy

640 extra calories if exclusively breastfeeding

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44
Q

What vitamins and supplements are required in pregnancy?

A

Folic acid

Vitamin D and calcium

Iron

Vitamin B

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45
Q

Why is Vitamin K given before parturition?

A

To prevent intracranial bleeding during labour

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46
Q

What foods should be avoided in pregnancy?

A

Raw meat, tuna, liver

Soft cheese

Raw or partially cooked eggs

Alcohol

Vitamin A (teratogenic in high doses - only given to patients with CF)

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47
Q

Describe a threatened miscarriage

A

Light bleeding

Closed cervical os

Painless

Doesn’t usually result in miscarriage

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48
Q

Describe an inevitable miscarriage

A

Bleeding (heavy with clots)

Cervical os is open
Uterine contents are visible on pelvic examination

Abdominal cramping pain

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49
Q

Describe an incomplete miscarriage

A

Uterine contents have begun to pass

Cervical os is open

Painful

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50
Q

Describe a complete miscarriage

A

Uterine cavity is empty

Cervix has closed

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51
Q

Describe a missed/ delayed miscarriage

A

gestational sac contains a dead/ non viable fetes

May be some light vaginal bleeding but usually n no pain

Cervical os is open

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52
Q

What is the role of HCG in pregnancy?

A

Prevents involution of the corpus luteum which stimulates production of oestrogen and progesterone

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53
Q

What is the role of HCS in pregnancy and when is it produced?

A

Produced from week 5 of pregnancy

Protein tissue formation

Decreases insulin sensitivity in the mother (more glucose for the foetus)

Involved in breast development

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54
Q

What is the role of progesterone in pregnancy?

A

Development of decidual cells

Decreases uterus contractility

Preparation for lactation

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55
Q

What is the role of oestrogen in pregnancy?

A

Enlargement of the uterus

Breast development

Relaxation of ligaments

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56
Q

What cardiovascular changes occur in the mother in pregnancy?

A

Increased CO

Increased HR

Increased contractility

BP drops in the 2nd trimester

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57
Q

What haemolytic changes occur in the mother in pregnancy?

A

Plasma volume increases

Erythropoiesis increases, HB is decreased in proportion - so overall decreases blood viscosity

Iron requirements increase

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58
Q

What respiratory changes occur in the mother in pregnancy?

A 
Increased C02 sensitivity in respiratory centres 
- Increased RR 
- Increased tidal volume 
(to lower C02 levels) 
- Decreased paC02

Increased Pa02 (02 consumption)

Respiratory alkalosis

Decreased functional residual capacity

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59
Q

What urinary system changes occur in the mother in pregnancy?

A

GFR and renal plasma flow increase

Increased re-absorption of ions and water

Increase in urine formation

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60
Q

How do postural changes in the mother affect renal function in pregnancy?

A

Upright position decreases function

Supine and lateral position (e.g when sleeping) increase function

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61
Q

Describe the hormonal control of lactation

A

Oestrogen and progesterone inhibit lactation before birth

Prolactin stimulates milk production

Oxytocin: ‘milk let down reflex’

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62
Q

What are some of the possible reasons for a small for dates baby?

A

Pre-term delivery

Intra-uterine growth restriction

Small for gestational age

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63
Q

What are some of the causes of preterm birth?

A

Infection

Over distention and cervical incompetence

Vascular problems

Intercurrent illness

Idiopathic

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64
Q

What are some of the risk factors for having a pre-term birth?

A

Previous PTL (preterm labour)

Multiple pregnancies

Uterine anomalies

Smoking, drugs

Low BMI

Maternal anaemia

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65
Q

What is a small for gestational age fetus?

A

Estimated fetal weight or abdominal circumference is below the 10th centile

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66
Q

What is meant by IUGR (intra uterine growth restriction)?

A

Failure to achieve growth potential

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67
Q

What are some of the clinical features of poor growth which might suggest IUGR?

A

Fundal height less than expected

Reduced liquor

Reduced fetal movements

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68
Q

When should a baby with IUGR be delivered?

A

If all is well, should still deliver by 37 weeks

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69
Q

What treatment can be offered for to mothers with a SGA fetus?

A

Steroids
- Helps to promote fetal lung maturity

Magnesium sulphate
- Neurodevelopmental protection for the baby

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70
Q

What are some of the causes of large for dates fetus?

A

Wrong dates estimated

Fetal macrosomnia

Polyhydramnios

Diabetes

Multiple pregnancy

Fibroid uterus

Placenta praevia

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71
Q

What are the risks to the mother and fetus with fatal macrosomnia?

A

Labour dystocia

Shoulder dystocia

PPH

72
Q

What is polyhydramnios?

A

Excess amniotic fluid

73
Q

What are some of the possible causes of polyhydramnios?

A

Diabetes

Viral infections

Monochorionic twin pregnancy

74
Q

What are some of the symptoms and signs of polyhydramnios?

A 
Abdominal discomfort 
Prelabour rupture of membranes 
Preterm labour 
Cord prolapse 
Tense shining abdomen 
Inability to feel fatal parts
75
Q

How is a large for dates baby diagnosed?

A

US

Oral glucose tolerance test

Serology : for toxoplasmosis, CMV etc

Antibody screen

76
Q

What are the risk factors for having multiple pregnancies?

A

Assisted conception

African origin

Increased maternal age

Increased parity

Tall women

77
Q

What is the age range for cervical screening?

A

25-64

78
Q

On abdominal palpation, the fundus of the pregnant uterus is normally palpable at how many weeks gestation?

A

12 weeks

79
Q

Hyperthyroidism may cause what cardiovascular changes in pregnancy?

A

ST, SVTs, AF

Should check TFTs in anyone presenting with palpitations in pregnancy

80
Q

Phaeochromocytoma can be a cause of palpitations in pregnancy. How does it present? How is it investigated?

A

Headaches, sweating, hypertension

Investigated with 24 hr catecholamines

81
Q

What is the 1/3rds trend with asthma in pregnancy?

A

1/3 improve

1/3 deteriorate

1/3 remain unchanged

82
Q

Long term PO steroid use for asthma in pregnancy (for >2 weeks) leads to what management being necessary in labour?

A

IV hydrocortisone is given during labour

(the woman will not be able to produce her own response to the stress of labour naturally as she has been on synthetic steroids which has suppressed her natural steroid production)

83
Q

What is the main direct cause of maternal death in the UK?

A

Thromboembolic disease

84
Q

When is the highest risk of thromboembolic disease?

A

In the puerperium

85
Q

What is Virchow’s triad?

A

Stasis

Hyper-coagulability

Vascular damage

86
Q

Where do DVTs usually occur?

A

LEFT leg

Ileofemoral

87
Q

What investigations should be done for a DVT?

A

FBCs, clotting, U&Es, LFTs

Duplex US on the lower limb

88
Q

How is a DVT managed?

A

TEDs

LMWH

89
Q

What are the symptoms of a PE?

A

Pleuritic chest pain

Haemoptysis

Faintness and collapse

90
Q

What investigations should be done for a PE?

A

CTPA or V/Q

ABGs, ECG

Duplex US of the lower limb (to identify a DVT)

91
Q

What are the possible CXR changes from a PE?

A

Atelectasis

Effusion

Focal opacities

Regional oligaemia

92
Q

When can LMWH vs warfarin be used?

A

LMWH
Doesn’t cross the placenta so safe in pregnancy
Used for DVTs and PE in pregnancy

Warfarin
teratogenic
Used post pregnancy

Both heparin and warfarin are ok for breastfeeding

93
Q

What is antiphospholipid syndrome?

A

Acquired type of thrombophilia - the clinical syndrome associated with the antibodies; aPL, aCL, LA

94
Q

What are some of the clinical features of APS?

A

Arterial/ venous thrombosis

Recurrent early pregnancy loss or a late pregnancy loss

Placental abruption

Severe early onset PET

Severe early onset FGR

95
Q

How is APS managed in pregnancy?

A

Aspirin and or heparin

96
Q

Which drugs used for connective tissue disorders are NOT safe in pregnancy?

A

Methotrexate

Gold, penicillamine

Leflunomide

Cyclophosphamide

NSAIDs >32 weeks

97
Q

What are some of the possible effects of diabetes on the fetus?

A

Macrosomnia

Polyhydramnios

Hyperinsulinaemia

Polycythaemia (elevated RBCs)

Fetal malformations

98
Q

What changes to medications should be done for hypothyroidism in pregnancy?

A

Increase the levothyroxine dose by 25-50mcg in the first trimester

99
Q

What are the effects of pregnancy on hyperthyroid women?

A

Get worse due to HCG in the first trimester

Improves in the second and third trimesters

Thyroid storm

100
Q

What effects can hyperthyroidism have on the pregnancy?

A

IUGR

Preterm labour

101
Q

What is the presumed diagnosis if a woman has her first ever seizure in pregnancy?

A

Eclampsia

102
Q

When is seizure risk highest in women with epilepsy in pregnancy?

A

Peripartum period

103
Q

What supplements should all women with epilepsy be taking preconceptually and throughout pregnancy?

A

Folate

the mechanism of teratogenesis in epilepsy is thought to be folate deficiency

104
Q

What are the reasons for deterioration of control of epilepsy in pregnancy?

A

Poor compliance with meds (fear of teratogenesis)

Hyperemsis causes decreased drug levels

Stress, pain, sleep derpivation and over-breathing increase the risk of seizures

105
Q

With a BMI >30, what supplement should pregnant women be on?

A

5mg folic acid daily

106
Q

What changes happen to BP throughout pregnancy?

A

BP falls in early pregnancy, peaking at 22-24 weeks

BP then rises until term

107
Q

What BP value is considered as hypertension in pregnancy?

A

140/90mmHg on 2 occasions

OR

160/110 mmHg once

108
Q

What are the causes of hypertension in pregnancy?

A

Pre-existing hypertension

Pregnancy induced (gestational) hypertension

Pre-eclampsia

109
Q

How is pre-existing (essential) hypertension defined?

A

Present at booking or at <20 weeks gestation

110
Q

How is pregnancy induced (gestational) hypertension defined?

A

New hypertension at >20 weeks gestation with no proteinuria

111
Q

How is pre-eclampsia defined?

A

New hypertension at >20 weeks with significant proteinuria

112
Q

What is the management for pre-eclampsia?

A

Treat hypertension (labetalol, methyldopa, nifedipine)

Aspirin

Deliver at 37 weeks

113
Q

What is eclampsia?

A

Tonic-clonic seizures occurring with features of pre-eclampsia

114
Q

How is eclampsia managed?

A

IV labetolol or IV hydralazine

115
Q

What infusion can be given to prevent seizures in patients with eclampsia?

A

Magnesium sulphate IV

116
Q

What is the main cause of maternal death in pre-eclampsia?

A

Pulmonary oedema

117
Q

Which genetic test can be used to identify more or less chromosomal material (unbalanced) ?

A

Array comparative genomic hybridisation

E.g used for trisomy conditions

118
Q

What genetic test is used to identify balanced chromosomal rearrangements?

A

Next generation sequencing

119
Q

What kind of sample is taken to test for Huntington’s in pregnancy?

A

Chorionic villous sampling

120
Q

if a fetus has a normal sized head but a small body, what is the likely cause?

A

Placental insufficiency

121
Q

Antidepressants are generally not too bad in pregnancy, but which ones should be avoided if possible?

A

Paroxetine (1st trimester)

Citalopram

122
Q

Can benzodiazepines be used in pregnancy?

A

No -avoid when possible!

123
Q

There is no evidence of fetal toxicity with antipsychotics but the fetus should be monitored for what signs?

A

Sedation and lethargy

124
Q

What’s the deal with lithium in pregnancy and breastfeeding?

A

Lithium should be avoided when possible

Avoid stopping suddenly

Don’t use if breastfeeding

125
Q

Which anticonvulsant is an absolute no in pregnancy but is not contraindicated for breast feeding?

A

Sodium valproate

126
Q

What are the risks to the baby associated with the different anticonvulsants?

A

Sodium valproate and carbamazepine - risk of neural tube defects

Lamotrigine - risk of oral cleft in pregnancy and Stevens Johnson syndrome with breastfeeding

127
Q

What are the clinical features of fatal alcohol syndrome?

A

Micrognathia and smooth philtrum

Lower IQ

Microcephaly

Dysplastic kidneys

Ventricular septal defect

Epilepsy

Hearing loss

128
Q

Bleeding in late pregnancy is considered to be from how many weeks?

A

From 24 weeks

129
Q

What is antepartum haemorrhage (APH)?

A

Bleeding after 24 weeks gestation and before the end of the second stage of labour

130
Q

What are some of the possible causes of APH?

A

Placental praevia

placental abruption

uterine rupture

vasa previa

local causes; polyps, cancer etc

131
Q

How are minor, major and massive haemorrhage defined in terms of quantities?

A

Minor = blood loss <50ml

Major = blood loss of 50-1000ml

Massive = blood loss >1000ml and/0r signs of shock

132
Q

What is placental abruption?

A

When the placenta detaches from the uterus before the birth of the fetus

133
Q

What are some of the risk factors for placental abruption?

A

Pre-eclampsia/ hypertension

Trauma

Substance misuse

Thrombophilias and renal disease

134
Q

How does placental abruption present?

A

Severe continuous abdominal pain

Preterm labour

Maternal collapse

Uterine tenderness/ ‘woody hard’ uterus/ fetal parts difficult to identify

135
Q

What is placental praevia?

A

Placenta is partially or totally implanted in the lower uterine segment, covering the cervical os

136
Q

What are some of the risk factors for placental praevia?

A

Previous C-section or TOP

Multiple pregnancies, assisted contraception and multiparty

Deficient endometrium e.g endometriosis

137
Q

How does placental praevia present?

A

Recurrent painless bleeding in the 3rd trimester

Uterus is soft and non-tender

Presenting part is high/ malpresentation

138
Q

In what circumstances should you do a C-section vs a vaginal delivery in women presenting with placental praevia?

A

C-section if placenta is <2 cm from the cervical os, vaginal delivery if >2cm from the cervical os

139
Q

What is placental accreta?

A

The placenta is abnormally adherent to the uterine wall

140
Q

How does placental accreta present?

A

Severe bleeding

Mortality

141
Q

How can placental accreta be managed?

A

Internal iliac artery balloon

Caesarean hysterectomy

142
Q

What are some of the risk factors for uterine rupture?

A

Previous C-section or uterine surgery

Multiparity

Obstructed labour

143
Q

How does uterine rupture present?

A

Severe abdominal pain and shoulder tip pain

Loss of contractions

Acute abdomen

Maternal collapse

Fetal distress

144
Q

What is vasa praevia?

A

Unprotected fatal vessels transverse the membranes over the internal cervical os

145
Q

How does vasa praevia present?

A

Sudden dark red bleeding

Fatal distress

146
Q

How can vasa praevia be investigated for?

A

Examination to try to feel any vessels

US doppler

147
Q

How is vasa praevia managed?

A

Steroids

Early elective c-section

148
Q

What is post partum haemorrhage?

A

Blood loss >500ml after the birth of the baby

149
Q

What are the 4Ts that cause post partum haemorrhage?

A

Tone

Truama

Tissue

Thrombin

150
Q

What management options are there for post partum haemorrhage?

A

Uterine massage

Bimanual compression

Packs and balloons

Syntocinon IV

Surgery

151
Q

How should a suspected milk placental abruption be managed?

A

Admission, steroids and close observation

152
Q

What are the recommendations for folic acid in pregnant epileptic women?

A

5mg of folic acid should be taken before and until 3 months after conception to reduce the risk of spina bifida

153
Q

What happens to the volume of drug distribution in pregnancy?

A

The vole of drug distribution in pregnancy is increased by changes in plasma volume and fat stores

154
Q

What are some of the risk factors for developing pelvic girdle pain (PGP) in pregnancy?

A

High BMI before pregnancy

History of low back pain/ pelvic pain or trauma

Hard physical labour

PGP in previous pregnancy

155
Q

What are the differences in pharmacokinetics in pregnancy? These things must be taken into account when prescribing in pregnancy

A

Absorption may be affected by morning sickness

Increased plasma volume and fat stores increases the volume of distribution

Decreased protein binding causes increased free drug in the circulation

Increased liver metabolism of some drugs

Elimination of renal excreted drugs increases

156
Q

Give some examples of drugs which are teratogenic

A

ACE Inhibitors and ARBs

Androgens

Antiepileptics

Lithium

Methotrexate

Warfarin

157
Q

Which anti epileptics must be avoided in pregnancy?

A

Valproate

Phenytoin

158
Q

Which diabetes drug class is not safe for use in pregnancy?

A

Sulfonylureas

159
Q

Pregnant women with significant risk factors for venous thromboembolism should be treated with what as prophylaxis?

A

LMWH

160
Q

What adverse effect can tetracycline have when given in pregnancy?

A

Staining of the teeth

161
Q

Phenytoin can cause what adverse effects when given in pregnancy?

A

Cleft lip and palate

162
Q

Valproate can cause which adverse effects when given in pregnancy?

A

Anencephaly

Spina bifida

163
Q

What happens to BHCG levels in molar pregnancy?

A

BHCG is extremely high

Causes hyperemesis

164
Q

What happens to BHCG levels in ectopic pregnancy?

A

BHCG levels stay the same or increase slightly

165
Q

A BHCG level of what suggests pregnancy?

A

> 20LU

166
Q

What are some of the possible causes of raised AFP in pregnancy?

A

Neural tube defects E.g anencephaly and meningocele

Abdominal wall defects E.g omphalocele and gastroschisis

Multiple pregnancy

167
Q

What are some of the causes of decreased AFP levels in pregnancy?

A

Down’s syndrome

Trisomy 18

Maternal diabetes

168
Q

Increased nuchal thickness may indicate which conditions?

A

Down’s syndrome

Congenital heart defects

169
Q

How does obstetric cholestasis present?

A

Abnormal LFTS

Pruritus in the absence of a skin rash

170
Q

What is the most important first medication to administer for eclampsia?

A

Magnesium sulphate

171
Q

What medication should be given to patients who have preterm prelabour rupture of membranes?

A

10 days erythromycin

same if they have a penicillin allergy

172
Q

Which antibiotic used for UTIs is not safe in the first trimester of pregnancy?

A

Trimethoprim

173
Q

Pregnancy induced hypertension refers to new hypertension presenting after what week of pregnancy?

A

Week 20

174
Q

What are some of the test results that may be suggestive of down’s syndrome?

A

Low AFP , estriol and PAPP-A
High HCG
Thickened nuchal translucency

175
Q

Why are twin pregnancies and molar pregnancies associated with higher rates of hyperemesis gravidarum?

A

Twin pregnancies and molar pregnancies involve a greater placental mass which produces higher levels of BHCG - this hormone is associated with hyperemesis gravidarum.

176
Q

Explain why oligohydramnios occurs

A

In growth restricted fetuses, chronic hypoxia due to impaired placental transfer leads to shunting of blood away from the kidneys towards other vital organs. This causes reduced urine output and low amniotic fluid levels (oligohydramnios).

REPRODUCTION (12 decks)

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