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Rob's RDA > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

Fertilisation means successful pregnancy

Trimester system is based on scientific model. T/F

What is a good indication that the pregnancy will last until term

A

No….. some estimations that only 1/3

F: only based on exprience and early understanding of pregnancy

a pregnancy completes the first trimester (13 weeks), it is very likely to last until close to the expected delivery time (term, 39-40 weeks).

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2
Q

What changes occur to mother, baby and placenta at which points

A

Maternal changes throughout

Embryo, foetus, viability (26 weeks), term

Placental changes- complex, mostly first half

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3
Q

What is absolute limit of infant survival

A

End of 2nd trimester 26-27 weeks

with modern medical science 23 weeks

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4
Q

Which things increase in a mother during pregnancy

A

Increased weight

Increased hormone levels / altered endocrine system

Increased blood clotting tendency

Increased basal body temperature

Increased breast size

Increased vaginal mucus production

Increased nausea and vomiting (‘morning sickness’)

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5
Q

…

A

….

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6
Q

What decreases during pregnancy and when

A

Blood pressure (2nd)

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7
Q

Why are pregnant women prone to collapsing

A

Decreased blood pressure

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8
Q

What other things are altered in pregnancy (not flat increase or decrease)

A

Altered brain function [1st & later]

Altered hormones [1st & later]

Altered appetite (quantity and quality) [1st & later] – GI imbalance

Altered fluid balance [2nd & later]

Altered emotional state [1st & later]

Altered joints [3rd]

Altered immune system [1st & later]

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9
Q

T/f implantation of the fertilised egg will occur around day 28

A

F! Fertilisation will occur within 24hrs of ovulation (day 14!) and implantaton would occur 3-5 days after fertilisation

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10
Q

Why can it be hard to identify when olvulaton occurred

A

he variability in length of the menstrual cycle was noted, making it difficult to identify (in a normal pregnancy) the exact timings of ovulation and fertilisation.

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11
Q

When is pregnancy counted

A

pregnancy is counted from the first day of the last menstrual period (LMP), with other events dated from this time. At least, this is the conventional timing from an obstetric-gynaecological view.

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12
Q

When would embryologist count emrbyo age from

A

An embryologist would start the count from fertilisation (wheter IVF or natural)… REFERRED TO AS PF (post-fertilisation)

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13
Q

What is the time difference between GA determined by LMP and the GA determined by conception

A

The GA determined by pregnancy will be 2-2.5 weeks longer than the embryo age

Because last menstruation would have occurred about 2 weeks (i.e. 14 days) before ovulation and fertilisation

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14
Q

Why does maternal weight change during pregnancy and when

A

on average will be in the range of 10-15 kg. This will include the weight of the fetus, amniotic fluid and placenta; increased fluid retention; increased nutritional stores (to feed the baby after delivery).

2nd and especially 3rd trimester

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15
Q

Why does blood clotting tendency increase and when

Why is blood clotting change in pregnancy and anomaly

A

From 2nd trimester

To reduce bleeding in delivery?

Anomaly because We are very used to the concept that increased blood clotting and increased blood pressure are parallel changes, as it is well established that hypertension is strongly linked to an increase in stroke and heart attacks.

In pregnancy BP decreases though

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16
Q

When does blood pressure decrease and why.

Impact

A

Maternal blood pressure is lowest during the second trimester,

and increases the risk of maternal fainting – so pregnant women should not stand for prolonged periods of time

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17
Q

What happens to BP during the 3rd trimester

A

Blood pressure tends to increase during the third trimester, but should still remain below a level that would be considered as hypertension; 120/70 mmHg would be considered normal.

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18
Q

What happens to basal body temp in pregnancy and why

A

Basal body temperature increases by ~0.5°C in the second half of the menstrual cycle after ovulation and is sustained into the first trimester of pregnancy, probably by the thermogenic roles of progesterone.

As the fetus increases in size, it contributes to maternal temperature, and normal maternal temperatures may exceed 38°C.

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19
Q

What happens to breast size in pregnancy and why

A

From first trimster

Breast size increases

dependent on increased hormone levels in the maternal circulation (human placental lactogen, prolactin, and ostrogens are all involved)

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20
Q

Why can women get increased clear discahrge in pregnancy

A

increased vaginal mucus production

is common and normal change in pregnancy

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21
Q

What is hyperemesis gravidarum

A

The most servere version of morning sickness (affects 1-2% of pregnancies whilst morning sickness generally affects 80%)

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22
Q

T/F morning sickness involves sickness specifically in themorning during pregnancies

A

F: ‘Morning sickness’ is not really an accurate name, as nausea and vomiting can occur at any time of day!

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23
Q

How does brain function change in pregnancy

A

The high levels of steroids, particularly progesterone, are thought to influence brain function during pregnancy, but due to the difficulties of doing detailed studies during pregnancy a precise understanding is lacking

Brain size actually decreases a bit! (might not have functional significance)

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24
Q

What happens to appetite during pregnancy

A

As the size of the uterus increases during the later stages of pregnancy, it imposes steadily increasing pressures on the gastro-intestinal system, including the stomach. This can decrease the distensibility of the stomach, and in late pregnancy the mother may need to have up to 6 smaller meals per day, rather than 3 bigger meals.

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25
Q

What happens to fluid balance in pregnancy

A

Kidney function changes in the mother as pregnancy proceeds leading to increased fluid retention and a higher plasma volume. BLOOD VOLUME IS 50% HIGHER THAN BEFORE PREGNANCY!

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26
Q

What happens to urination frequency in pregnancy

A

1st tri. increases (thought to be due to changes in the maternal hormones, regulating altered kidney function)

2nd tri. normalises

3rd increases (greatly enlarged uterus will be exerting pressure on the bladder)

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27
Q

During the 3rd trimester, the mother will be passing more urine in each visit to the toilet. T/f

A

F: By the third trimester, the greatly enlarged uterus will be exerting pressure on the bladder, decreasing the maximum size and volume of urine it can contain, so the mother will pass smaller volumes of urine more frequently.

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28
Q

What happens to emotional state during pregnancy

A

due to changes in hormone levels

motional changes linked to pregnancy can be very variable.

In some cases women are said to ‘glow’ with their pregnancy and with happiness – they are delighted to be pregnant, and the world is wonderful.

Alternatively, women may be equally happy to be pregnant, but may be emotionally very labile, crying with little or no obvious cause; or they may become clinically depressed during pregnancy, which may continue into post-natal depression.

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29
Q

Why do altered joints occur in pregnancy

A

Changes to the maternal pelvis, making the connections between the bones more flexible are necessary to permit the delivery of a normally-grown human infant.

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30
Q

Condequence of joint changes to materna pelvis for flexibility in pregnancy

A

Parallel changes are observed in other maternal joints, and these generally persist after pregnancy, causing permanent modifications to joint structure and (modestly) function.

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31
Q

How do changes in immune system occur in pregnancy

A

Baby is non-self but there is no immune response against it:

  1. Suppression of maternal immune system at utero-placental interface. Cooperate to reduce Th1 and increase Th2
  2. HLA antignes on placenta in contact with maternal tissue. Usually HLA very polymorphic, but these placental HLA are almost invariant.

HLA G (placental) has just 5 sequence variants.. HLA G could provide an immunological signal that shows that the tissue is human. Suppresses leuocyte activity too

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32
Q

When does hCG peak

A

8 weeks

this could be involved in morning sickness, which also increases at 8 weeks

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33
Q

When do the placental hormones peak and why, what are they

A

Placental lactogen

Oestrogen

Progesterone

All increase up to a peak in the 3rd trimester (parallel increasing size of the placenta)

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34
Q

What is hCG produced by

A

Also the placenta, but its regulation is different other placental hormone groups, which all peak much later (in third trimester, not third like hCG) in line with placental size

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35
Q

Why is there small increase in the progesterone and oestrogen at the beginning of the GA

A

Fertilisation occurs after day 14 of mensutraul cycle

Then the menstrual cycle continues for 2 weeks, so this represents the luteal phase of the menstrual cycle

You can compare the difference between menstrual cycle hormone concentration and concentration in pregancy

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36
Q

What is the main oestrogen in birth

A

Oestriol

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37
Q

Why is progesterne imprtnat in pregnancy

A

The very high levels of progesterone are of particular importance, as progesterone is the key hormone in allowing the pregnancy to continue. Low progesterone levels, or administration of a progesterone antagonist, will lead to loss of the pregnancy at all gestational ages.

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38
Q

What happens to gonadotrophns during prengancy

A

The maternal endocrine system is modified substantially during pregnancy, with the high levels of steroids suppressing the HPG, leading to very low levels of LH and FSH throughout pregnancy, and hence no cyclic ovarian or uterine functions.

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39
Q

What is the source of progeserone during early pregnancy

A

From the time of fertilisation to about 8 weeks gestation, the corpus luteum is the main source of progesterone, and this production is sustained by the rapidly increasing levels of hCG

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40
Q

T/F the placenta does not produce progesterone in the early part of pregnancy

A

F… The placenta can also produce progesterone as well as corpus luteum, but in the earliest weeks of pregnancy, the small size of the placenta means that its net contribution to maternal progesterone levels is limited.

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41
Q

What is the source of progesterone after the early pregancy

A

Increasing placental size means that it contributes increasingly to the levels of progesterone after 8 weeks in the maternal circulation, and by 10 weeks of gestation the placenta is the source of all progesterone.

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42
Q

T/f the corpus luteum still produces progesterone after week 10 but main progeserone production is from the placenta

A

F:

From about 6 weeks of gestational age, the corpus luteum gradually produces less progesterone (despite the very high hCG levels), and by about 9 weeks it has ceased to make steroids

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43
Q

What is the luto-placental shift

A

Change in progesterone production from corpus luteum to placenta at 8/9 weeks

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44
Q

Where is oestrogen produced early and later in pregnancy

A

Early weeks corpus luteum (mainly 17b-oestradiol)

After luteo-placental shift, oestrogens produced involving complex interaction between placenta and foetal adrenal glands

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45
Q

Outline oestrogen production in the placenta and foetal androgen gland

I. 17b-oestradiol
II. Oestriol

A

Placenta doesn’t contain enzyme needed for androgen production from pregnenolone (we need to produce androgen before oestrogen)

17b-esotradiol:

So pregnenolone from placenta is converted to a weak androgen, DHEA, in the foetal adrenals using 16aOH.

But we don’t want the DHEA to have androgenic effects, as the foetus might be a girl, so we sulfate the DHEA DHEA-S (also in the adrenals)

DHEA-S is then taken back to placenta, where it is converted to 17b-oestradiol.

Oestriol:
pregnenolone again converted to DHEA in foetus, and sulfated to DHEA-S.

DHEA-S is taken to the foetus liver, where it converts DHEA-S to 16aOH-DHEA-S.

This is then taken back to the placenta where it is converted to estriol

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46
Q

What enzyme is required for conversion from pregnenolone to andrgen

A

Cytochrome P450 17,20-lyase

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47
Q

What are the precursors for 17b oestradiol and estriol in the placenta (produced using the baby’s adrenals)

A

DHEA-S for 17b oestradiol

16aOH-DHEAS-S for oestriol

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48
Q

What is development of strucutre in utero depend on

A

Genetic control + interaction with environment incl maternal nutrition

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49
Q

What is evidence of genetic basis of contorl of development of structures

A

Chromosomal abnormalities provide the clearest evidence of such genetic regulation. All cases of too many chromosomes or too few chromosomes show changes in development.

50
Q

What is the only viable example of too few examples

A

he only viable example of too few chromosomes is Turner’s Syndrome: 45 chromosomes, with one X-chromosome (45 X0). Loss of any autosome (chromosomes 1-22) leads to non-viability, as does 45 Y0).

51
Q

Examples of loss of autosomal chromosomes

A

None, this is non-viable

52
Q

Examples of extra set of sex chromosome adn of extra autosom

A

Extra sex chromosomes (XXX, XYY, XXY (Kleinfelter’s syndrome)) have modest effects, and the only viable autosome trisomy is Down’s syndrome (chromosome 21 trisomy).

53
Q

When is embryo most vulnerable to teratogens

A

Early development of the human embryo is vulnerable to teratogens

(mostly up to 7 weeks embryo age)

54
Q

Define teratogens

A

factors that can affect the details of development, although the primary structures will be present

55
Q

Which organ systems develop late in pregnancy (last few weeks)

and why

A

he lungs, the digestive system, the immune system and the brain.

fetus has limited need of them in utero, whereas they become much more important after birth, so their late development is logical.

However, this means that in a preterm infant, they may not function correctly, and thereby cause illness or death to the infant.

56
Q

In addition to being affected by teratogens, what other problems occur in early stage of development

A

Other complications of human development, including spina bifida and cleft palate, also occur in this early stage of development.

57
Q

Define conceptus

A

everything resulting from the fertilised egg (baby, placenta, fetal membranes, umbilical cord)

58
Q

Define embryo

A

the baby before it is clearly human

59
Q

Define fetus

A

the baby for the rest of pregnancy

60
Q

Defie infant

A

– less precise, normally applied after delivery

61
Q

Why the difference between fertilisation and implantation

A

Fertilisation usually occurs in ampulla

Takes a while to get round the fallopian tube and be implanted ino the lining of the uterus

62
Q

What occurs between fertilisation and implantation

A

The cells of the embryo are undergoing mitotic (cleavage) division, deriving their nutrients from the secretions of the Fallopian tube.

63
Q

Distinguish the two meanings of embryo

A

During week 1 PF, refers to while conceptus

After differentiation to form a blastocyst, the embryo refers to the cells that contribute to (or are) the baby alone; other tissues have separate identities.

64
Q

T/f most of the second half of pregnancy is concerned with forming the strucutres

A

F

Once the main structures of the baby have formed (Figure 3.6) during the first months of pregnancy, the rest of pregnancy is more concerned with growth of the fetus, and the maturation of the structures that have been developed

65
Q

Approximate weight of baby at end of 1st, 2nd and 3rd trimester. What does this sho

A

1: 50g
2: 1050g
3: 2100g

Shows most of the growth occurs in 2nd and 3rd trimester and structure formation in the 1st

66
Q

t/f structures required high levels of oxygen to form

A

F…. formation of structures in trimester 1 takes place in low oxygen environent (3%)

67
Q

Key events in 2nd week of development

A

Development of bilaminar dsic

68
Q

Key events in 3rd week of development

A

Formation of trilaminar disc (mesoderm), CNS &; somites.

Blood vessel initiation. Formation of placental villi. (3mm).

69
Q

Key events in 4th week of development

A

Closure of neural tube. Heart, Face, arm initiated.

Umbilical cord. Elaboration of placental villi. (4mm)

70
Q

Key events in 5th week of development

A

Face & limbs continue. (5-8mm)

71
Q

Key events in 6th week of development

A

Face, ears, hands, feet, liver, bladder, gut, pancreas. (10-14mm)

72
Q

Key events in 7th week of development

A

Face, ears, fingers, toes

73
Q

Key events in 8th week of developement

A

Lungs, liver, kidneys, (28-30mm)

74
Q

What is the bilaminar disc

A

In the blastocyst , there is a circle of trophoblasts with a bilaminar disk of epiplasts and hypoplasts across the centre

75
Q

Function of the placenta

A 
Separation
Exchange
Biosynthesis
Immunoregulation
Connection
76
Q

Outline the ‘connection’ function of placenta

A

The placenta must make sufficiently strong connections with the underlying maternal decidua to last for the 9 months of pregnancy.

77
Q

How do we know that the placenta is the key tissue in immunoregulation

A

Even when there is implantation other than in the uterus, there are still some survivals (ectopic) showing it is not the uterus responsible for preventing an immune attack of the fetus

78
Q

Primary subunit of the placenta

A

Villus

79
Q

What allows exchange between maternal adn fetal vascular system

A

Villus, which has the complex branched structure shown. This provides a very large surface area (estimated to be 11 square metres) for exchange between the maternal and fetal vascular systems, thus meeting a primary requirement for exchange

80
Q

What can be found in villi

A

ithin each villus there is a complex blood supply, including arterial and venous vessels, connected to smaller capillaries in the terminal portions of each villus.

81
Q

What is the oxygen content of veins and arteries for foetal musculature to and from the placenta

A

the arterial system contains de-oxygenated blood, and the venous blood is oxygenated – because the placenta has a parallel function to the lungs for the fetus during pregnancy

(i.e. travelling away from the baby heart to the placenta is artery, travelling from the placenta to the heart is vein)

82
Q

What is the maternal surface of the placenta subdivided into

How many villi in each

A

cotyledons (30-60 per placenta)

each cotyledon contains one or more villi, with larger cotyledons containing more villi.

83
Q

Outline the strucutre of the conceptus once it has implanted within teh maternal decidualising endometrium

A

At day

There is epiblast and hypoblast. Amniotic cavity within the epiplast layer

Then exoxoelomic cavity (primative yolk sac)

This is surrounded by cytotrophoblast

Which is surroundd by syncitiotrphoblast

84
Q

In which cell layer of the conceptus does the placenta develop

A

From the cytotrophoblast

85
Q

What is special about syncytiotrophoblasts

A

This outerlayer is multinucleated cells and containing fluid-filled lacunae

86
Q

How does placenta develop

A

After implantation.

Cytotrophoblast proliferate into the syncytium (with the lacunae)

Forms a cytotrophoblast column). Which then undergoes branching (villus sprouts)

At centre of each villus is a mesenchymal cell (=extra-embryonic mesoderm), from which villus vascular system develops.

Note that the lacunae in the syncytium become intervillous spaces!

SO NOTE THAT THE VILLUS IS MADE FROM THE CRTOTROPHOBLAST, WHILST THE VASCULAR SYSTEM IN THE VILLUS IS MADE FROM EXTRA-EMBYRONIC MESODERM

87
Q

How does the structrue of the villus change through pregnancy

A

The overall structure of a placental villus does not change throughout pregnancy but there are modifications

There are fewer cytotrophoblast present at term, so that there can be a closer apposition between the syncytium and the placental capillaries.

88
Q

Why are there fewer crytotrophoblasts present near term

A

This will maximise the efficacy of nutrient transfer into the fetal blood, and enhance fetal growth in later pregnancy.

89
Q

T/F the conceptus never makes contact with the maternal capillaries

A

F…. As it grows, it makes transient contact with the maternal capillaries before it is isolated from maternal capillaries

90
Q

How is the conceptus separated from the maternal blood

A

the rapidly proliferating cytotrophoblast cells form a shell around the conceptus (Figure 3.16), isolating it from maternal blood by about 4 weeks post fertilisation.

Note that the placenta then forms by branching of these cells into the synctytium

91
Q

What provides nutrition for the developing embryo

A

1st trimester:

DECIDUAL GLANDS of the uterus hypertrophy to provide nutrients for placenta and baby= histotrophic nutrition

LATER:
Maternal blood=haemotrophic utrition

92
Q

What is the cytotrophoblast shell

A

From the cryptotrophocyte layer. Blocks spiral arteries, preventing maternal blood from filling the intervillous space until 10 weeks GA (8 weeks PF)

93
Q

When does the cytotrophoblast break down and why

A

During weeks 10-12 (GA), the cytotrophoblast plugs gradually break down, beginning with those at the periphery of the placenta, and ending with those near the centre.

Note that the development of structures mostly occurs in an anaerobic environment

spiral arteries providing maternal blood to the placenta, and hence forming the main supply of nutrients to the developing placenta and fetus.

94
Q

Name a particularly risky time in pregnancy

A

When the cytotrophoblast plug breaks down, maternal blood enters the intervilous space.

if the placenta is not fully anchored to maternal decidua, the increase in pressure as it is exposed to the maternal arterial supply can detach the placenta and lead to miscarriage (late first trimester)

95
Q

SUMMARY OF NUTRITION AND PLACENTA DEVELOPMENT

A

So conceptus has some contact with maternal blood during growth, but soon isolates itself with the cytotrophblast layer.

The cytotrophoblasts branch into the syncytium to form columnar structures which become branching villi.

Cytotrophoblast cells also block spiral arteries of the mother until about week 10 GA

Up until this point, maternal blood is not the source of nutrients, instead there is hypertrophy of deciduous glands in the endometrium which supply nutrients to placenta and baby

Then, at 10-12 GA, the Cytotrophoblast plug is broken down and maternal blood flows in the intervillous space , becoming the source of nutrient for the baby

96
Q

How to cytotrophoblasts affect spiral arteries

A
  1. Block them until week 10 GA

2. Remodelling

97
Q

How do cytotrophoblasts remodel spiral arteries

A

the vascular endothelium, and underlying smooth muscle cells are lost, and replaced by cytotrophoblast. This remodelling process begins during the first trimester, and continues until weeks 16-18 of gestation.

98
Q

What is the point of the cytotrophoblasts remodelling spiral arteries

A

critical for later growth of the fetus, as it converts the narrow, vasoactive spiral arteries to wide-bore vessels that can transport very large volumes of maternal blood to the placenta, and hence provide the quantities of nutrients needed. The lack of smooth muscle cells in these remodelled vessels is important, as this means that the blood flow remains high as these arteries cannot respond to vasoconstrictors.

99
Q

Why can no pain be felt during the cutting of the umbilical cod

A

The placenta has no nervous system, so it is not regulated by such systems at any stage of pregnancy. This means that it can feel no pain during delivery, and the umbilical cord can be cut after delivery without any impact on the infant.

100
Q

What is the main methofd of regulation of placental growth and dvelopment

A

In general terms, the placenta regulates its own growth and development through autocrine mechanisms.

It produces a rnage of GFs and proteins

The maternal decidua mainly seems to modulate (restrain) placental growth and development, so that the placenta is optimal for both the mother and the fetus

101
Q

T/f normal human pregnancy poses great risk to mother

A

F. It is the process of labour and delivery that poses the dominant risk and is the commonest cause of maternal death linked to pregnancy

102
Q

Why are mothers should to blood loss after delivery? What limtits this

A

The remodelling of the uterine spiral arteries (see Session 3.3) means that these vessels can lose relatively large volumes of blood after delivery.

his should be limited by contraction of the uterus after the placenta has been delivered, which diminishes the blood loss very strongly. Sometimes it is necessary for drugs to be given to ensure this happens correctly.

103
Q

Why is it important that all of the placenta is delivered

A

Placental tissue is relatively inflexible, and any left within the uterus will prevent the contraction of uterine tissue, and permit continued blood flow through the spiral arteries into the uterine lumen.

104
Q

What poses biggest risk to infant during pregnancy

A

defects in the production of gametes, so that they contain too few or too many chromosomes. Loss of any autosome is not compatible with life

Changes in sex chromosomes are generally less severe

105
Q

Which of these are viable genotypes:

43XX
43 XY
44XXX
44XXY
44XYY
44XO 
44YO
A 
43XX=no
43 XY=no
44XXX=yes 
44XXY= yes 
44XYY=yes
44XO =yes (but more severe than gain of sex chromosome= turner's, infertility)
44YO=no
106
Q

When are placental problems most common. What are the common placental problems

A

In first trimester

Some will be due to developmental problems affecting the embryo/fetus or placenta, others will result from detachment of the placenta in late first trimester

107
Q

What is key problem for pregnancy after the limits of viability (23 weeks GA) have been passed?

A

early delivery of the infant

108
Q

Why are infants delivered early

A
  1. Labour starts befroe term

2. Deteriorating maternal or foetal health (delivery is best option to save life of mother or child)

109
Q

What is stillbirth

A

death of an infant within the uterus, so that it is delivered without any signs of life.

Sometimes,

deliveries before viability are miscarriages, and after are stillbirths

110
Q

Why can stillbirth happens

A

Pregnancy complication, or labour complication

111
Q

T/f stillbirth only occurs pre-term

A

F: stillbirth can occur at any gestational age, including term;

112
Q

Reason for higher stillbirth rate in developing coutnries

A

availability of monitoring equipment, coupled with access to facilities for an emergency Cesarean section if complications in the infant are detected

113
Q

Give examples of why infants are delivered early to save life of baby, mother or oth

A

Growth Restricted infants, and Pre-eclamptic pregnancies

114
Q

Why are babies born before 32 weeks GA at risk

A

incomplete development of their lungs, digestive system, brain and immune system

115
Q

At which GA are you at severe risk of complications due to preterm delivery

A

Before 32 weeks GA= very preterm (lung, digestive, brain and immune problems)

Moderately preterm= 32-37 weeks of gestation….. much less risk

116
Q

Why can we not definitively only classify ‘viable’ babies as stillborns, and non-viable as miscarriage

A

Given that the viability of an infant born at less than 28 weeks gestational age is so variable, it is hard to provide a completely rigorous time definition, so ‘delivered without any signs of life’ may be the best option.

117
Q

Rate of stillbirth in UK

A

0.35%, or 2,600 infants per year, so a large hospital with 4,000 deliveries per year is likely to have 10-15 cases per year.

118
Q

What could indicate increased risk of stillbirth

A

The detection of stillbirth depends on monitoring of fetal wellbeing; a decrease in, or lack of, fetal movements may indicate an increased risk

119
Q

What is preferred method for checking for stillbirth

A

The preferred method is ultrasound assessment of the infant, perhaps coupled with assessment of the fetal blood flow (doppler ultrasound)

120
Q

Causes of stillbirth

A

not well understood; about 50% of cases are thought to occur during the process of labour, which emphasises the importance of monitoring fetal wellbeing during pregnancy

121
Q

Is risk of stillbirth increased in subsequent pregnancy

A

Some studies have suggested that the risk of stillbirth is increased in a subsequent pregnancy, but it is not clear if this is universally applicable, or what the mechanism might be.

122
Q

Outline the 4 things which the conceptus refers to

A

The embryo, the placenta, the foetal membranes and the umbilical cord

Rob's RDA (10 decks)

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