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MFSRH Part 1 CM > Pregnancy And Antenatal Care > Flashcards

Pregnancy And Antenatal Care Flashcards

1
Q

What 3 STIs are part of routine antenatal screening

A

HIV, STS, hep B

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2
Q

Why do vulval varices occur in pregnancy

A

Increased intra abdominal pressure

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3
Q

What happens to the glycogen content of the vaginal epithelium in pregnancy

A

Increases

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4
Q

Vaginal PH on pregnancy increase or decrease

A

Decrease

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5
Q

STIs linked to infertility or sub fertility

A

CT, GC, LGV

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6
Q

STIs most likely to affect early pregnancy

A

BV, STS, TV

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7
Q

STIs most likely to affect late pregnancy

A

HSV, CT, GC, STS, TV

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8
Q

Complications of BV

A

Prem membrane rupture (PROM)
Increased risk of uterine and wound infection
Preterm labour and birth
PP endometritis

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9
Q

Pregnancy BV tx

A

Metronidazole 400mg BD/TDS 5-7 days
Clindamycin 300mg BD 7 days
Increased complications with PV tx in preg

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10
Q

Does routine BV screening affect preterm birth rates

A

No

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11
Q

TV pregnancy complications

A

Low birth weight,
Preterm birth
PROM

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12
Q

VVC preg complications

A

None

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13
Q

Goal of VVC tx in pregnancy

A

Symptom management

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14
Q

Pregnancy PID complications

A

Low birth weight
Prem delivery
PROM
Chorioamnionitis
PP sepsis

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15
Q

CT vertical transmission rate

A

Up to 50%
Can spread at CS

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16
Q

Most common neonatal comp of CT

A

Conjunctivitis

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17
Q

CT in pregnancy tx

A

1g Azithromycin
Erythromycin 500mg BD 14 days/QDS 7 days
Amoxicillin 500mg TDS

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18
Q

GC preg complications

A

Low birth weight
Prem delivery
PROM
PP sepsis

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19
Q

GC intrapartum infection rate if untreated

A

30-50%

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20
Q

GC pregnancy tx

A

Ceftriaxone 1g IM
Spectinomycin 2g IM
Azithromycin 2g orally

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21
Q

HSV intrapartum transmission rate in primary infection

A

30-50%

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22
Q

Does CS negate HSV transmission risk

A

No, only reduce

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23
Q

How does STS transmit in pregnancy

A

Trans placentally

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24
Q

Complications of STS tx in pregnancy

A

Jarisch-Herxheimer reaction - can cause fetal distress/premature labour

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25
Q

STS tx in pregnancy

A

Benzathine Penicillin 2.4 million units IM once/three times
Exposure therapy required if mother allergic to penicillin

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26
Q

Complications of warts in pregnancy

A

1 in 400 chance of neonatal transmission
(Causing juvenile respiratory papillomatosis)

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27
Q

Wart tx in pregnancy

A

Cryo
85% bi/trichloroacetic acid
Surgery

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28
Q

Hep b vertical transmission risk

A

At birth only
90% if e antigen positive
10% if e antigen negative

29
Q

Hep B in neonate prevention

A

Hep B immunoglobulin immediately after birth
Hep B vaccine in 12 hours
3 more doses at 1,2,12 months

30
Q

HIV in pregnancy modes of transmission

A

In utero, during delivery, breastfeeding

31
Q

Maternal risk factors for hiv transmission in pregnancy

A

High viral load
Low CD 4

32
Q

Intrapartum risk factors for hiv transmission

A

Prolonged rupture of membranes in viral load >50
Vaginal delivery if viral load >50

33
Q

Infant risk factors for hiv transmission

A

Prematurity
Breastfeeding

34
Q

Untreated HIV transmission rates

A

35% (15% breastfeeding)

35
Q

When is HIV tx advised in trim 1

A

If CD4 <200 VL>100,000
Otherwise start by wk 24

36
Q

HSV complications for the mother

A

Dissemination

37
Q

HSV risk to neonate

A

Dissemination (70%)
Significant morbidity and mortality
Skin/eye/mucus membrane infection (30%)

38
Q

Why is primary HSV so dangerous to neonate

A

Prolonged cervicitis
High viral load
No time for maternal antibodies to develop

39
Q

Heart changes in pregnancy

A

12% enlargement
Lateral displacement of apical beat
Increased intracardiac volume (80ml)

40
Q

Plasma volume increase in pregnancy

A

50%

41
Q

How does estrogen contribute to increased blood circulation in pregnancy

A

Increased oestrogen stimulates renin angiotensin system, increasing aldosterone, increasing na+ reabsorption

42
Q

Increased red cell percentage In pregnancy

A

30%

43
Q

Cardiac output increase in pregnancy

A

40%

44
Q

What causes increased cardiac output in pregnancy

A

Increased stroke volume and increased heart rate

45
Q

Changes in BP in pregnancy

A

Slight drop in systolic
Larger drop in diastolic
Widened pulse pressure

46
Q

What happens to vascular resistance in pregnancy

A

Decreases

47
Q

Common heart murmur of pregnancy

A

Ejection systolic

48
Q

Pregnancy ECG changes

A

15-20 degree left axis shift
St segment depression
T wave flattening

49
Q

What is the effect of the hyperventilation of pregnancy

A

Mild respiratory alkalosis (CO2 breathed off)

50
Q

What are the chances on pregnancy lung volumes

A

Increased tidal volume
(Smaller inspiritory reserve, smaller expiratory reserve, smaller residual)

51
Q

Effects on lung capacity in pregnancy

A

Decreased total capacity
(No change in vital capacity, increase in inspiritory capacity, decrease in functional)

52
Q

Why why is there increased acidity of stomach acid in pregnancy

A

Increase in production of gastrin increases stomach volume and acidity of secretions

53
Q

What clotting factors increase in pregnancy

A

Fibrinogen and factor VIII +++
Factors VII, IX, X, XII +

54
Q

What clotting factor is majorly reduced?

A

Factor XIII

55
Q

Average weight gain in pregnancy

A

12.5kg

56
Q

Base tissue of the placenta

A

Trophoblast

57
Q

What is the chorion

A

Where the trophoblast is penetrated by fetal mesoderm

58
Q

What does the embryonic body stalk become

A

Umbilical cord

59
Q

Why does uterine atony cause pph

A

Terminal maternal arterioles lose their elastic reticulum - they can’t clamp themselves

60
Q

What cells produce hcg

A

Syncytiotrophoblast

61
Q

What hormones share an alpha subunit?

A

LH, FSH, TSH, hCG (glycoprotein hormones)

62
Q

Where is relaxin produced

A

Corpus luteum

63
Q

What does the placenta use to make estrogens

A

DHEAS (comes from fetal adrenal glands)

64
Q

What is Wharton’s jelly derived from

A

Primary mesoderm

65
Q

What is the umbilical vein in an adult

A

Ligamentum teres

66
Q

What is ligamentum teres contained in

A

Falciform ligament

67
Q

What is the only type of immunoglobulin that can cross the placenta

A

IgG

68
Q

Would baby igM be diagnostic of congenital infection

A

Yes, igM cannot cross the placenta

69
Q

What does hypersensitivity to GDF15 cause

A

Hyperemesis gravidarum

MFSRH Part 1 CM (15 decks)

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