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11- Reproduction > Pregnancy and Antenatal Care > Flashcards

Pregnancy and Antenatal Care Flashcards

1
Q

what is Naegele’s Rule?

A

predicts estimated due date based on the onset of womans last menstrual period

add on 9months and 7days to arrive at due date- 280 days

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2
Q

what is placenta praevia?

A

placneta is low lying in the woman covering part or all of the cervix

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3
Q

if placenta praevia is diagnosed what are the next steps?

A

second scan offered at 32 weeks and vaginal scan if this comes back unclear

(in most woman as womb grows upwards placenta moves with it causing no problems)

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4
Q

what can inc chance of having a child w downs syndrome?

A

maternal age

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5
Q

what is checked during the first trimester?

A

skin thickness behind foetal neck (11-13wks)

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6
Q

what is normal skin thickness behind foetal neck when measured at 11-13 weeks?

A

<3.5mm

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7
Q

what is measured during the second trimester?

A

blood sample

assay of HCG and AFP

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8
Q

what is AFP?

A

Alpha feroprotein tumour marker

(need dating US before this to establish gestation as not accurate in dating)

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9
Q

what does a high AFP indicate?

A

nueral tube defect i.e. spina bifida

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10
Q

what does a low AFP indicate?

A

chromosomal abnormality i.e. down syndrome, edwards

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11
Q

if you miss first trimester screening for downs syndrome what can be offered?

A

mid trimester screenign option- aneuploidy which looks for abnormal chromosomes

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12
Q

what is cell free foetal DNA and why is it tested?

A

foetal material in womans blood- can be used to identify those women at higher risk of having a baby with a chromosomal abnormality

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13
Q

how is personal risk calculated when investgating chance of havign baby with downs syndrome?

A

results of first and second trimester screeing with maternal age and gestation

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14
Q

what risk would be considered high and require further investiagation when screenign for downs syndrome?

A

>1:250 e.g. amniocentisis

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15
Q

amniocentisis is usually performed at what stage?

A

>15weeks

carries miscarriage risk of 1%

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16
Q

chorionic villus sampling is usually performed at what stage?

A

>12 weeks

carries a miscarriage risk of 2%

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17
Q

when is maternal anaemia screened for?

A

booking and 28 weeks

(mums blood group, Rhesus status and risk facotrs for gestational diabetes also looked at)

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18
Q

how is foetal growth mesaured at each antenatal appointment?

A

Symphysis Fundal Height (SFH) from 24 weeks

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19
Q

is SFH plotted on personal or population chart?

A

personal chart

those demostrating slow or static growth are referred fro US measurement

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20
Q

the placenta is dervied from which tissues?

A

trophiblast and decidual tissue

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21
Q

which cells invade the decidua to from cavities filled with maternal blood within the placenta?

A

synctiotophoblasts

(derived from trophoblast cells)

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22
Q

how are placental villi formed?

A

developing embryo send capillaries into synciotophoblast projections

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23
Q

what signals the corpus luteum to continue secreting progesterone?

A

HCG

24
Q

what seperates embryos blood from mums blood so no direct contact?

A

intervillus space

25
Q

what is the bohr effect?

A

inc affinity for oxygen when carbon dioxide is low

26
Q

how does foetal blood differ?

A

inc ability to carry oxygen

high Hb conc

27
Q

can iron and Ca2+ be transferred betwen mum and baby?

A

yes but only mum to baby not reverse

28
Q

how is glucose exachanged between mum and baby?

A

simplified transport

29
Q

how are fatty acids exchanged between mum and baby?

A

free diffusion

30
Q

what hormone is responsible for decreased insulin sensitivity in pregnant women?

A

Human chorionic somatomammotropin produced from wk 5

(growth hormone like effect on protein tissue formation/involved in breast development)

31
Q

why does insulin sensitivty decrease in pregnant woman?

A

to allow more glucose for the baby

32
Q

which hormone is important in the development of decidual cells?

A

progesterone

33
Q

during what trimester does BP usually drop in pregnant women?

A

drops during second then goes back up in third

34
Q

are systolic murmurs worrying?

A

no- v common and no need to investigate unless symptomatic

35
Q

what happens to CO levels during pregnancy?

A

they increase up to 30-50% due to demands of uteroplacental circulation

36
Q

why is Hb decreased during pregnancy?

A

palsma volume increases with CO and so decreased by dilution

37
Q

who requires iron supplementation during pregnancy?

A

may be required in 2nd thalf of pregnancy as when Hb most diluted

Twin pregnancy always gets iron supplementation

38
Q

which hormone signals the brain to lower CO2 levels?

A

progesterone

39
Q

what is pre-eclampsia?

A

pregnancy induced hypertension with proteinuria

40
Q

how does pre-eclampsia affect the kidneys?

A

kidney function declines resulting in salt and water retention

renal blood flow and GFR decrease

41
Q

women with >1 mod risk factor for pre-eclampsia are advised to take what medication?

A

75mg aspirin daily from week 12until baby born

42
Q

what are risk factors for pre-eclampsia?

A

first pregnancy

>40yrs old

pregnancy interval >10yrs

BMI >35

family history

multiple pregnancy

43
Q

what BP is borderline pre-eclampsia and what requires treatment?

A

140/90 borderline

150/100 treatment

44
Q

what is eclmapsia?

A

extreme pre-eclampsia (lethal without treatment)

45
Q

how do you treat eclampsia?

A

labetalol

betamethasone (helps babies lungs mature)

hydralazine (vasodilator)

Mg sulphate (stop seizures in mum)

46
Q

up to how many weeks of pregnancy can magnesium sulphate be given?

A

up to 30 weeks

47
Q

how many extra calories a day should be ingested by mother?

A

250-300kcal

48
Q

what are the two phases of metabolism in pregnancy?

A

20th week- mothers anabolic phase

40th week- catabolic phase, accelerated starvation of mother

49
Q

where is oxytocin released from?

A

posterior pituitary

50
Q

what effect does oxytocin have in labour?

A

increases contraction and excitabilty

51
Q

what is parturition?

A

birth of baby

52
Q

what are the effects of oestrogen and progesterone on the breast during pregnancy?

A

oestrogen → growth of ductile system

progesterone → development of lobule-alveolar system

53
Q

what happens to levels of oestrogen and progesterone at birth?

A

suddenly drop

54
Q

what hormone stimulates milk production?

A

prolactin

55
Q

sucking stimulation on nipple from baby during breast feedign is known as what?

A

milk let down reflex

11- Reproduction (19 decks)

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