Pregnancy and Perinatal health Flashcards
1
Q
What are factors for fertility issues?
A
- Age
- Smoking
- High BMI
- Exercise
- Drugs
- Folate levels
- Alcohol levels
2
Q
What is spina bifida related to a low level of?
A
- Low level of folic acid
3
Q
What is foetal alcohol syndrome?
A
- Group of conditions that can occur in a person who was exposed to alcohol before birth
- Physical or neurological condition
4
Q
When does the fertilised zygote implant into the uterus?
A
- Approx day 8/9
5
Q
How are the weeks someone is pregnant for divided?
A
First trimester - 6-12 weeks
Second trimester - 24weeks
Third trimester - 25-40 weeks
6
Q
What maternal changes occur in pregnancy?
A
- Physical changes
- Hormonal changes
- Haematological changes
- Cardiovascular changes
- Coagulation changes
7
Q
What is the total weight gain of mother during pregnancy?
A
Approx 11-16kg
- Extra blood vol produced as lost will be lost during lost and protects mother against hypovolemia
8
Q
How do the oestrogen and progestogen levels change in pregnancy and what do they do?
A
- Both are increased
- Act on kidney ot increase Renin secretion
- Increased salt and water retention
- Increased plasma vol by 45%
9
Q
How does increased plasma vol protect against haemorrhage at birth?
A
- Dilution effect makes HB fall from 15-12g/dL
- But Hb carried in blood is still high as higher circulating plasma vol
10
Q
What happens to the lower oesophageal sphincter during pregnancy?
A
- Relaxes
- As increase abdominal pressure gives increased GORD (Gastro-oesophageal reflux disease)
11
Q
What do women with type 2 need to be careful of during pregnancy?
A
- Hormonal changes increase
- This reduces insulin sensitivity
- Result in larger heavier baby that can cause complications during delivery
12
Q
What happens to the vascular smooth muscle during pregnancy?
A
- They become more relaxed
- Reduced peripheral resistance
- Reduces systolic and diastolic blood pressure
- Compensatory increase in heart rate by 25%
13
Q
What happens to the vena cava and aorta during pregnancy?
A
- Vena cava and aorta lies behind uterus
- Vascular compression by uterus leads to difficulty with venous return when mother is lying supine in dental chair
- Let mother sit slightly to one side and propped to prevent vascular compression
14
Q
What happens to coagulation screens during pregnancy?
A
- Remain normal
- Clotting factor production increases
- Fibrinolysis increases
- Increased system sensitivity leads to increased DVT risk which can cause problems in birth
15
Q
What foods can pregnant women not eat?
A
- Raw/ slightly cooked meat and raw fish due to danger of infection with toxoplasmosis
- Raw eggs due to salmonella risk
- Non pasteurised milk and cheese due to listeria risk
- Spicy, grilled or fried food due to dyspepsia
- Marlin, tuna, shark due to mercury toxicity
- Liver and other internal organs of slaughtered animal during first three months of pregnancy
16
Q
What occurs at week 4 of pregnancy?
A
- Developmental starts at week 4
- Zygote becomes an embryo
17
Q
What occurs at week 6 of pregnancy?
A
- Start of embryonic circulation
- Weeks 6-10 embryonic development and growth
18
Q
What occurs at week 10 of pregnancy?
A
- Embryo stops at 10 weeks
- Foetus 10-14 weeks
- Features and limbs become developed and active
19
Q
When is miscarriage most likely to happen?
A
- Highest in first trimester due to abnormality in developmental stage and it is not compatible for life
- Can happen anytime
20
Q
What specialised tissue occurs from week 14?
A
- Hair
- Nails and toenails
- Eyelids start to form
- Movement may be felt
21
Q
What specialised tissue forms at week 18?
A
- Toes and fingers
- Hearing starts to respond
22
Q
What specialised tissue forms at week 20-26?
A
- Development of vision and senses
- Brain development and body fat increase
23
Q
What occurs during third trimester form week 27?
A
- Growth and nervous system maturation
- Build up fat reserves ready for trauma birth
24
Q
What is the placenta?
A
- Disc of tissue that connects mothers uterus to umbilical cord
- Largely vascular
- Responsible for delivering nutrients and oxygen to foetus
- Baby doesn’t receive HIV if mother has it due to placenta barrier (will get HIV at birth therefore C-section done)
25
What are the stages of Labour?
- Induction of labour (when 10cm dilated)
- First stage (delivery of baby)
- Second stage (delivery of baby)
- Third stage (delivery of placenta)
26
What instruments can be used to help labour?
- Forceps (don't touch the child)
- Ventoux
- Caesarean section
27
What happens to the umbilical cord after birth?
- It is clamped
- Allows baby to maintain own oxygenation
- Vessels get no oxygenation, allows stump to become necrotic and fall off
28
How is the screening of the first trimester used to provide info for the mother?
- Establish dates of pregnancy
- Determine number of foetuses and identify placental structures
- Diagnose ectopic pregnancy or miscarriage
- Examine uteruses and other pelvis anatomy for potential problems in delivery
- Some cases detect foetal abnormalities (genetic or developmental)
- Chronic or infectious diseases of Mother (Hep B/C HIV)
29
What Chronic diseases are screened for?
- Hypertension as this can cause condition called preeclampsia
- Diabetes
30
What infectious diseases are being screen for?
- Rubella
- Syphilis
- Hep C
- HIV
31
What is preeclampsia?
- Condition that causes high blood pressure during pregnancy and after labour
- Can be serious if not treated
32
What does the detailed screening exam look for that happens at 18-20 weeks?
- Confirm pregnancy dates
- Determine number of foetus and examine placental structures
- Examine anatomy for abnormalities
- Check amniotic fluid
- Examine placenta
- Examine blood flow patterns
- Monitor foetal growth
33
What is FAST?
- Foetal abnormality screening programme
34
In the first trimester what does FAST screen for?
- Neuchal translucency via ultrasound
- Maternal hCG via bloods
- PAPP-P via blood
- Combined results can suggest chromosome abnormality
35
In the second trimester what does FAST screen for?
- AFP
- Abnormality follow up of previous tests
- CVS and amniocentesis for genetic changes
- Ultrasound for spina bifida
36
When is birth testing taken place?
- Incredible soon after birth
37
What occurs during the birth testing?
- Physical examination
- Hearing test
Blood spot
- Phenylketonuria (PKU)
- Hypothyroidism
- Cystic fibrosis
- Sickle cell disease
- MCADD (acyl CoA dehydrogenase deficiency)
38
What is the APGAR score?
- Used to determine assertiveness of baby 1min after birth and 5 mins after birth
- Should be a significant rise between the two
39
What is monitored in the APGAR score?
A - Activity (muscle tone)
P - Pulse (>100/min)
G - Grimace (Reflex irritability)
A - Appearance (colour)
R - Respiration (rate)
If low then transported to special care unit
40
What are some things we need to consider with pregnant women during pregnancy?
- Free dental care
- Be aware drugs can pass on to baby
- Pregnancy gingivitis
- Periodontal health in pregnancy
- Position of mother on chair
