pregnancy and perinatal health Flashcards
fertility issues
Age
Smoking
BMI
Exercise
Drugs
Folate - high in both parents before conception
Alcohol
ivf
success decreases as age increases
early pregnancy
day 0 - early fertilisation
fertilisation happens often but rarely progresses to pregnancy
most pregnancies fail within first 10 weeks
3 stages of pregnancy
1st trimestr- 1 to 12
2nd - 13 to 28
3rd - 29 to 40
most things are formed by 28 weeks
maternal changes in pregnancy
Physical changes - growth - increase in weight
a lot of extra blood volume
Hormonal changes
Haematological changes
Cardiovascular changes
Coagulation Changes
physiological changes
Increased Oestrogen & Progestogen
act on kidney to increase Renin secretion
Increased salt & water retention
Increased plasma volume by 45%
Dilution effect makes Hb fall from 15-12g/dL
Protects against haemorrhage at birth
anaemic because diluted blood
Lower oesphageal sphincter relaxes
With increase abdominal pressure gives increased GORD
Hormonal changes increase reduce insulin sensitivity
Diabetes in pregnancy = warning you can become diabetic
Haematological
increased production of RC, WC, Platelets
20% increase in RC mass
Increased platelet consumption makes platelets normal to low
Increased WC makes diagnosing infections difficult
Relaxation of vascular smooth muscle
Reduced peripheral resistance
Reduced systolic and diastolic blood pressure
Compensatory increase in heart rate by 25%
Vascular compression by uterus
Vena cava and aorta
Difficulty with venous return when supine
Coagulation screens remain normal
Clotting factor production increases
Fibrinolysis increases
Increased system sensitivity with increased DVT risk
what not to eat
· Raw/slightly cooked meat and raw fish
danger of infection with toxoplasmosis
· Raw eggs = salmonella
· Non-pasteurized milk and milk cheese
listeria
· Spicy, grilled and fried food = dyspesia
· Marlin, tuna, and shark = Mercury toxicity
· Liver and other entrails and internal organs of a slaughtered animal during the In the first three months of pregnancy
foetal changes in pregnancy
Development starts at week 4
zygote becomes and embryo
Week 6 – start of embryonic circulation
Weeks 6-10 embryonic development & growth
Embryo stages stops at 10 weeks
Foetus 10-14 weeks – features and limbs become developed and active!
Miscarriage rate highest in first trimester
Maternal and foetal factors
Second Trimester from week 14
Hair, nails toenails and eyelids start to form
Movement may be felt
18 weeks – toes and fingers formed and hearing starts to respond
20-26 final development of vision and senses
Brain development and body fat increase
Third trimester from week 27
Growth and nervous system maturation
placenta
lungs of the foetus
thin membrane which allows oxygen to move in and ca dioxide to move out
mum and baby circulation are separate
labour
Induction of labour
First stage
Second stage
Third stage
Forceps
Ventoux
Caesarean section
screening in pregnancy
In the first trimester=
to establish the dates of a pregnancy
to determine the number of foetuses and identify placental structures
to diagnose an ectopic pregnancy or miscarriage
to examine the uterus and other pelvic anatomy
in some cases to detect foetal abnormalities
Mother
Chronic diseases=
Hypertension
Diabetes
Infectious diseases=
Rubella
Syphilis
Hepatitis C
HIV
Foetus
Genetic and developmental abnormalities
18-20 weeks
to confirm pregnancy dates
to determine the number of foetuses and examine the placental structures
to assist in prenatal tests such as an amniocentesis
to examine the foetal anatomy for presence of abnormalities
to check the amount of amniotic fluid
to examine blood flow patterns
to observe foetal behavior and activity
to examine the placenta
to measure the length of the cervix
to monitor foetal growth
foetal testing in pregnancy
FAST – foetal abnormality screening programme
1st Trimester – 11-14 weeks
Neuchal Translucency – Ultrasound
Maternal hCG - blood
PAPP-P - blood
Combined results can suggest chromosome abnormality
Second Trimester Screening
AFP
Abnormality follow-up
CVS & Amniocentisis – genetic changes
Ultrasound – spina bifida
Physical examination
Hearing test
Blood spot
Phenylketonuria - PKU
Hypothyroidism
Cystic Fibrosis
Sickle cell disease
MCADD – acyl CoA dehydrogenase deficiency
APGAR Score
A Activity muscle tone
P Pulse > 100/min
G Grimace reflex irritability
A Appearance colour
R Respiration rate
at 1 min and 5 min
dentistry during pregnancy
Cost of dental care
Drugs in pregnancy - don’t give them anything unless really needed
paracetamol for pain relief
Pregnancy gingivitis
Periodontal health in pregnancy
Position of mother
