Pregnancy Health Complications

Question 1

first predictor of health, psychological wellbeing, financial security as an adult is

Answer 1

• mother’s health during pregnancy

Question 2

medical conditions to consider throughout pregnancy

Answer 2

• depression and anxiety
• maternal obesity
• thromboembolism

Question 3

complications presenting in first trimester

Answer 3

• hyperemesis gravidarum
• UTIs

Question 4

complications presenting in second trimester

Answer 4

• gestational diabetes
• iron deficiency anemia

Question 5

complications presenting in third trimester

Answer 5

• preeclampsia

Question 6

how to take a history from a pregnant woman - PAMPHLETS

Answer 6

P - past medical and surgical history
A - allergies
M - medications, OTC, smoking, alcohol, recreational drugs
P - past obstetric history: outcome of each pregnancy
H - hand held record (orange book)
L - last menstrual period (or dating scan) to confirm gestation
E - events leading to presentation today
T - tests (routine antenatal test results)
S - social history and safety

Question 7

define perinatal

Answer 7

period of time from when become pregnant to 1 year after giving birth

Question 8

antenatal care

Answer 8

care received during pregnancy

Question 9

define prenatal

Answer 9

before birth, during, or relating to pregnancy

Question 10

[depression and anxiety] % occurrence of perinatal anxiety

Answer 10

18.4%

Question 11

[depression and anxiety] % occurrence perinatal depression

Answer 11

16.3%

Question 12

[depression and anxiety] are mental health disorders a common presentation during pregnancy

Answer 12

yes

Question 13

[depression and anxiety] for mental health presentation during pregnancy, what should you take in the history

Answer 13

• past medical history of mental illness (include care received & if level of impact made & if still on medications) or previous symptoms
  (note: if medications are safe during pregnancy)
• past obstetric history - is there a history of post-natal depression following previous pregnancies
• recent stressors
• general levels of worry
• antenatal risk questionnaire
• edinburgh perinatal depression score

Question 14

[depression and anxiety] what are the 2 questionnaires that should be included in a history of a presenting complaint of depression and anxiety in a pregnant woman

Answer 14

• antenatal risk questionnaire (ANRQ)
• edinburgh perinatal depression score (EPDS)
  > results put into orange book

Question 15

[depression and anxiety] what is the difference between antenatal risk questionnarie and perinatal depression score

Answer 15

• antenatal risk questionnaire: looks at previous events and current risks
• edinburgh perinatal depression score: looks at symptoms in past 7 days

Question 16

[depression and anxiety] are there any tests to be done around anxiety and depression in pregnant women

Answer 16

no
but think of conditions that may exacerbate symptoms eg/ anaemia

Question 17

[depression and anxiety] what could be offered to a pregnant woman with depression and anxiety

Answer 17

• psychological support and therapy
• medications if needed

Question 18

[depression and anxiety] what needs to be considered in giving medications to pregnant women with depression and anxiety

Answer 18

• benefit-to-risk; risk of taking medication during pregnancy vs risk of severe mental health issues during pregnancy and post-natal
• pregnancy rating of medications
• beware of: SSRIs

Question 19

[depression and anxiety] if significant signs of depression, remember to explore if:

Answer 19

• risk of harm to self
• risk of harm to infant

Question 20

[maternal obesity] obesity is BMI what

Answer 20

greater than 30

Question 21

[maternal obesity] what does maternal obesity increase risk of:

Answer 21

• dyspnoea (shortness of breath)
• sleep apnoea
• gestational diabetes
• preeclampsia
• large baby (macrosomia)
• maternal trauma during birth (eg/ vaginal tears)
• caesarean birth
• birth defects (cardiac and neural tube)
• childhood obesity (influences development of fat cells in baby and their tendency to continue to store fat as they grow older)

Question 22

[maternal obesity] what is obesity a product of

Answer 22

• heredity and environment
  > consider context, other health issues

Question 23

[maternal obesity] maternal obesity (BMI >30) is related to significant…

Answer 23

complication rates during pregnancy and births

Question 24

[maternal obesity] obesity can accentuate dyspnoea, why might pregnant women have SOB already?

Answer 24

in late pregnancy diaphragm can be splintered by uterus

Question 25

[maternal obesity] list how some factors that are increased risk from maternal obesity can be causing further weight gain

Answer 25

- dyspnoea -> reduced interest and uptake of physical activity - sleep apnoea -> disrupted sleep can lead to weight gain

Question 26

[maternal obesity] briefly describe how childhood obesity can be increased by maternal obesity during pregnancy

Answer 26

influences development of fat cells in baby and their tendency to continue to store fat as they grow older

Question 27

[maternal obesity] how to promote reduction of maternal obesity during a consult

Answer 27

- support not shame - aim for lower pregnancy weight gain - dietitian review early - encourage regular moderate exercise - early screening for gestational diabetes (via oral glucose tolerance test; instead of waiting for standard 24wks gestation)

Question 28

[maternal obesity] how does desired pregnancy weight gain change based on pre-pregnancy BMI

Answer 28

- more weight gain the lower the BMI - less weight gain the higher the BMI

Question 29

[thromboembolism] in pregnancy woman's body is in a physical state of what

Answer 29

hyper-coagulation

Question 30

[thromboembolism] in pregnancy what is the increase risk of thromboembolism

Answer 30

5x

Question 31

thromboembolism is the ___ highest cause of death in pregnancy and childbirth after bleeding

Answer 31

second