Pregnancy Health Complications Flashcards
first predictor of health, psychological wellbeing, financial security as an adult is
- mother’s health during pregnancy
medical conditions to consider throughout pregnancy
- depression and anxiety
- maternal obesity
- thromboembolism
complications presenting in first trimester
- hyperemesis gravidarum
- UTIs
complications presenting in second trimester
- gestational diabetes
- iron deficiency anemia
complications presenting in third trimester
- preeclampsia
how to take a history from a pregnant woman - PAMPHLETS
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
define perinatal
period of time from when become pregnant to 1 year after giving birth
antenatal care
care received during pregnancy
define prenatal
before birth, during, or relating to pregnancy
[depression and anxiety] % occurrence of perinatal anxiety
18.4%
[depression and anxiety] % occurrence perinatal depression
16.3%
[depression and anxiety] are mental health disorders a common presentation during pregnancy
yes
[depression and anxiety] for mental health presentation during pregnancy, what should you take in the history
- 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
[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
- antenatal risk questionnaire (ANRQ)
- edinburgh perinatal depression score (EPDS)
> results put into orange book
[depression and anxiety] what is the difference between antenatal risk questionnarie and perinatal depression score
- antenatal risk questionnaire: looks at previous events and current risks
- edinburgh perinatal depression score: looks at symptoms in past 7 days
[depression and anxiety] are there any tests to be done around anxiety and depression in pregnant women
no
but think of conditions that may exacerbate symptoms eg/ anaemia
[depression and anxiety] what could be offered to a pregnant woman with depression and anxiety
- psychological support and therapy
- medications if needed
[depression and anxiety] what needs to be considered in giving medications to pregnant women with depression and anxiety
- 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
[depression and anxiety] if significant signs of depression, remember to explore if:
- risk of harm to self
- risk of harm to infant
[maternal obesity] obesity is BMI what
greater than 30
[maternal obesity] what does maternal obesity increase risk of:
- 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)
[maternal obesity] what is obesity a product of
- heredity and environment
> consider context, other health issues
[maternal obesity] maternal obesity (BMI >30) is related to significant…
complication rates during pregnancy and births
[maternal obesity] obesity can accentuate dyspnoea, why might pregnant women have SOB already?
in late pregnancy diaphragm can be splintered by uterus
[maternal obesity] list how some factors that are increased risk from maternal obesity can be causing further weight gain
- dyspnoea -> reduced interest and uptake of physical activity
- sleep apnoea -> disrupted sleep can lead to weight gain
[maternal obesity] briefly describe how childhood obesity can be increased by maternal obesity during pregnancy
influences development of fat cells in baby and their tendency to continue to store fat as they grow older
[maternal obesity] how to promote reduction of maternal obesity during a consult
- 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)
[maternal obesity] how does desired pregnancy weight gain change based on pre-pregnancy BMI
- more weight gain the lower the BMI
- less weight gain the higher the BMI
[thromboembolism] in pregnancy woman’s body is in a physical state of what
hyper-coagulation
[thromboembolism] in pregnancy what is the increase risk of thromboembolism
5x
thromboembolism is the ___ highest cause of death in pregnancy and childbirth after bleeding
second
