Pregnancy & Perinatal Health Flashcards
What factors affect fertility?
- age (decreases with age)
- smoking
- BMI (decreases with high BMI)
- exercise
- drugs
- folate (neural tube defects due to deficiency)
- alcohol (foetal alcohol syndrome)
How does IVF success with age compare to natural pregnancy success?
- very similar
- both decrease after 35-40
Detail the timescales of each trimester of pregnancy
1st - 0-12 weeks
2nd - 12-24 weeks
3rd - 24-40 weeks
What happens during the first trimester?
Structures of the embryo form and tissues differentiate
What happens during the second trimester?
Specialisation and final differentiation of tissues
What happens during the third trimester?
Growth and physiological changes for successful birth
Outline the maternal changes during pregnancy
- physical changes
- hormonal changes
- haematological changes
- cardiovascular changes
- coagulation changes
What causes increased weight during pregnancy?
- increased tissue size
- functionality
- increased fluid volume
- compensates for blood loss during birth
- protects against hypovolaemia
- growth of foetus
What are the hormonal changes during pregnancy?
- increased oestrogen and progestogen
- act on kidney to increase renin secretion
- increased salt and water retention
- reduced insulin sensitivity
- gestational diabetes
- changes to mother and foetus
- larger, heavier baby
- delivery complications
What are the physical changes during pregnancy?
- relaxation of lower oesophageal sphincter
- accompanied by increased abdominal pressure
- increased GORD
- particularly towards the end of pregnancy
- increased bladder and bowel compression
- increases with baby’s size
- urgency and frequency increase
What are the haematological changes during pregnancy?
- increased plasma volume by 45%
- as a result of salt and water retention
- dilution of blood makes Hb fall
- 15g/dL to 12g/dL Hb
- protects against haemorrhage at birth
- artificial anaemia, often treated with iron
- increased cell production
- red blood cells
- white blood cells (infection diagnosis difficult)
- platelets (increased consumption makes platelets look low)
- increased cell mass
- red blood cells
- normal coagulation screens
- clotting factor production increased
- fibrinolysis increased
- increased system sensitivity
- increased DVT risk
What are the cardiovascular changes during pregnancy?
- relaxation of vascular smooth muscle
- reduced peripheral resistance
- reduced systolic and diastolic blood pressure
- compensatory increase in heart rate by 25%
- all aid to cope with increased vascular load
- vascular compression by uterus
- vena cava and aorta
- difficulty with venous return when supine
What are the cardiovascular changes during pregnancy?
- relaxation of vascular smooth muscle
- reduced peripheral resistance
- reduced systolic and diastolic blood pressure
- compensatory increase in heart rate by 25%
- all aid to cope with increased vascular load
- vascular compression by uterus
- vena cava and aorta
- difficulty with venous return when supine
What should not be eaten during pregnancy?
- raw/slightly cooked meat and raw fish
- danger of toxoplasmosis infection
- raw eggs
- salmonella risk
- non-pasteurised milk and cheese
- listeria risk
- spicy, grilled and fried foods
- dyspepsia
- worsens gastro-oesophageal reflux
- marlin, tuna and shark
- risk of mercury toxicity
- liver, entrails and internal organs
- must be avoided in first trimester
What happens to the zygote at week 4?
It becomes an embryo
- neural tube, gut tube and brain begin developing
