Pregnancy Risks Flashcards

1
Q

What are the four variables affecting teratogenicity?

A

Nature of agent
Timing of exposure
Pattern of exposure
Embryo/fetus susceptibility

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2
Q

What days in pregnancy are most susceptible to anomalies?

A

Days 18-60

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3
Q

Teratogens in second and third trimester are most likely to cause ___

A

CNS abnormalities, fetal growth issues

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4
Q

What are genetic teratogens caused by?

A
Gene deficiency
Gene abnormality
Chromosome rearrangement 
Chromosome deletion
Chromosome excess
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5
Q

What are the most common environmental teratogens?

A

Lead and mercury

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6
Q

What are common sources of lead and what can high levels of lead cause?

A

Paint and environmental chemicals

Low birth weight, preterm delivery, neurological defects

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7
Q

What are common sources of mercury, what are the limits on those sources, and what can high levels cause?

A

Shellfish and large fish
Shellfish/small fish/light tuna- 12oz/wk
White albacore tuna- 6oz/wk

Neurological defects

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8
Q

What common medications have teratogenic effects?

A
Accutane
Tetracycline
Warfarin
Anti-seizure meds- depakote/dilantin/tegretol
ACEI's and ARB's (switch to labetolol)
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9
Q

What are the risks with smoking?

A

IUFGR, preterm birth, SGA, abruption, placenta previa, PPROM, SIDS

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10
Q

What are the risks with alcohol use?

A

FAS, SGA, facial anomalies, CNS abnormalities, mental retardation

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11
Q

What are the risks with cocaine?

A

Vasoconstrictor

Abruption, cardiac and CNS anomalies

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12
Q

What are the risk with narcotics?

A

SAB, preterm delivery, IUFGR, NAS

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13
Q

What’s the definition of teratogen?

A

An agent or substance that causes birth defects

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14
Q

What is the only imaging studies with enough radiation to pose a risk?

A

Repeated CT scans, fluoroscopies

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15
Q

What are the two most common neural tube defects?

A

Spina bifida

Anencephaly

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16
Q

Why is folic acid important in preventing neural tube defects and how much should be taken?

A

Essential to DNA synthesis

400-800mcg daily

17
Q

Where is physical violence most often directed at on a pregnant woman?

A

Abdomen, breasts, genitalia

18
Q

What are direct and indirect effects of abuse on fetus?

A

SAB, Fetal injury/death

Maternal stress, maternal smoking/alcohol/drug abuse

19
Q

What is the recommendation for screening for intimate partner violence?

A

At initial visit, at least once per trimester, at pp visit