Pregnancy Risks Flashcards
What are the four variables affecting teratogenicity?
Nature of agent
Timing of exposure
Pattern of exposure
Embryo/fetus susceptibility
What days in pregnancy are most susceptible to anomalies?
Days 18-60
Teratogens in second and third trimester are most likely to cause ___
CNS abnormalities, fetal growth issues
What are genetic teratogens caused by?
Gene deficiency Gene abnormality Chromosome rearrangement Chromosome deletion Chromosome excess
What are the most common environmental teratogens?
Lead and mercury
What are common sources of lead and what can high levels of lead cause?
Paint and environmental chemicals
Low birth weight, preterm delivery, neurological defects
What are common sources of mercury, what are the limits on those sources, and what can high levels cause?
Shellfish and large fish
Shellfish/small fish/light tuna- 12oz/wk
White albacore tuna- 6oz/wk
Neurological defects
What common medications have teratogenic effects?
Accutane Tetracycline Warfarin Anti-seizure meds- depakote/dilantin/tegretol ACEI's and ARB's (switch to labetolol)
What are the risks with smoking?
IUFGR, preterm birth, SGA, abruption, placenta previa, PPROM, SIDS
What are the risks with alcohol use?
FAS, SGA, facial anomalies, CNS abnormalities, mental retardation
What are the risks with cocaine?
Vasoconstrictor
Abruption, cardiac and CNS anomalies
What are the risk with narcotics?
SAB, preterm delivery, IUFGR, NAS
What’s the definition of teratogen?
An agent or substance that causes birth defects
What is the only imaging studies with enough radiation to pose a risk?
Repeated CT scans, fluoroscopies
What are the two most common neural tube defects?
Spina bifida
Anencephaly
Why is folic acid important in preventing neural tube defects and how much should be taken?
Essential to DNA synthesis
400-800mcg daily
Where is physical violence most often directed at on a pregnant woman?
Abdomen, breasts, genitalia
What are direct and indirect effects of abuse on fetus?
SAB, Fetal injury/death
Maternal stress, maternal smoking/alcohol/drug abuse
What is the recommendation for screening for intimate partner violence?
At initial visit, at least once per trimester, at pp visit
