Prgenancy Flashcards

1
Q

What vitamins should pregnant women take?

A

Folic acid 400micrograms (deficiencies cause neural tube defects)
Vitamin D 10 micrograms a days
AVOID vitamin A

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2
Q

When is the first appointment?

A

8-12 weeks (ideally before 10 weeks)

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3
Q

What 6 things are done at every appointment?

A

Blood pressure
Urine dip
Identify women with risk factors for pre-eclampsia (to start ibuprofen)
Offer influenza vaccination between oct and jan
Give info and support
Symphysis fundal height (every appointment after and including 25 weeks)

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4
Q

What is screened for?(Bloods)

A

Blood group/Rhesus D status
Haemoglobinopathies, anaemia, red-cell antibodies
Hep B, HIV, syphillis

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5
Q

Why is blood group/ rhesus status checked?

A

Because if mother rhesus -ve and baby rhesus +ve mother might initiate immune response (usually not first but subsequent pregnancies if mother becomes sensitised)

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6
Q

Why is blood screened for HIV, Hep B, syphillis?

A

Prophylaxis treatment and effects delivery methods

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7
Q

When is Down’s screened?

A

Combined test 11wks -13(+6days) weeks - bloods and ultrasound looking at nuchal thickness
Quadruple test (15wks - 20wks) - bloods only
Bloods - beta‑human chorionic gonadotrophin, pregnancy‑associated plasma protein‑A
Diagnostic testing - chorionic sampling or amniocentesis if screening indicates higher risk

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8
Q

When are ultrasound scans performed?

A

11weeks-13(+6days) - gestational age assessment

19-20(+6days) weeks -USS for structural abnormalities (i.e. heart, limb, cranial)

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9
Q

When are the 10 appointments in a nulliparous pregnancy? (Asterix shows nulliparous only)

A
  1. 8-12 weeks
  2. 16 weeks
  3. 25 weeks*
  4. 28 weeks
  5. 31 weeks*
  6. 34 weeks
  7. 36 weeks
  8. 38 weeks
  9. 40 weeks*
  10. 41 weeks
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10
Q

When is pertussis vaccine offered and what is it for?

A

16 week appointment - whooping cough

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11
Q

When is Symphysis fundal height measured?

A

25 week appointment and every subsequent apptmt

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12
Q

What is treatment for rhesus -ve mother?

A

Anti-D prophylaxis (offer at 28 weeks and then second dose at 34 weeks)and injection of rhesus positive antibodies (to mop up small amounts of fetal blood)

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13
Q

What vitamin is often given at 36 week appointment?

A

Vit K because newborns are often deficient

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14
Q

2 ways to induce labour

A

Membrane sweep or vaginal prostaglandins

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15
Q

Why does membrane sweep induce labour?

A

Separates amniotic sac from cervix to induce prostaglandin release

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16
Q

Define neonate

A

An infant less than 28 days old

17
Q

Define extreme pre-term

A

Less than 26 weeks of pregnancy

18
Q

Define pre-term

A

Less than 37 weeks of pregnancy

19
Q

Define term

A

37-42 weeks of pregnancy

20
Q

Describe post-term

A

Greater than 42 weeks of pregnancy

21
Q

Describe an episiotomy

A

Widening of the vaginal opening before delivery by making an incision in the perineum

22
Q

What are 4 complications of an episiotomy?

A
  1. Bleeding
  2. Infection
  3. Tearing into rectal tissue and anal sphincter (potentially leads to incontinence)
  4. Dyspareunia (pain in genital area during sex)
23
Q

Why does prematurity cause lung problems?

A

There is not enough surfactant to reduce surface tension so the lungs aren’t spongey and elastic
Surfactant is produced from 32 weeks

24
Q

Which cells produce surfactant?

A

Type 2 alveolar epithelial cells

25
Q

When does surfactant start being produced?

A

Approx 32 weeks

26
Q

How is surfactant production induced?

A

Steroids (given to either the mother or fetus)

27
Q

3 Ps for the reasons for delayed labour

A
  1. Power (of uterine contractions)
  2. Passenger (is the fetus too big/ in the right position/breech)
  3. Pelvis (is it big enough for delivery)
28
Q

What can be done in the first stage of labour if the uterine contractions aren’t powerful enough?

A

Perform an amniotomy (break the waters) or give oxytocin

29
Q

What can be done in the second stage of labour if the uterine contractions aren’t powerful enough?

A
Give encouragement
Give syntocinon (synthetic oxytocin) 
Instrumental delivery using forceps
30
Q

How long should be allowed for third stage of pregnancy?

A

30 mins should be allowed for delivery of placenta and membranes

31
Q

What can be done if third stage is delayed?

A

Give oxytocin
Controlled cord traction (pull the placenta gently)
Surgery to manually remove placenta from the myometrium

32
Q

Describe the process of pathologically fetal hypoxia

A
  1. Poor gas exchange between fetus and mother causes an increase in fetal CO2 (hypercapnia) which causes decrease in pH (acidaemia)
  2. Low fetal O2 leads to hyperaemia which causes low fetal O2 in tissues leading to hypoxia which changes respiration from aerobic to anaerobic which increase lactate, which decreases pH which causes acidaemia. Can lead to tissue death (necrosis)
33
Q

What can cause acute hypoxia?

A

During contractions gas exchange doesn’t occur so prolonged contractions can cause acute hypoxia.