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Reproductive > Problems in Pregnancy > Flashcards

Problems in Pregnancy Flashcards

1
Q

What may cause a large for dates pregnancy?

A 
Wrong dates
Foetal macrosomia
Polyhydramnios
Diabetes
Multiple pregnancy
Obesity
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2
Q

At which birth weight is c-section recommended if the baby is large for gestational age?

A

5kg

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3
Q

What is polyhydramnios?

A

An excessive amount of amniotic fluid.

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4
Q

What is the most common form of twinned pregnancy?

A

Dizygotic (70% of cases).

Arising from 2 separate eggs being fertilised by 2 separate sperm

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5
Q

What increases risk of all pregnancy complications?

A

Diabetes

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6
Q

What is the most common cause of iatrogenic prematurity?

A

Pre-eclampsia

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7
Q

What is pre-eclampsia?

A

A condition arising during pregnancy characterised by high BP, proteinuria and oedema.

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8
Q

Do all 3 classic symptoms of pre-eclampsia always appear?

A

No, this does not rule out diagnosis.

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9
Q

Can pre-existing hypertension be diagnosed during pregnancy?

A

No, needs to be diagnosed prior to pregnancy or 3 months after (if not returned to a normal level).

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10
Q

Pregnancy-induced hypertension occurs when?

A

The 2nd half of pregnancy.

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11
Q

What occurs in pre-eclampsia physiologically?

A

Diffuse vascular endothelial dysfunction alongside circulatory disturbance.

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12
Q

At which gestation is early pre-eclampsia diagnosed?

A

Before 34 weeks.

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13
Q

At which gestation is late pre-eclampsia diagnosed?

A

After 34 weeks.

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14
Q

What are the 2 stages of pre-eclampsia?

A

Abnormal placental perfusion

Maternal syndrome

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15
Q

What is seen in HELLP syndrome?

A

Haemolysis
Elevated liver enzymes
Low platelets

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16
Q

What can commonly be the first marker of pre-eclampsia?

A

Elevated serum urate.

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17
Q

How should pre-eclampsia be investigated?

A 
U+Es
LFTs
FBC
Coagulation screen
Check BP
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18
Q

What can be given to reduce the risk of pre-eclampsia?

A

Low dose aspirin.

This is safe to take in pregnancy.

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19
Q

When should a patient with pre-eclampsia be admitted?

A

If BP > 170/110mmHg, or BP>140/90mmHg with ++ proteinuria
Abnormal biochemistry
If symptoms are significant
Upon initiation of antihypertensive treatment
If there are signs of foetal compromise

20
Q

What does a MAP > 150mmHg indicate?

A

There is a significant risk of a cerebrovascular accident.

21
Q

At which Bp should antihypertensive treatment be initiated in pregnancy?

A

> 150/100mmHg

If > 170/110mmHg, treat immediately.

22
Q

What drugs are used to treat hypertension in pregnancy?

A

Methyldopa
Labetalol
Nifedipine

23
Q

When is methyldopa contraindicated?

A

In patients with depression.

24
Q

When is labetalol contraindicated?

A

in asthmatic patients.

25
Q

Is it possible to cure pre-eclampsia?

A

yes, only achievable by delivering the baby.

Important to stabilise the mother first.

26
Q

When is delivery of the baby indicated in pre-eclampsia?

A

At-term gestation (37 weeks)
Inability to control BP
Rapid deterioration of the mother
Progression to eclampsia

27
Q

What is eclampsia?

A

A seizure in association with hypertension occurring during pregnancy.

28
Q

What form of seizure is seen in eclampsia?

A

Tonic clonic seizure

29
Q

How is eclampsia treated?

A

Magnesium sulfate infusion.

This can be given prophylactically.

30
Q

Which age group most commonly suffers from eclampsia?

A

Teenagers

31
Q

What is defined as small for gestational age?

A

An infant born with a birthweight below the 10th centile.

32
Q

What is defined as a low birthweight?

A

Infant <2.5kg at birth.

33
Q

Is small for gestational age, the same thing as a low birthweight?

A

No.

34
Q

What is foetal growth restriction?

A

Failure of the foetus to achieve its genetic growth potential.

Suggestive of a pathological obstruction.

35
Q

Is SGA always a sign of pathology?

A

No, around 70% are meant to be small.

Try not to overtreat.

36
Q

Treatment for SGA is initiated if below which centile?

A

3rd centile.

37
Q

Are SGA babies more likely to be stillborn?

A

Yes

38
Q

At which gestation should the measurement of the symphysis-fundal height begin?

A

24 weeks.

If below the 10th centile, refer.

39
Q

How is SGA diagnosed?

A

USS
Measurement of the abdominal circumference
Estimated foetal weight

40
Q

What is uterine artery notching a risk factor for?

A

Foetal growth restriction

41
Q

If SGA is detected, how often should measurements be taken?

A

Every 2 weeks.

42
Q

How should pre-eclampsia/uterine artery notching treated prophylactically?

A

150mg of aspirin taken nightly from 12 weeks gestation.

43
Q

What are the main tools used to measure foetal growth?

A

Umbilical artery doppler

Abdominal circumference

44
Q

When should babies found to be between the 3rd and 10th centile be delivered?

A

39 weeks gestation

45
Q

When should babies below the 3rd centile be delivered?

A

Between 37 and 37+6 weeks.

46
Q

What should be given to reduce complications and promote foetal lung maturity in premature babies?

A

Steroids

47
Q

How should labour be monitored in SGA babies?

A

Continuous CTG

Reproductive (28 decks)

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