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Risikosvangerskap Flashcards

2
Q

Hvilke fakotorer er assosiert med økt risiko ved svangerskap?

A
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3
Q

Hvilke komplikasjoner utgjør 90% av alle perinatale dødsfall?

A
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4
Q

Hvor er det preeklampsi har sitt utspring, og hvordan er prevalensen?

A

Er en sykdom der patofysiologien stammer fra placenta.

Prevalens på 2-3%.

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6
Q

Hvilken tommelfingerregel har man når det gjelder alvorlighetsgraden til preeklampsi, og hvilke former er alltid alvorlige?

A
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7
Q

Hvilke risikofaktorer er identifisert for at en pas. få preeklampsi?

A
APS; Antiphospholipid syndrome.
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8
Q

Hvilken risikofaktorer er mest knyttet opp til preeklampsi?

A
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9
Q

Hvilket medikament har vist å redusere forekomsten av PE?

A
Here is the data of the recent meta-analyses in more detail: Bujold meta-analysis (2010) showed that aspirin treatment initiated before 16 weeks reduced the risk of PE by 50% (and IUGR by 55%) in high risk women. The following study (Roberge 2012) showed that low dose aspirin administered at or before 16 weeks of gestation reduces the risk of preterm PE by 89% (but not term PE). There was also a reduction in perinatal death (about 70%).

https://www.youtube.com/watch?v=E4XHwBLQw3Q

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10
Q

Hvilke pas. er anbefalt å starte med ASA ved svangerskap?

A
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11
Q

Hvordan er algoritmen for å predikere risikoen for at en kvinne vil få preeklampsi?

A
PLGF; Placental growth factor. PAPP-A (Pregnancy associated plasma protein-A); A protein produced by the placenta. It is needed for the implantation process and to maintain a healthy placenta (afterbirth).

https://ntnuopen.ntnu.no/ntnu-xmlui/bitstream/handle/11250/3100148/pdf-export-62769.pdf?sequence=1&isAllowed=y

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12
Q

Hvilke forskjeller i Doppler av uterinarteriene er det mellom en ikke-gravid og en gravid?
Hva er pulsatile index?

A
Lav ende-diastolisk blodstrøm og tidlig diastolisk notch karakteriserer kurveformen av uterinkarene hos ikke-gravide eller tidlig første trimester. Persisterende ende-diastolisk notch utover gestasjonsuke 24 og eller blodstrøms ratio PI er assosiert med inadekvat trofoblast invasjon. Pulsatility Index er en analyse av blodstrømmens pulsatilitet, kvalitativ informasjon og vinkeluavhengig.
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13
Q

Hvilke angiogeniske placentaassoiserte proteiner finner man i maternelt blod, og hvilke nivåer tyder på en placental dysfunksjon?

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14
Q

Hva ble vedtatt i beslutningsforum i 2023?
Hva er dette basert på?

Preeklampsi

A
The performance of the 1° trimester screening of pre-eclampsia with this model has been evaluated in a huge prospective study with almost 60 000 women. All PlGF measurements were measured with PerkinElmer instrument,DELFIA Xpress. In this study, in this population mix the DR for pre-eclampsia Screening by maternal characteristics, biophysical and biochemical markers detected 96% of cases of PE requiring delivery before 34 weeks and 54% of all cases of PE at fixed FPR of 10%. This method is very effective in identifying the women who are at high risk of developing PE early (<34w), which is the same group that are likely to benefit from treatment with aspirin. It also identifies a high proportion of cases that will develop middle or late PE.
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15
Q

Hva slags blodtype (ABO og Rh) er vanlig i forskjellige befolkningsgrupper?

A
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16
Q

Under hvilke omstendigheter dannes det antistoffer mot Rh+?

17
Q

Når blir antistoffer mot et Rh- barn et problem?

18
Q

Hva er rhesus profylakse, og hvem skal få dette?

A
Amniocentesis is a test done during pregnancy. During amniocentesis, an ultrasound wand (transducer) is used to show a baby's position in the uterus on a monitor. A sample of amniotic fluid, which contains fetal cells and chemicals produced by the baby, is then taken for testing.
19
Q

Når tar man blodserologi av gravide?

20
Q

Ved hvilken MCA PSV er det indikasjon for føtal anemi?

A
MCA PSV; Middle cerebral artery peak systolic blood flow.
21
Q

Hva er behandlingen av føtal anemi, og hvilket resultat gir det?

A
Hydrops fetalis — or hydrops — is a condition in which large amounts of fluid build up in a baby's tissues and organs, causing extensive swelling (edema).
22
Q

Hva må huskes om Rh-d?

Svangerskap

23
Q

Hvilke strukturer us. ved obstretisk Doppler?

24
Q

Hvordan regner man ut pulsatility index?

A
PI = (peak systolic velocity–end diastolic velocity)/(mean flow velocity).
25
Q

Hva viser dette bildet?

26
Q

Hva viser dette bildet?

27
Q

Hvordan klassifiserer man Doppler av a.umbilicalis som BFC?

28
Q

Hvordan er prevalensen av ICP, og hva tenker man er mulige årsaker?

A
Although the exact mutations that lead to ICP are as yet unknown, ICP is still seen to be running in families. It is speculated the these faulty genes may interfere with the removal of the breakdown products of the female hormones estrogen and progesterone and as the levels of these hormones rise in blood during pregnancy the risk of ICP rises Environmental factors such as diet and seasonal variations are also implicated in causation of ICP. Presence of gall bladder stones and Hepatitis C also raises the risk of ICP. However, these causes are usually accompanied by a genetic predisposition in most cases.
29
Q

Hva er symptomer på ICP?

30
Q

Hvordan diagnostiserer man ICP?

A
Otherwise unexplained abnormalities in transaminases, gamma-glutamyl transferase and/or bile salts are considered sufficient to support the diagnosis of obstetric cholestasis.
31
Q

Hvordan behandler man ICP?

32
Q

Fyll ut figuren

A
Figure 2. Pathophysiology of hemolytic disease of the fetus and newborn.
33
Q
A
Monitoring pregnancies at risk of hemolytic disease of the fetus and newborn (HDFN).
34
Q

Hvilke celleantistoff har mest potensiale for alvorlige komplikasjoner?

A
The role of red cell antibodies in the occurrence of hemolytic disease of the fetus and newborn and clinical manifestations. 1; A blood group system is formed by antigens encoded by allelic genes, such as A, B, and O in the ABO blood group system and those encoded by linked genes, such as the alleles D, C, E, c, and e of the Rh system. To date, a total of 36 blood group systems have been identified, encompassing more than 350 red cell antigens, over 50 of which have been implicated in HDFN. 2; Severe: requiring intrauterine transfusions and/or neonatal exchange transfusions. Moderate: call for late preterm birth and/or neonatal top-up transfusions. Mild: phototherapy usually suffices. 3; The prevalence of red cell antigens varies greatly on the basis of ethnic background, with 15% of people of European origin being RhD negative, compared with 5% of people of African and less than 1% of people of Asian descent.
35
Q

Hvilke antistoffer screener man for i Norge?

A
Routine antenatal screening in the Norway.
36
Q

Hvilke kliniske tilstander øker risikoen for alloimmunisering ved svangerskap?

A
Clinical conditions associated with a risk of immunization.

Obstetrikk (11 decks)

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