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Phase 3a Obstetrics + sexual health > Terms and physiology + checks > Flashcards

Terms and physiology + checks Flashcards

1
Q

How long is a pregnancy?
What are the 1st, 2nd and 3rd trimesters?

A

40 weeks

1st: 0-12 weeks
2nd:13-27 weeks
3rd: 28-40 weeks

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2
Q

What is Naegele’s Rule for?

A

To estimate the baby’s due date
1st day of last menstrual period, add 7 days, add 9 months

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3
Q

What is gravidity?

A

Number of pregnancies regardless of outcome

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4
Q

What is parity?

A

Number of deliveries beyond 24 weeks not including current

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5
Q

what is primigravida?

A

first time pregnancy regardless of outcome

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6
Q

what is Primiparous?

A

First time delivery >24 weeks

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7
Q

What is Multiparous?

A

2+ births >24 weeks

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8
Q

What is nulliparous?

A

Never birthed >24 weeks

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9
Q

How many weeks are full term?

A

37-42 weeks

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10
Q

How many weeks are premature?
mild?
early?
severe?

A

<37 weeks
mild: 32-27
early: 28-32
severe: <28

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11
Q

What is the gravidity and parity of twins?

A

1 pregnancy and 1 birth
G1P1

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12
Q

What routine vaccines are offered to pregnant women and when?

A

16+ weeks
Pertussis (whooping cough)
Flu

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13
Q

What is the ideal presentation of a foetus in a womb?
Head
lie
placenta
attitude

A

Head first
Longitudinal
upper segment
flexed vertex

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14
Q

How big should the cervix diameter be for delivery?

A

10cm

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15
Q

What 5 things is the placenta responsible for/transport?

A

NICHE
Nutrition
Immunity
Circulation
Hormonal
Excretion

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16
Q

What type of blood does the baby have?
What hormones are exchanged?

A

HbF - high O2 affinity

Progesterone, oestrogen, bhCG, hPL (human placental lactogen)

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17
Q

How do we monitor the foetus?

A

With ultrasound

18
Q

What does CRL stand for?
what does it mean?

A

Crown rump length

The length of the fetus from the top of its head to bottom of torso.

19
Q

How many weeks is it classified as an embryo?

What should the CRL be at 8-12 weeks and 21 weeks?

A

1-8 weeks

50mm

210mm

20
Q

When is surfactant produced?

A

at 35 weeks

21
Q

What is surfactant used for?

A

Reduce surface tension and prevent alveolar collapse after expiration

22
Q

What do we give if the baby is premature? ie. reduced surfactant prod
prenatal?
postnatal?

A

Prenatal - maternal prenatal corticosteroid

Baby surfactant after birth

23
Q

What are the maternal changes in pregnancy?
Cardio?
Haem?
GI?
Immunity?

A

Low BP (high CO but low TPR)

Anemia (high CO + same RBCs)

Dysmotility therefore constipation and GORD

Low immune response

24
Q

What are the maternal changes in pregnancy?
Endo?
GU?
Hormones?

A

poor glycemic control = lots of hypos in DM

High renal excretion and High UTI risk + Asymptomatic bacteriuria (ASB)

High Oestrogen, progesterone, prolactin, T3+T4, bhCG, ESR + CRP, ALP

25
Q

what 3 visual changes can we have and what are they?

A

linea nigra - dark line from umbilicus to pic area

striae gravidarum - stretch marks

Polymorphic eruption of pregnancy - itchy bumpy rash within stretch marks

26
Q

What is the main things midwifes check every appointment?

A

symphysis fundal height (SFH)

27
Q

What is SFH and what is it used for?
what is the normal height?

A

Distance from the pubis symphysis to the top of the uterine fundus

Monitors fetal growth

+/- 2cm for gestational age

28
Q

What is the first check that is done and its name?
How many weeks?
What is tested/checked?

A

8-12 weeks
Booking
Screen mum for Hep B, HIV, Syphilis, sickle cell and thalessemia (HHSST)
BMI, BP, FBC

29
Q

What is after the booking scan?
How many weeks?
What is tested for in that?

A

Dating scan
11-13+6 weeks
USS to check Nuchal translucency
Check the bhCG, PAPP-A

30
Q

What does nuchal translucency check?
What is PAPP-A? What does it check for?

A

thickness of tissue round baby’s neck

Pregnancy associated plasma protein - protein made by placenta

checks for trisomy 13 (Palau’s syndrome), 18 (Edwards syndrome) and 21 (Downs syndrome)

31
Q

What do we look for specifically in the bhCG, PAPP-A and nuchal translucency for Downs?

A

High bhCG
Low PAPP-A
>/ 6mm nuchal translucency

32
Q

What do we check for at 18 - 20+6 weeks? what is that appt called?

A

Anomaly/anatomy USS

Congenital heart defects (CHD), Neural tube defects (NTD), Gastroschisis + omphalocele, placenta previa

33
Q

What is checked at 28 weeks?

A

OGTT + Rhesus if Rhesus Negative
Midwife - BP Checks, SFH, Urine dip

34
Q

What checks are done and 34, 38 and 41 weeks?

A

34 weeks - USS + 2nd RhoGAM dose, 2nd placenta previa scan

38 weeks - Discuss long PREG

41 weeks - Discuss inducing labour

35
Q

what is the technique to induce labour called and what happens in it?

A

Membrane sweep
Finger around cervix to induce labour

36
Q

What are all mums advised to take/stop?

A

Vit D suppose 10mcg/day
folate for first trimester
smoking cessation
no alcohol
Healthy eating

37
Q

What are 3 other tests that are done?

A

CVS (Chorionic villi sample)
Amniocentesis
NIPT (Non invasive prenatal testing)

38
Q

When is CVS done?
what is it done for?

A

11-14 weeks
cells from the placenta
checks for chromosomal conditions

39
Q

Amniocentesis
when is it done? what is it to check for?
What are the risks and %?

A

15 weeks
sample amniotic fluid to check for trisomy 13, 18 and 21
Risk 0.5-1% miscarriage, precipitation of RHD, clubfoot and infection

40
Q

NIPT (Non invasive prenatal testing)
when is it done?
what do we do/look for?
how sensitive for which disease?

A

screening test done between 15-20 weeks
sample mums blood for cffDNA (Cell free foetal)
99% sensitive for Downs

41
Q

What is the quad test?
when is it done?
Tests for?
what is shown on the test?

A

15 weeks
tests for downs
High bhCG
Low AFP
Low E3
High Inhibin A

42
Q

What is a hyperechogenic bowel?
what is it associated with?
When is it seen?

A

18-20 weeks
downs, CF, CMV+B19
non specific marker - brighter appearing bowel

Phase 3a Obstetrics + sexual health (15 decks)

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