Week 3 videos

Question 1

antenatal growth chart

Answer 1

Customized (pubic symphysis fundal height, fetal weight)

detects foetus size

Question 2

what may be the cause of small sized baby

Answer 2

Uteroplacental insufficiency
Chromosomal abnormalities
Foetal abnormalities
Foetal infections

Question 3

what are the causes of a large baby

Answer 3

Gestational diabetes
Insulin dependent

Question 4

what is eclampsia

Answer 4

Hypertensive disorder - multi organ, new onset hypertension raised bp 20 weeks post gestation

Can occur
Antepartum
Intrapartum
Postpartum

Question 5

what are clinical features of eclampsia

Answer 5

Clinical features
bp>160 systolic
Hyperrelexia
Visual changes
Tonic clonic

Question 6

what are differentials of eclampsia

Answer 6

Epilepsy
Encephalitis
Metabolic disorders

Question 7

when eclampsia is an obstetric emergency how is it managed

Answer 7

ABC, lfts, U&E, coags
IV Magnesium sulphate, antihypertensive, deliver child

Question 8

what are complications of eclampsia

Answer 8

HELLP syndrome
DIC
Acute respiratory distress
Pulmonary oedema
Aspiration
Fetal hypoxia
Increased maternal mortality

Question 9

how does magnesium sulphate aid eclampsia

Answer 9

Magnesium sulphate causes cerebral dilatation
Competitively blocking calcium at synaptic nerve endings

Should be continued 24H post delivery

Safety net
Low dose aspirin from 12 weeks

Question 10

how is chicken pox spread

Answer 10

Respiratory droplets (fever, malaise, vesciular rash)
Infectivity 48H before rash develops → once lesions have crusted over 5-7 days

Small risk congenital infection in first 28 weeks pregnancy

Question 11

what is foetal varicella syndrome

Answer 11

Skin scarring
Congenital eye abnormalities
Neurological abnormalities
Hypoplasia ipsilateral limbs
No increased risk miscarriage

Question 12

when does shingles develop

Answer 12

dormant virus remain in sensory nerve root

Question 13

what should be the steps for a pregnant women following exposure to chickenpox

Answer 13

IgG taken
positive - reassure
negative - offer VZ immunoglobulin

Question 14

Parvovirus B19
Slapped cheek disease
how does it spread

Answer 14

Fever
Rash
Erythema cheeks
Aplastic anaemia / haemolysis
Preeclampsia oedema

Question 15

what can be the effect of slapped cheek disease on a foetus

Answer 15

cardiac failure
Hydrops retalis
Fetal death

12-20 weeks
Fetal infection 5 weeks after maternal

Question 16

how is toxoplasmosis spread

Answer 16

Infected cat faeces or undercooked meat
asymptomatic , mild flu like symptoms, dever, sore throat
Arthralgia, coryza

Parasitaemia 3 weeks post ingestion

Question 17

what are serious complications of toxoplasmosis

Answer 17

Chorioretinitis
Encephalitis
Myocarditis
Pneumonitis

Question 18

what are foetal complications of toxoplasmosis

Answer 18

Hydrocephalus
Intracranial calcifications
Microcephaly
Chorioretinitis
Ventriculomegaly ]IUGR
Ascites
Hepatosplenomegaly
Miscaarriage intrauterine death (3rd trimester highest risk

Question 19

what steps should be taken if a pregnant individual has HIV

Answer 19

Increased risk
Preeclampsia, miscarriage, preterm delivery, low birth weight

Referral to neonatology for hiv testing following birth

MDT input
Obstetric consultant team
Community midwifery
Hiv specialist
Neonatologist
GP

Treatment
cART
Viral load <50
Reduce risk vertical transmission
Improve mothers health

Question 20

hepatitis B how is it tranmission

Answer 20

Blood body fluids vertical transmission

Women chronic HBV and high viral load - tenofovir monotherapy

Vaginal birth safe

Question 21

if a foetus has been born from a mother with Hep B what should be done

Answer 21

Hep B immunoglobulin
Accelerated immunisation schedule
Initial dose vaccine at birth within 24H of delivery, further 4 doses 4 weeks and 8 weeks and fourth 12 months age

Question 22

Hepatitis C in a pregnant women

Answer 22

decline in liver function

no treatment in pregnancy - teratogenic

Question 23

syphyllis mode of transmission

Answer 23

Direct contact skin lesion
Infection possible more than once

Increased risk
Miscarriage
Stillbirth
Hydrops fetalis
Growth restriction
Congenital infection
Can spread trans-placentally
Congenital symptoms 5 weeks - 12 moths life

Hutchinsons triad
Hutchisons Teeth
Interstitial keratitis
deafness