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Repro and Sexual Health > Week 4 > Flashcards

Week 4 Flashcards

1
Q

Which anti-emetic is used in pregnancy?

A

Cyclizine

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2
Q

List some complications of pre-eclampsia

A
  • Eclampsia
  • HELLP Syndrome
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3
Q

What does HELLP stand for?

A

Haemolysis
Elevated Liver enzymes
Low Platelets

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4
Q

How can HELLP Syndrome be managed?

A

This condition can only be treated by delivery of the baby, hence ASAP

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5
Q

When is HELLP Syndrome most likely to occur?

A

Immediately after the baby is delivered

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6
Q

What is the triad of symptoms of pre-eclampsia?

A
  1. Hypertension
  2. Proteinuria
  3. Oedema
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7
Q

What do you give as prophylaxis of pre-eclampsia?

A

Aspirin (150mg) from 12 weeks until birth

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8
Q

When during pregnancy does gestational hypertension usually develop?

A

During the second trimester

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9
Q

What are some of the reasons for a baby being Large for Dates?

A
  1. Fetal macrosomia
  2. Multiple pregnancy
  3. Wrong dates
  4. Polyhydramnios
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10
Q

What is the management of Large for Dates?

A
  1. Exclude diabetes
  2. Reassure
  3. Conservative vs IOL vs C section
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11
Q

Define Polyhydramnios

A

Excess amniotic fluid

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12
Q

What is the normal range of Symphysial Fundal Height?

A

Within 2cm on either side of how many weeks along she is

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13
Q

What are some aetiologies of Polyhydramnios?

A
  1. Maternal
    • diabetes
    • red cell antibodies
  2. Fetal
    • twin or multiple pregnancy
  3. Idiopathic
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14
Q

How heavy must a newborn be to be classed as large for gestational age?

A

4.5kg
During pregnancy it is above 90th centile

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15
Q

How does obstetric cholestasis present?

A
  • During the 2nd half of pregnancy
  • severe pruritus
    • (no rash present)
    • Particularly on the palms and soles
  • Very very dark urine, anorexia and steatorrhea
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16
Q

Why do you carry out a left lateral tilt

A

Left-lateral tilt position is used to reduce assumed aortocaval compression by the pregnant uterus

17
Q

At the booking scan an USS is carried out, in this the Crown Rump Length and Nuchal Translucency. What does Crown Rump Length indicate?

A

Indicates the gestation
Plotted on a graph

18
Q

At the booking scan an USS is carried out, in this the Crown Rump Length and Nuchal Translucency. What does Nuchal Translucency indicate?

A

It’s diameter indicates the 3 trisomies and an increased NT could be an early sign/link to a structural abnormality or hydrops

19
Q

From when can CVS be carried out?

A

11-14 weeks

20
Q

From when can amniocentesis be carried out?

A

15 weeks

21
Q

If the booking scan is missed, how can you test for trisomy 13, trisomy 18, and trisomy 23

A

Down’s Syndrome can be tested for on a blood test
Trisomy 13 and Trisomy 18 can be seen on the 20 week scan

22
Q

What is the definitive test for Down’s Syndrome, trisomy 13 and Trisomy 18?

A

NIPT (Non-Invasive Prenatal Testing)

23
Q

Name 2 abdominal wall defects that can be screened for antenatally?

A
  1. Gastrochisis
  2. Exomphalos
24
Q

Define Gastrochisis

A

Gastroschisis is a defect of the abdominal wall, which results in your baby’s bowel being outside of their tummy. This means the bowel is not protected by any membrane or sac.

25
Q

Define Exomphalos

A

Gastroschisis is a defect of the abdominal wall, which results in your baby’s bowel being outside of their tummy. This means the bowel is not protected by any membrane or sac. Exomphalos is a defect at the base of the umbilical cord. It causes the bowel to push through (herniate) into the umbilical cord.

26
Q

Which abdominal wall defect, gastrochisis or exomphalos, is more dangerous and why?

A

Exomphalos is more dangerous because these babies almost always have other problems e.g. chromosomal defects or structural abnormalities

27
Q

When is magnesium sulfate used antenatally?

A
  • Prevention of seizures in pre-eclampsia
  • Treatment of seizures and prevention of
    seizure recurrence in eclampsia
  • Neuroprotection of neonate [in established
    preterm labour or planned preterm birth
    within 24 hours]
28
Q

When is pre-eclampsia defined as Eclampsia?

A

When a woman with pre-eclampsia has at least 1 seizure

29
Q

What antihypertensives can be used for hypertension in pregnancy?

A
  • Labetalol
  • Methyldopa
  • nifedipine
30
Q

Management of severe PET/Eclampsia

A
  1. Control BP: anti-hypertensives
    • IV Labetalol
    • IV Hydralazine
  2. Stop/prevent seizures
    • magnesium sulfate for 24hrs
      • loading dose
      • maintenance dose: IV infusion 1g/h
      • if further seizures administer: 2-4gMg SO4
  3. Fluid balance
  4. Delivery
31
Q

What are some factors that make you high risk for pre-eclampsia?

A
  • current hypertension
  • hypertension during a previous pregnancy
  • CKD
  • autoimmune diseases e.g. SLE or APS
  • T1DM or T2DM
32
Q

Is gestational diabetes likely to recur?

A

Rate of recurrence is high

33
Q

What are some indications that high dose folic acid should be given?

A
  • Coeliac disease (because of the restricted diet)
  • Sickle cell anaemia or thalassaemia
  • diabetes
  • BMI > 30
  • anticonvulsants (for epilepsy)
  • previous pregnancy affected by spina bifida, anencephaly, heart or limb defects and some childhood brain tumours and anaemia
34
Q

When and how much folic acid should be given for women trying to conceive/pregnant?

A

400mcg from before conception to 12 weeks

35
Q

What can deficiency in folic acid cause?

A

Neural Tube Defects (NTDs) e.g. Anencephaly, Spina Bifida

36
Q

Which vitamin is neurotoxic to the fetus in high doses?

A

Vitamin A
Hence no supplementation and no liver (as it is high in it)

37
Q

Why is listeria dangerous in pregnancy?

A

Listeria monocytogenes infection can cause in utero infection. This can cause miscarriages, stillbirths and preterm labour

38
Q

If a woman has a seizure during labour, what is the first line management?

A

Benzodiazepines

Repro and Sexual Health (7 decks)

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