Week 5- other preganacy conditions

Question 1

What is hyperemisis gravidarium?

what are the causes and things to consider

Answer 1

sevre vomitting
Causes- unknown, endocrine?
often assocaited with multiple births (twins, tripplets)

Starts around 6 weeks
may last longer than first trimester

consider electrolytes and hypovolemia

Question 2

what is the managment for hyperemisis gravidarum?

Answer 2

History: EPOMS
Examination- vital signs, vomitus, skin, turgor
Managment- transport to primary obsetric service- consult with clanician- ?IVF, ?antiemetic

Question 3

what is an in compitent cervix?

Answer 3

painless dilation of cervix, the foetus, placenta and membranes completly expelled- painless delivery of foetus usually in second trimester (16-23 weeks)
- If known stich paced untill dilation of the cervix

Question 4

what are reduced foetal movements?

Answer 4

foetal movements start 16-24/40, recognise normal pattern by 28 weels- expect 10 movements in 2 hours

maternal concern with decreased movments overids any definition of DFM- should be assessed within 2 hours of noticing.

Question 5

what assesments will the hospital do if there is reduced foetal movements?

Answer 5

Need to consider risk factors for still brith; foetal growth restriction, hypertension, diabetes, advanced maternal age
Examination and investigation depends on gestation and risk factors

Question 6

What is the definition of a venous thromboembolism?

What id deep vein and PE?

is it more likley in pregnant people?

Answer 6

Thrombus in the venous system which becomes detached- lodges elsewhere. Deep vein- lodged in the veins of the legs or the pelvis
PE

it is 10 times more common in pregnant women than in women the same age that are not pregnant.

Question 7

what are the risk factors for deep vein thromboembolism?

Answer 7

age >35
obesity
parity >4
History of thromboembolism
prolonged travel
operative delivery
instrumental vaginal delivery
prolonged labour >12 hours
> 4 days bed rest or immobility

Question 8

What is the ambulance diagnosis and treatment for venous thromboembolism?

Answer 8

DIfficult to diagnose
Manage as per non-pregnant paitent, consut PIPER or clinician, MICA early, Upright poistion, Oxygen and rapid transport with notification

Question 9

what i amniotic fluid embolism?

Answer 9

Rare condition- unpredictable-without warning, rapidly progressive, patho unknown.

Usually during labour or procdure- amniotic flud entres maternal circulation and there is anapylaxis or activstion of complement cascade

Question 10

what are the sings and symptoms of amniotic fluid embolsim?

Answer 10

Acute resp distress or collapse after birth or push

Symptoms prior to colapse- breathlessness, chest pain, cold and light headed, restlessness, paniced and distressed, pins and needles, nausea and vomitting.

Question 11

what is the av managment for amniotic fluid embolsim?

Answer 11

Manage what you see
oxygen therapy
IV enroute- fluids to maintain CO
consult
lights and sirens with pre-alert

Question 12

what are the causes of sepsis likned with pregnancy?

- antenatal and post-partum periods

Answer 12

Often due to genital tract

A- misscarriage, termination of pregnancy, cervical structure, ruptured ectopic

p- retained producys, postoperative infections

could also be unrealted to pregnancy

Question 13

what are the signs and symptoms of sepsis in pregnancy?

Answer 13

Everything from normal spepsis plus vaginal discharge, abdo pain and D and V
DIC and uterine atony common: can lead to PPH

Question 14

what is the managment for a pregnant sepsis paitent?

Answer 14

In sevre sepsis the foetus needs to be delivered
- manage as per non-pregnant paitents
Pre-alert and time critical pt transport

Question 15

when is suicide highest in pregnancy?

Answer 15

in the third trimester

Question 16

what is tokophobia?

Answer 16

pathological fear of pregnancy can lead to an avoidance of childbirth

Question 17

what are the risk factors for mental health presentations ?

Answer 17

women in late pregnancy and first three months post partum
previous mental health issues
social isolation
previous puerperal psychosis
recent termination
unwanted pregnancy

Question 18

what is the managment for mental health conditions in pregnancy?

Answer 18

new onest- transport and follow up
support and guidance
good communication
check environment if safe for the baby

Question 19

what are the most common minor conditions of pregnancy?

Answer 19

naesea and vomitting, constipation, reflux, heammorides, vericose veins, pelvic gerdle pain, carple tunnel syndrome

Question 20

what causes fainting in pregnancy?

Answer 20

vasodilation and poor venus return to heart
supine hypotension in later pregnancy >28 weeks
anemia

Question 21

what is the managment for fainting in pregency

Answer 21

left lateral position

don’t stand or lay down for prolonged periods of time

Question 22

what causes anemia in pregnancy?

Answer 22

increased blood volume 30-50%
increased red blood cell mas 18-20%
plasma volume increase 50%

Question 23

what are the sings and symptoms of anemia in pregnancy?

Answer 23

weakness, fatigue, dizziness, SOB, palpitations

Question 24

what is the managment for anemia in pregnancy?

Answer 24

increased iron dietry and supplimentary

Question 25

what causes varicose veins in pregnancy?

Answer 25

progesterone relaxes smooth muscle

increasing weight an dpelvic congestion puts pressure on circulitory system

Question 26

what is the managment of vericose veins in pregnanacy?

Answer 26

leg exercises, raising legs when able, compression stockins, usually cease after preganancy

Question 27

what is the cause of morning sickness in pregnancy?

Answer 27

nausea and vommiting usually occurs in the 1st trimester- cause unknown due to HGC? Oestrogen?

Question 28

what is the managment of morning sickness?

Answer 28

smaller, more frequent meals, ginger, prescription meds

Question 29

what are some of the complications of morining sickness in pregnancy?

Answer 29

Dehydration and loss of weight

Question 30

what causes heart burn in pregnancy?

Answer 30

usually late
progestorone relaxes the gastric sphincter
as size of foetus gros, there is increased pressure on the stomach and gastric contests into the oesophegus

Question 31

what is the managment of reflux?

Answer 31

avoid bending over, small meals, sleep semi-recumbant, if severe antacids

Question 32

what are the causes of constipation in pregnancy?

Answer 32

Progestorone relaxes the bowel, bowel displaced by growing uterus, iron suppliments

Question 33

what is the managment for constipation?

Answer 33

high fibre diet, moderate exercise

Question 34

why xo pregnant people experince frequent urine output and UTIs?

Answer 34

bladder compressed by growing uterus

Question 35

what are some of the things that cause musculoskeltal back pain in pregnancy?

Answer 35

Progesterone and relaxin later are muscle relaxants
there is a change in the centre of gravity
weak pelvic floor muscles and activation of the core

Question 36

what causes carpel tunnel in pregnancy?

Answer 36

progesterone causes genralised odeam- in the wrist can put pressure on the median nerve

Question 37

what are the signs and symptoms of carple tunnel syndrome?

Answer 37

pain

wekaness and pins and tingling

Question 38

what is the managment for carpal tunnel sydrome?

Answer 38

reassure- resolve after pregnancy
raisinf hand on illow ad night
splinting of the hand at night