Y2 cases Flashcards
Thrush
Fungal infection affecting vagina, nipples or mouth in both mum and baby. Can be uncomfortable and affect breastfeeding. Treated with topical clotrimazole cream that can be found in pharmacies.
Syphilis
STI (bacterial), mostly affecting male to male sexual activity, screened for at booking as potentially fatal to fetus if mother has primary infection during pregnancy. Spirochetes bore through the skin and create a painless chancre at infection site, very contagious. Other symptoms can be fever, swollen lymph nodes, tiredness, headaches, joint pain. Later a rash can develop and finally major organs go in to self-defence overdrive and start shutting down. Fetus very likely to be affected and can cause miscarriage, stillbirth, pre-term birth, polyhydramnios, hydrops, congenital syphillis. treated with Penicillin IM injection and baby will need a paediatric review. After treatment MWU possible, if access to paediatric care.
Chalmydia
STI (bacterial, the most common) most people have no symptoms but some have thick smelly discharge, bleeding in between periods/after sex, pain in lower tummy and painful urination. Treated with oral antibiotics. Can cause pneumonia and conjunctivitis in baby if untreated.
Anaemia
Not enough Hb in blood, leaving body lacking oxygen. Can cause tiredness, being pale, breathlessness. Risks to baby are rare but might include include IUGR and premature birth. Mum might get PPD. Treated with oral iron therapy, regulated diet and blood transfusion in severe cases.
Hypertension
High blood pressure, can be caused by many things, pre-eclampsia being one. Can lead to an underdeveloped placenta, IUGR, placental abruption and preterm birth as not as much oxygen can make it through the narrowed blood vessels of the placenta. Treated with vasodilator such as Labetalol, which can make baby hypoglycaemic.
Eczema
No risks to baby, treated with topical hydro cortisol cream. Baby might be affected as well later in life.
Sickle cell anaemia
Recessive autosomal. Affecting mostly people from African/Caribbean decent. Red blood cells have odd shape, affecting their ability to transport oxygen. They sometimes clot up and block blood vessels, causing a painful sickle cell crisis. Might require repeated blood transfusions. Condition can worsen in pregnancy.
Rubella
Viral, part of the MMR vaccine. Spots/rash and fever but severity of symptoms vary greatly. If contracted in first trim, baby will get it as well, leading to miscarriage, stillbirth and deformities (microcephaly, cardiac, cataracts, learning impairment), deafness is common. No specific treatment for rubella.
Cystic fibrosis
Autosomal recessive. affects epithelial cells, causing thick and stringy mucus. Most organs will be affected, mainly lungs and recurring lung infections are common. Symptomatic treatment but no cure, shortens life expectancy to about 40 yo. Gets progressively worse.
Hyperemesis gravidarum
Extreme nausea and vomiting in pregnancy. Can leave mum lacking fluids and with extreme fatigue and weight loss. Unlikely to harm baby although the mother feels very ill. Might cause low birthweight. Mothers might need admission for fluids and may require anti emetics to keep food down.
GBS
Common (ca 18%) bacteria colonising vagina or bowel, normally as asymptomatic but can be passed on to baby during birth, causing infection and sepsis. Avoided through Antibiotics in labour and obs of baby in the first 24 hrs (90% of affected will develop symptoms at early onset). Vertical transmission- early onset, horizontal transmission- late onset (7 days to 3 months). Most babies will recover fully, ca 10 % will die (prematurity huge risk factor). GBS is not screened for as results and timing are suboptimal. Sometimes picked up when investigation has taken place for something else.
Eating disorders
Can cause mother to be dehydrated, cardiac problems, anaemic and weak, linked to depression, low milk supply. Baby can be small and born early. CBT can help, usually better to address problems before falling pregnant.
PN depression
Affectin 1 in 10 mums (sometimes dads). Symptoms: low mood, not feeling joy, struggle to bond with baby, intrusive thoughts. Can develop into psychosis. Treatment include: self help, psychiatry, antidepressants.
Can affect BF.
Mastitis
Follows engorgement of the breast in BF mothers. A blocked milk duct causes build up of milk, leading to inflammation. Red, swollen and very sore triangle appear on breast. Mum displays flu symptoms and can develop into bacterial mastitis. Treated with antibiotics. Important that baby keeps feeding of the affected boob.
Haemorrhoids
Piles, swollen enlarged veins, inside or outside the rectum. Can be very sore and are common in pregnancy/after birth. Avoid constipation and “pushing” when pooing, lots of fluid intake and fiber in food. Can use icepack and paracetamol for the discomfort. A bath can ease the itching. May require lactulose and topical cream.
Smoking- Risk to baby
SGA, preterm birth, Cleft lips, greater risk for asthma and infections later in life.
Drinking- risk to baby
FAS- Range of different issues. If intake high early in pregnancy it can cause facial features and physical deformities, later affects neurological development causing ADHD, learning impairment, hyperactivity, cognitive function.
Club feet
Talipes, affecting one or both feet and varying in severity. Tendons in babys leg are too tight causing the foot to turn inward/backwards. If positional it is likely to correct it self within 6 months. If severe it can be treated through using splints and this is very successful, referral to orthodontics.
PROM
When water break >24 hrs before birth. Inreases the risk of infection in baby and will therefor require obs for 24 hrs after birth to pick up on signs of sepsis early. baby may require antibiotics.
Breech
Risks during labour: cord prolapse/compression, the body descending before the cervix is open enough to deliver the head, head extension (causing it to get stuck).
Post birth: Greater risk of needing resus/ being hypoxic. Hip dysplasia. No difference in outcomes in one year olds.
Rashes
Often benign, erythema toxicum, babys skin adjusting to extrauterine life. They mostly go away on their own, can be eased with nut oil. If the rash persists, referral to paeds or go to GP
Jaundice
Failure to breakdown red-blood cells, often occurs in newborns between 2-3 and two weeks of age. Normally resolves on its own but might need light treatment if symptoms persist. Symptoms are yellow skin/sclera, lethargy, reluctant feeder, low urine/stool output. If untreated it can cause brain damage. Severity tested wit SBR, serum bilirubin test.
Risks- RH negative
Maternal Rh- and fetal Rh+ can cause issues for the fetus has the mother been previously sensitised. Maternal blood cells attack the fetal ones, potentially causing anaemia, jaundice, brain damage, heart failure and stillbirth.
Citalopram
Antidepressant, preferred to others in pregnancy. Ok for BF
Labetalol
Vasodilator, can be used in pregnancy, note it can make baby hypoglycaemic, check sugars. Too low if below 2 mml.. normally between 2,5-7 mml.
Paracetamol
Analgesia, ok to use in pregnancy/while BF within recommended limits (1g/4 hrs, max 4 g/24 hrs)
Iron therapy
Might be needed if mother is anaemic, to be taken with food and vit C to maximise intake.
Hydrocortisone
Topical cream for eczema is not harmful during pregnancy, don’t use on baby, consult your GP for them.
Aspirin
Might be prescribed in low dose if mother shows risk factors for pre-eclampsia. It dilates the blood vessels in the placenta, lowering risk of IUGR.
Aspirin is NOT recommended as analgesia whilst BF.
Clotrimazole
Topical cream for thrush, can be picked up from a local pharmacy.
Lactulose
oral liquid for constipation.
Laxedo
Sachets with powder to be mixed with water for constipation.
