Antenatal Care
18 important questions on Antenatal Care
Normal blood pressure changes in pregnancy
Rises in 3rd trimester
Clinical Manifestations of Pre-eclampsia
Proteinuria
Hypertension
Eclampsia
Liver damage
Clotting abnormality
Assessment of Protein in pre-eclampsia
24hr collection <0.3g/24hrs
Protein:Creatinine ratio > 30mg/nmol
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Foetal complications in Gestational diabetes
Preterm labour in 10%
Birthweight increased (hyperinsulinaemia/fat deposition)
Polyhydramnios
Maternal Complications in Gestational diabetes
Diabeteic nephropathy
Retinopathy
Management of Pre-existing diabetes in pregnancy
Visitis until 34 weeks fortnightly
Monitor foetus
Aspirin 75mg daily for 12 weeks to reduce risk of pre-eclampsia
Delivery by 39 weeks (c-section if exceeds 4kg)
Management of Gestational Diabetes
Metformin
Insulin if high
Respiratory changes in pregnancy
RR stays the same
Asthma common in pregnancy
Renal changes in pregnancy
Urea and creatinine levels decrease
Illegal Drugs and Pregancy
Cocaine = IUGR; placental abruption; teratogenic; Intellectual impairment
Ecstasy = teratogenic (cardiac defects and gastroschisis)
Benzodiazepines = facial clefts; neonatal hypotonia and withdrawal
Cannabis = IUGR and later development (hard to be sure as people tend to use more than just cannabis
Foetal alcohol syndrome
IUGR
Abnormal or small brain
Developmental delay
> 18 units per day
Treatment for Anaemia in Pregnancy
Folic acid can co-exist. Symptoms absent unless <9g/dL
Oral iron
Folic acid and vit B12 should be considered in macrocytic anaemia.
Management of non-viable intrauterine pregnancy
Medical (prostaglandins)
Surgical
Sites of ectopic pregnancy
Ovary
Cervical
Cornual (where tubes and uterus meet)
Abdominal
Clinical Features of ectopic
Dark vaginal bleeding
Amenorrhea in 4-10 weeks but may think vaginal bleed is period
Movement of uterus may cause pain
Cervical os closed
Intrauterine Growth Restriction
Ultrasound assessment of foetal growth
Doppler waveforms of the foetal circulation
CTG
Abdominal wall defects
Gastroschisis (free loops of bowel in the amniotic cavity)
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