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17 Cards in this Set
- Front
- Back
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Effects of ETOH on developing fetus
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Fetal ETOH syndrome
1. Growth restriction 2. CNS involvement (structural, neurological, functional impairment) 3. Craniofacial dysmorphic features (short palperbral fissues, thin upper lip, abnormal philtrum, hypoplastic midface) |
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Effect of smoking of the developing fetus
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Lower average birth weight
Dose-dependent can be reversed if smoking is stopped early in pregnancy spontaneous abortion prematurity placental abruption premature rupture of membranes stillbirth increased risk of SIDS |
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Effects of opiates on developing fetus
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no teratogenic effects
risk of withdrawal Miscarriage, preterm delivery, and foetal death seizures |
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Effect of cocaine on the developing fetus
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Placental abruption
IUGR Preterm labour and delivery CNS complications and developmental delay Causes vasoconstriction and hypertension |
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effects of amphetamines on developing fetus
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Decreased head circumference, length, birth weight
increased rates of abruption, prematurity, growth restriction intracranial lesions - haemorrhage, infarction, cavitatory lesions |
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What is the scoring system used for nenoatal abstinence syndrome
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Modified Finnegan scoring system
Infants scoring 3 consecutive abstinence scores > 8 or > 12 for 2 scores should be treated for NAS Scoring 4 hourly until infant has stabilised |
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Describe the Finnegan scoring system for NAS
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CNS
High pitched cry Restlessness: sleep for < 1-3 hrs after feeding tremors increased mm tone excoriation myoclonic jerks generalised convulsions Metabolic/vasomotor/ respiratory disturbances fever frequent yawning nasal stuffiness sneezing > 3-4 times RR > 60/min with retractions GIT disturbances excessive sucking poor feeding regurgitation/ projectile vomiting loose stools |
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When will an infant of a mother on heroine/methadone withdraw
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heroin typically within 24 hrs of birth becoming more obvious over 3-5 days - can take up to 7 days to reach severity, can take up to 2 weeks to present
methadone 2-7 days after birth NAS can last from 1 week to 6 months |
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Which infections may be associated with mothers with drug dependency
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HIV
Hep C/ Hep B |
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In what situations are infants born to Hep C mothers at risk of devloping Hep C infection?
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anti-HCV +ve; HCV RNA -ve
Will not get infection only 5-10% of infants born to anti-HCV +ve; HCV RNA +ve mothers will develop HCV infection |
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Can mothers with HCV breastfeed?
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yes as long as they are asymptomatic
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Does breastfeeding increase the risk of HIV transmission
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yes
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In what situations are infants born to Hep B mothers risk of getting hep B infection?
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Without immunisation > 70% born to HBsAg+ve HBeAg +ve mothers
Without immunisation 5-10% born to HBsAg+ve HBeAg -ve mothers All infants born to HBsAg +ve mothers should receive hep B vaccination and immunoglobulin < 12 hr |
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Can mothers with Hep B breastfeed
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Yes as long as the infant has received hep B vaccination and immunoglobulin
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How shoudl women with HBV deliver
NVD or CS |
There is no evidence to suggest that CS prevents maternal infant transmission
Therefore CS is not routinely recommended for HBV mothers NB: risk of transmission is related to the HBV replicative status of the mother i.e. HbeAg |
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What is the risk of trasmission of HCV vertically?
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5%
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Should HCV mothers devlier vaginally or CS
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There is no good evidence on the mode of delivery
Vertical transmission is higher when the mother is co-infected with HIV |
