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38 Cards in this Set
- Front
- Back
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High risk pre-eclampsia |
Previous hypertensive disease in pregnancy CKD Autoimmune disease Diabetes mellitus |
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Hypertension in pregnancy |
>140/90 OR an increase from booking BP > 30/15 |
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Rhesus negative women |
Anti-D at 28 and 34 weeks. |
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Gestational diabetes risk factors |
Previous gestational diabetes BMI > 30 Previous baby > 4.5kg 1st degree relative with diabetes South Asian, black Caribbean, Middle Eastern |
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Gestational diabetes screening |
Previous history - GTT at booking and 26-28 weeks Other risk factors - GTT at 26-28 weeks |
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Harmful drugs in pregnancy |
tetracyclines, warfarin, aminoglycosides, trimethoprim, sulphonamides, quinilones (ciprofloxacin), ACEi, statins, sulfinylureas, retinoids, cytotoxic agents - most antiepileptics. |
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ANC 8-12 weeks |
Booking visit - BP, urine dipstick, BMI Bloods - FBC, Blood group, haemoglobinopathies, Hep B, syphillis, rubella, HIV, urine culture |
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ANC 11-13+6 weeks |
Scan - Downs syndrome screening (nuchal thickness) and EDD. |
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ANC 16 weeks |
Blood results, BP, urine dispstick |
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ANC 18-20+6 weeks |
Anomaly scan |
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ANC 25 weeks |
If primip - BP, urine dip, SFH |
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ANC 28 weeks |
BP, urine dip, SFH Bloods - FBC If rh -ve - anti-D |
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ANC 31 weeks |
If primip - BP, urine dip, SFH |
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ANC 34 weeks |
BP, urine dip, SFH 2nd dose of anti D Birth plan |
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ANC 36 weeks |
BP, urine dip, SFH Check fetal position |
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ANC 38 weeks |
BP, urine dip, SFH |
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ANC 40 weeks |
If primip - BP, urine dip, SFH Discussion about possibility of inducing labour |
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Amniocentesis |
Performed at 16 weeks Karyotype available after 3 weeks Fetal loss 0.5-1 % |
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Causes of increased nuchal translucency |
Down's syndrome congenital heart defects abdominal wall defects |
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Cause of hyperechoic bowel |
Down's syndrome CMV CF |
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Oligohydramnios |
Fluid volume < 500ml at 32-36 weeks OR below 5th centile PROM Fetal renal problems IUGR Post-term gestation pre-eclampsia |
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Increased AFP |
Neural tube defects - meningocele, anecephaly Abdominal wall defects - omphalocele, gastroschisis |
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Decreased AFP |
Down's syndrome Trisomy 18 Maternal DM |
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Alcohol and pregnancy |
Avoid in first trimester, after this drink no more than 1-2 units per week |
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Antiphospholipid syndrome and pregnancy |
Aspirin 75mg from positive urine hcg LMWH once fetal heart seen and discontinue at 34 weeks Complications - recurrent miscarriage, IUGR, pre-eclampsia, placental abruption, pre-term delivery, VTE. |
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Biophysical profile |
Fetal movements Fetal tone Fetal heart responsiveness Amniotic fluid Fetal breathing |
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Breast-feeding and epilepsy |
All antiepileptics are safe with the exception of barbituates |
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Fitness to fly - pregnancy |
36 weeks - single pregnancy 32 weeks - multiple pregnancy Fitness to fly certificate needed after 28 weeks to ensure normal pregnancy |
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Hepatitis B and pregnancy |
Baby - course of vaccination and hepatitis B immunoglobulin. No need for CS. Breast feeding is safe. |
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Hyperemesis Gravidarum Risk Factors |
Multiple pregnancies Trophoblastic disease Hyperthyroidism Null parity Obesity |
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Hyperemesis Gravidarum Complications |
Wernickes encephalopathy Mallory Weis tear Central Pontine myelinolysis Acute tubular necrosis IUGR Prematurity |
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Diagnosis of gestational diabetes |
Fasting - >= 5.6 2 hour - >= 7.8 |
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Gestational diabetes management |
Fasting BM < 7 - diet and exercise - 1-2 weeks - no improvement - metoformin - no improvement - insulin. Fasting BM > 7 - insulin Fastin BM 6-6.9 + evidence of macrosomia/hydramnios - insulin |
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Gestational DM Targets |
Fasting - 5.3 1 hour post meal - 7.8 2 hour post meal - 6.4 |
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Hypothyroidism and pregnancy |
Thyroxine TSH in each trimester and 6-8 weeks postpartum Safe to breast feed |
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Hyperthyroidism and pregnancy |
Propylthiouracil Do not use block and replace Values in upper third of normal Antibodies checked at 30-36 weeks Radioiodine is contraindicated |
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UTI |
Test of cure MSU should be sent in treated pregnant women |
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Vitamin D supplementation |
All pregnant women Children 6 months to 5 years - if < 500ml of formula milk per day adults > 65 years adults not exposed to the sun |
