1
Q
S&S IN PREGNANCY
A
- N & V: Usually stops after 1st trimester but some women experience it longer due to HCG levels
- Increased urination
- Back pain
- Striae Gravidarium (stretch marks)
- Linea Nigra- line going down from sternum
2
Q
Implantation bleeding
A
- not all bleeding is bad!
- After implantation, bleeding usually occurs 5-12 days after fertilisation
- Any clots? How big?
- Usually lasts 1-2 days
3
Q
Pseudo pregnancy
A
- Phantom pregnancy
- No real know cause for it
- Very rare
- Abdomen usually distends and breasts secrete a cloudy liquid
- MH
4
Q
Pregnancy notes:
A
- Document everything
- Safe and effective practice
5
Q
MEOWS
A
- Maternity NEWS2 score
- Consider sepsis in pregnant/ postpartum pts
- Early warning tool
- Find out what’s normal for them
- In hospital, lochia & urinalysis forms part of the assessment!
- Values differ due to physiological adaptations in pregnancy
6
Q
Back Pain
A
- Common
- Advise paracetamol and if so severe, refer to GP
- Waddling gait caused by increase in relaxin which increases pelvic laxity (movement)
- Increased abdominal weight leads to a shift
In the centre of gravity and a tenderness - Stretched abdominal muscles lose their ability to maintain posture, therefore the lower back has to support majority of the weight
7
Q
Braxton hicks
A
- Irregular contractions, moving/resting/changing position may stop braxton hicks!
- “Practice contractions”
- Uncomfortable, not as painful as labour contractions, weaker rather than stronger- debatable
- It doesn’t follow a regular pattern like labour does and doesn’t come closer together like it does in labour.
8
Q
Gastric reflux
A
- Increase in progesterone loosens everything up and pressure from the uterus shoves everything up and it feels like you’re breathing fire!
- Refer to GP
- Increase in progesterone causes the smooth muscle of the stomach to relax into the oesophagus causing heartburn.
9
Q
DVT
A
- Pregnancy increases risk by 5-10 times, not that common though.
- Level of blood clotting proteins increases & anticlotting protein level decreases.
- Swelling, Redness, heat, painful leg
- They will receive a D dimer test, ultrasound
- They may be given heparin which does not cross through to the placenta
- Enlarged vein puts uterus in additional pressure
10
Q
Varicose veins
A
- Occurs when valves in the veins weaken from an increase in progesterone, circulatory volume and weight of growing baby, placenta & uterus causing blood to pool!
- May be the result of hormonal changes
- Skin thins over the veins so haemorrhage easily and often hard to stop!
- Discomfort, swelling , muscle cramps especially at night, burning or throbbing legs
- Are they on blood thinners?
11
Q
Examination in hospital
A
- Internal examination in under 8 weeks pregs
- Visualisation via ultrasound
- Pinnard steth used to auscultate fetal heart
12
Q
Growing pains
A
- Round ligaments in the lower abdomen get stretched by the growing uterus
- Sharp, achy sensations on one or both sides of the lower back
- Usually felt around 14 weeks but can be anytime from the second trimester onwards.
- RED FLAG- severe pain with NO fetal movement, assume placental abruption until proven otherwise
13
Q
Braxton hicks vs Labour contractions
A
- Braxton:
- Practice contractions
- Irregular, don’t come close together as time goes on
- Moving, resting or changing position will stop Braxton hicks
Labour:
- regular contractions, lasting 30-60secs
- Contractions increase in frequency and power
14
Q
Pulmonary embolism
A
-Occurs because:
- pts are not moving as much,
- more clotting tendency to prevent blood loss during childbirth puts mum at greater risk of clots
- Limited mobility: Especially in the later stages, less movement increases blood stasis
- Reduced blood flow as the uterus grows and compresses on blood vessels, it may reduce blood flow to the heart and lungs.
15
Q
Haemorrhoids
A
- Dilated veins in the anal canal
- May become very painful, bleed or become infected
- Increased risk of constipation due to decrease in gastric motility
- Chronic constipation may lead to it
- Iron supplements
16
Q
Anaemia
A
- Increase in blood during pregnancy which dilates red blood cells
- Look at conjunctiva, perfusion, energy levels, breathlessness (exertional?), palpitations
- When the body doesn’t have enough healthy red blood cells/ haemoglobin to carry adequate oxygen to tissues and organs
17
Q
Gestational diabetes
A
- Risk: Worried about a large baby, premature birth, excessive amniotic fluid, can make eclampsia and preeclampsia more likely!!
- May also cause still birth
- May present with hyperglycaemia symptoms
18
Q
Pregnancy induced hypertension
A
- Persistently elevated BP-140/90 after 20 weeks gestation
- Complications: Blood vessel damage, decreased blood flow to the uterus
Preeclampsia s&s: Headache, visual disturbances, seizures, chest pain, dizziness, swelling (face and hands)
19
Q
Morning sickness
A
- Offer antiemetics through GP referral if so severe
20
Q
Hyperemesis gravidarium
A
- Associated with dehydration, weight loss, postural hypotension, tachycardia, ketosis, electrolyte imbalance
- Requires hospital treatment- fluids & antiemetics
- Foetus is at risk of being small due to lack of nutrients
21
Q
UTI
A
- Group b streptococcus can infect baby and be fatal
- Bladder capacity is compromised by growing uterus
22
Q
Thrush
A
- Babies can develop oral or genital thrush due to vaginal birth.
- Babies can get oral thrush as they don’t have a developed immune system yet
- When mum is breast feeding, the baby may give it to mother and breastfeeding may be really painful leading to cessation
- Treated with cream
- PH changes and increased glycogen content make pregnant women more susceptible to thrush!
23
Q
Miscarriage
A
- Loss of pregnancy before 24 weeks. Most common in the first 12 weeks
- Diagnosis is made in hospital with an ultrasound
Cervical shock- decomponsated shock, bradycardia
24
Q
Termination pains
A
- Medical or surgical
- Likely to feel discomfort and bleed pV for up to a fortnight (14 days to a month)
- Ibuprofen for the pain and sanitary pads for bleeding not tampons
25
FGM
- Scar tissue does not stretch like normal tissue
26
Mastitis
- Inflammation of the breast , usually in breast feeding women
- Most efficient way is to continue breast feeding as the baby is the best to get this out!
- May cause tachycardia, pyrexia and rigor
27
Post partum depression
- Suicide is a direct cause of maternal death
- Baby blues last usually 6 weeks:/
28
Domestic abuse
- 15% of women report violence during their pregnancy
- Over a 3rd of domestic violence starts or gets worse during pregnancy
PMMH
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Decks in class (12)
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