repro week 3

What is the average duration of pregnancy?

270 days

What are the three stages of labour?

1. Dilation, 2. Expulsion, 3. Placental

What occurs during early dilation of labour?

Onset of labour until cervix is fully dilated (10cm), with weak contractions and amnion rupture.

What is the duration of early dilation in labour?

Longest part of labour, lasting 6 to 12 hours.

What happens during the expulsion stage of labour?

Strong contractions every 2-3 minutes lead to the delivery of the baby, lasting 0.5 to 2 hours.

What is the purpose of tocolytic drugs?

To suppress premature labour and delay preterm birth.

What is the role of prostaglandins in labour?

They soften and dilate the cervix and induce uterine contractions.

What is the function of oxytocin during labour?

It stimulates uterine contractions and milk ejection during breastfeeding.

What are the pharmacological options for pain relief during labour?

Epidurals, opioids, nitrous oxide, and local anesthetics.

What non-pharmacological methods can help relieve pain during labour?

Relaxation techniques, massage, TENS, and warm water baths.

What initiates lactation after birth?

Stimulation of mechanoreceptors in nipples by suckling sends signals to the hypothalamus.

What are the advantages of breastfeeding for infants?

Reduced risk of infections, chronic diseases, and better weight management.

What are the advantages of breastfeeding for mothers?

Faster recovery, reduced risk of maternal depression, and lower cancer risk.

What is a teratogen?

Any agent that can cause malformation or adverse effects during fetal development.

What are Wilson's 6 principles of teratogenic effects?

1. Genotype, 2. Developmental stage, 3. Specific action on cells, 4. Pharmacokinetics/dynamics, 5. Manifestations of damage, 6. Dose-response relationship.

What is the classification of medications in pregnancy in Australia?

Categories A, B1, B2, B3, C, D, and X, based on their safety and effects on the fetus.

What are the risks associated with the use of thalidomide during pregnancy?

20-30% incidence of malformations.

What are the effects of diethylstilboestrol (DES) on female offspring?

Vaginal and cervical abnormalities and increased cancer risk.

What is fetal hydantoin syndrome?

A condition caused by antiepileptic drugs, leading to growth retardation and craniofacial defects.

What are the effects of warfarin during pregnancy?

9% risk of birth defects, especially during weeks 6-9 post-conception.

What are the risks associated with alcohol consumption during pregnancy?

Fetal alcohol syndrome, growth retardation, and craniofacial abnormalities.

What complications can arise from smoking during pregnancy?

Reduced birth weight, preterm labour, and increased risk of stillbirth.

What is the role of folic acid during pregnancy?

Essential for neural tube closure within 4-8 weeks of pregnancy.

What is the purpose of cervical ripening?

To prepare the cervix for labour through methods like membrane sweeping and balloon catheters.

What is the function of IV oxytocin in labour induction?

It stimulates uterine contractions after membranes are ruptured and cervix is dilated.

What are the potential effects of NSAIDs during pregnancy?

Risk of miscarriage, fetal renal impairment, and delayed labour.

What is the significance of maternal factors in drug transfer to the fetus?

Factors like body weight, plasma volume, and renal function can affect drug transfer.

What are the effects of illicit drugs on pregnancy?

Potential for growth deficiencies and developmental issues.

What is the purpose of managing pre-term labour?

To ensure the health of both the mother and the baby, delaying delivery if necessary.

What are the effects of cocaine during pregnancy?

Vasoconstriction, hypertensive effects, stillbirth, miscarriage, vascular disruption.

What are the risks associated with heroin and opioids during pregnancy?

Miscarriage, prematurity, growth restriction, respiratory depression, and withdrawal.

What is the mechanism of action of Methotrexate?

Inhibits dihydrofolate reductase, leading to DNA damage and inhibited cell replication.

What are the recommendations for drug use during pregnancy?

Less concern beyond the first trimester, monitor maternal conditions, and assess relative risks to fetus.

What is the optimal form of infant feeding recommended for the first 6 months?

Exclusive breastfeeding.

What are some benefits of breastfeeding for infants?

Reduced risk of diarrhea, necrotizing enterocolitis, respiratory illness, middle ear infections, and enhanced cognitive development.

What are the maternal benefits of breastfeeding?

Faster recovery, reduced risk of pre-menopausal breast cancers, ovarian cancer, and maternal depression.

What is colostrum and its significance in the first week postpartum?

Rich in antibodies and nutrients, it provides complete nutrition and helps colonize the GI tract.

What hormones regulate lactation?

Prolactin stimulates milk production, while oxytocin facilitates milk ejection.

What are galactagogues and provide examples?

Drugs that stimulate milk production; examples include Metoclopramide and Domperidone.

What is the effect of dopamine on lactation?

Dopamine inhibits prolactin secretion, affecting milk production.

What factors affect drug transfer into breast milk?

Lipid solubility, molecular weight, diffusion, and protein binding.

What is the milk/plasma ratio and its significance?

It indicates the concentration of a drug in breast milk compared to maternal plasma; a ratio > 1 indicates higher concentration in milk.

What is considered safe infant exposure to drugs through breast milk?

Infant dose should be

What analgesics are considered safe during breastfeeding?

Paracetamol and ibuprofen are safe with low transfer into breast milk.

Which antibiotics are generally safe during breastfeeding?

Penicillins, cephalosporins, and macrolides, but monitor for bowel flora alterations.

What antidepressant is preferred for breastfeeding mothers?

Paroxetine is preferred due to the lowest transfer rate (1-3%).

What is the recommendation regarding caffeine intake during breastfeeding?

Low intake is probably safe, but monitor for restlessness and irritability in infants.

What is the recommended action regarding alcohol consumption during breastfeeding?

Minimize to 2 drinks/day and withhold breastfeeding for 2 hours after consumption.

What are the risks associated with nicotine during breastfeeding?

Variable percentage of maternal dose; should be avoided; use nicotine patches instead.

What is the impact of maternal drug use on neonates?

Neonates are at greater risk due to immature excretory functions, leading to potential drug accumulation.

What is the significance of monitoring infant signs during maternal drug use?

To detect adverse drug reactions and ensure infant health.

What is the role of the hypothalamus in lactation?

It regulates the hormonal changes necessary for milk production.

What is the difference between foremilk and hindmilk?

Foremilk is watery and low in fat, while hindmilk is creamier and higher in fat.

What is the effect of maternal drug administration timing on breast milk concentration?

Feeding immediately prior to drug administration can lead to higher milk concentrations.

What should be considered when choosing a drug for breastfeeding mothers?

Mechanism of action, infant dose, short half-life, high protein binding, and low oral bioavailability.