Pregnancy 1.0

Morning sickness, preeclampsia, HELLP syndrome, Rhesus incompatibility & Placenta previa

When does morning sickness usually resolve

12-20 weeks, new vomiting after 12 weeks should be investigated

What are the proposed causes of morning sickness

Hormonal factors, intestinal distension, genetic factors

What is hyperemesis gravidarum and the complications it poses

A severe form of nausea and vomiting in pregnancy that can persist throughout pregnancy. Increased maternal and fetal complications due to dehydration, starvation and weight loss.

Define preeclampsia

New onset hypertension after 20 weeks with proteinuria or evidence of maternal organ dysfunction.

What symptoms may suggest preeclampsia

Headache, visual disturbance, edema, nausea/vomiting, epigastric px.

Risk factors for developing preeclampsia

Multiple pregnancy, first pregnancy, obesity, increased age, diabetes, chronic kidney disease.

What BP meets the definition of hypertension in preeclampsia

>140/90 on two occasions 4 hrs apart.

What is the management of preeclampsia

Control BP, magensium to prevent seizures. Delivery of the baby.

What is eclampsia

Generalised seizures

What is HELLP syndrome and what does it stand for:
H:
EL:
LP:

Complication associated with preeclampsia
Haemolysis
Elevated liver enzymes
Low platelets

When does HELLP syndrome usually occur

In the third trimester, but it can occur postpartum.

Why does physiological anemia occur during pregnancy

Plasma volume increases more than red blood cell mass, causing dilution of hemoglobin.

Is physiological anemia caused by iron deficiency

No. It is a normal adaptation to pregnancy

What are risk factors for iron deficiency anaemia in pregnancy?

Multiple pregnancy, frequent vomiting, and heavy pre-pregnancy menstrual bleeding.

What are common symptoms of iron deficiency anaemia?

Fatigue, weakness, difficulty concentrating, headache, dizziness, and SOB.

What is pica and how can it relate to iron deficiency?

Craving or chewing non-food substances, particularly ice.

Why does gestational diabetes develop

Pregnancy causes increased insulin resistance. GDM occurs when pancreas cannot produce enough insulin to compensate.

What complications are associated with poorly controlled GDM?

Congenital abnormalities, stillbirth, preeclampsia, preterm/operative delivery, and neonatal hypoglycaemia.

What long-term risk does GDM increase?

Mothers risk of developing type 2 diabetes.

What is placenta previa

When placenta partially or completely covers the cervix

What is the classic presenation of placenta previa

Painless vaginal bleeding, can be severe.

What are risk factors for placenta previa

Previous pregnancies, previous C-section, multiple pregnancy, increased age, uterine abnormalities, and smoking.

What fetal complications can occur with placenta previa?

Reduced fetal growth and preterm birth.

What is rhesus incompatibility?

When an Rh- mother carries and Rh+ fetus. Potentially causing maternal antibodies to attack fetal red blood cells.

What is sensitisation in terms of rhesus incompatibility

Maternal immune system becomes exposed to fetal Rh+ and produces anti-D antibodies. Can occur through falls, abdominal trauma or vaginal bleeding.

Why is rhesus incompatibility more problematic in later pregnancies?

After sensitisation, maternal anti-D antibodies can remain and affect a future Rh-positive fetus.

What can rhesus incompatibility cause in the fetus/newborn?

anemia, heart failure, enlarged liver/spleen, stillbirth.