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    CMCA LEC 9-Antepartum Pregnancy - Part2 - Week 4

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    Carl Josef C. Garcia
    Naegele's rule and ultrasounds are used to estimate fetal age and due dates. Fundal height measurements track fetal growth and are taken from the pubic symphysis to the top of the uterus. Common teratogens include infections like toxoplasmosis and rubella, as well as drugs, chemicals, radiation, and maternal stress. Live virus vaccines and unnecessary drugs should be avoided during pregnancy. Alcohol and smoking increase risks of fetal alcohol syndrome and low birth weight.

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    CMCA LEC 9-Antepartum Pregnancy - Part2 - Week 4

    Uploaded by

    Carl Josef C. Garcia
    27 views34 pages
    Naegele's rule and ultrasounds are used to estimate fetal age and due dates. Fundal height measurements track fetal growth and are taken from the pubic symphysis to the top of the uterus. Common teratogens include infections like toxoplasmosis and rubella, as well as drugs, chemicals, radiation, and maternal stress. Live virus vaccines and unnecessary drugs should be avoided during pregnancy. Alcohol and smoking increase risks of fetal alcohol syndrome and low birth weight.

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    CMCA LEC 9-Antepartum Pregnancy_Part2_week 4

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    Naegele's rule and ultrasounds are used to estimate fetal age and due dates. Fundal height measurements track fetal growth and are taken from the pubic symphysis to the top of the uterus. Common teratogens include infections like toxoplasmosis and rubella, as well as drugs, chemicals, radiation, and maternal stress. Live virus vaccines and unnecessary drugs should be avoided during pregnancy. Alcohol and smoking increase risks of fetal alcohol syndrome and low birth weight.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    27 views34 pages

    CMCA LEC 9-Antepartum Pregnancy - Part2 - Week 4

    Uploaded by

    Carl Josef C. Garcia
    Naegele's rule and ultrasounds are used to estimate fetal age and due dates. Fundal height measurements track fetal growth and are taken from the pubic symphysis to the top of the uterus. Common teratogens include infections like toxoplasmosis and rubella, as well as drugs, chemicals, radiation, and maternal stress. Live virus vaccines and unnecessary drugs should be avoided during pregnancy. Alcohol and smoking increase risks of fetal alcohol syndrome and low birth weight.

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    ESTIMATED DATE OF CONFINEMENT

    (EDC)
    NAEGELE’S RULE
    – count back 3 months from the first day of LMP and add seven and
    one year (-3+7+1).
    ULTRASONOGRAPHY
    – estimates fetal age from head measurements.
    FUNDAL HEIGHT
    – measurement of fundal height from the top of symphis pubis to the
    top of the fundus with a flexible, non-stretchable tape measure;
    used as a gross estimate of dates.
     Above the level of symphysis – bet. 12 – 14 weeks
     At the umbilicus or 20 cm – about 20 wks.
     Rises about 1 cm/week until 36, after which it varies.

    QKCC 1
    FUNDAL MEASUREMENT

    QKCC 2
    FUNDAL
    HEIGHT

    QKCC 3
    Teratogens in
    pregnancy

    QKCC 4
    QKCC 5
    What is TERATOGENS?
    Any agent that can disturb the development of an embryo
    or fetus. Teratogens may cause a birth defect in the child.

    teratogen may halt the pregnancy outright

    teratogens include radiation, maternal infections, chemicals,


    and drugs

    any substance, organism, or process that causes


    malformations in a fetuS

    QKCC 6
    TORCH

    T OOXOPLASMOSIS

    O THER: GONORRHEA, HEP.B, VZV,SYPHILLISO

    R UBELLAO

    C CYTOMEGALOVIRUS

    H ERPES SIMPLEx VIRUS

    QKCC 7
    parasitic disease caused by the protozoan Toxoplasma gondii

    he parasite spreads by the ingestion of infected meat or the


    feces of an infected cat
    •There may be no symptoms.
    •Symptoms usually occur about 1 to 2 weeks after you come in
    contact with the parasite.
    •The disease can affect the brain, lung, heart, eyes, or liver.

    Headache, sore throat, Fever, Muscle pain, enlarged lymph nodes

    Those without symptoms typically do not need treatment.


    Medications to treat the infection include an antimalarial drug and
    QKCC 8
    antibiotics.
    QKCC 9
    Other ( GONORRHEA )

    Caused by Neisseria gonorrhea

    Opthalmia neonatorum

    Eye prophylaxis ( erythromycin ointment )

    QKCC 10
    opthalmia neonatorum

    QKCC 11
    Others ( SYPHILIS )

    Treponema pallidum

    Affects—liver, kidney, adrenal glands

    Copper colored maculopapular dermal rash appears


    in untreated NBs

    Rash appears on---palms of hand, soles of foot,


    diaper area, around mouth & anus
    QKCC 12
    QKCC 13
    QKCC 14
    Care management ( syphilis )

    • 10 day course of penicillin G


    ( consult )
    • Erythromycin is the substitute
    antibiotic

    QKCC 15
    Other—Varicella Zoster
    • Caused by VZV( Varicella Zoster Virus)
    • Eye abnormalities
    • IUGR- intrauterine growth restrictions

    QKCC 16
    rubella

    Mother---mild rash

    Teratogenic effect---deafness, cataracts, mental/motor


    challenges

    QKCC 17
    CYTOMEGALOVIRUS (CMV)
    •member of the virus family

    Droplet infection

    Fetus is neurologically challenged

    Hydrocephalus, microcephaly, spasticity

    Deafness, eye damage, chronic liver disease


    QKCC 18
    CYTOMEGALOVIRUS (CMV)
    Child skin--
    Blueberry muffin ( covered with large petechiae )

    Dx—blood serum

    No treatment/vaccine

    Routine screening for CMV during pregnancy is not


    recommended

    Handwashing before eating, avoid crowds


    QKCC 19
    QKCC 20
    Herpes Simplex
    ( genital herpes infection )

    Virus spread through the blood stream

    1st trimester:
    Severe congenital anomalies, spontaneous miscarriage

    2nd/3rd trimester:
    Premature birth, IUGR, continuing infection

    Fetus may contact the virus from direct exposure when genital
    lesion present at time of birth

    Woman with history of genital herpes----CS


    QKCC 21
    genital herpes infection

    QKCC 22
    Herpes Simplex
    ( genital herpes infection )

    IV/ oral Acyclovir ( Zovirax ) can be administered

    Safe sex is important

    QKCC 23
    Potentially Teratogenic Vaccine
    Live virus vaccine ( mumps, measles, rubella,
    poliomyelitis )

    Live virus vaccine are contraindicated during


    pregnancy

    May transmit viral infection to a fetus

    QKCC 24
    Teratogenic drugs
    Any drug/herbal supplements maybe detrimental to
    fetal welfare
    Pregnant mother should not take any drug or
    supplement not specifically prescribed

    Drugs should be approved by MD, RN,RM

    Pregnancy risk categories of drugs

    QKCC 25
    Teratogenicity of ROH
    Congenital deformities
    Cognitive impairment

    FEATAL ALCOHOL SYNDROME

    - Small for gestational age, cognitively challenged

    - Short palpebral fissure, thin upper lip, upturned nose

    QKCC 26
    FAS

    QKCC 27
    QKCC 28
    Teratogenicity of Cigarettes

    Smoking is associated with infertility in woman

    Risk for SID syndrome

    Low birth weight—vaso constriction of uterine vessels

    Secondary smoking, inhaled carbon monoxide

    QKCC 29
    Metal and chemical hazards

    Pesticides, carbon monoxide

    Arsenic—by product of copper, lead

    Formaldehyde, Hg

    QKCC 30
    Radiation
    Rapidly growing cells are extremely vulnerable to
    destruction by radiation
    Range of malformation –depending on the stage of
    development of the embryo or fetus

    Before implantation---fetus is killed

    6 weeks after conception ---most damaging

    PT is done before dx test involving x-ray


    QKCC 31
    Hyperthermia/hypothermia
    Hyperthermia
    Interferes with cell metabolism

    Saunas, hot tubs, tanning beds, work environment

    Hot tubs----40 degrees Celcius, not >10 minutes

    Maternal fever
    -4-6 weeks causes abnormal fetal brain development, seizure
    disorders, hypotonia,skeletal deformities

    Hypothermia
    Not well known
    QKCC 32
    Teratogenic Maternal Stress

    Myths, effects of being frightened or surprised while


    pregnant

    Maternal stress is severe---counselling

    QKCC 33
    QKCC 34

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