antenatal care Flashcards

1
Q

when is the booking visit

A

12 weeks

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2
Q

what investigations at this point

A

FBC- anaemia, glucose; BMI; urine dips; ABO and Rh, syphilis and rubella, HIV test

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3
Q

purpose of the booking visit

A

give information, confirm pregnancy, date the pregnancy (LMP), identify maternal risk factors, offer screening for fetal disorders

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4
Q

what investigations at this point

A

FBC- anaemia, glucose; BMI; urine dips; ABO and Rh

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5
Q

disadvantages of LMP calculations

A

relies on 28 d cycle and ovulation at 14d

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6
Q

what should happen to an unvaccinated Rubella lady

A

do not vaccinate until after the pregnancy

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7
Q

what are underweight women more at risk of

A

IUGR

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8
Q

disadvantages of LMP calculations

A

relies on 28 d cycle and ovulation at 14d

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9
Q

what is an obese woman more at risk of

A

C sections, pre eclampsia

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10
Q

why is accurate dating important

A

downs screening relies on accurate age, pre and post term labour

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11
Q

what is measured at >13 weeks on US dating scan

A

crown rump length

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12
Q

risk factors gestational diabetes

A

obese, FHx diabetes, prev gestational diabetes

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13
Q

why is accurate dating important

A

downs screening relies on accurate age, pre and post term labour

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14
Q

when should a woman with risk factors for gestational diabetes have GTT

A

16 and 28 weeks

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15
Q

risk factors gestational diabetes

A

obese, FHx diabetes, prev gestational diabetes

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16
Q

at what weeks is a Rhesus negative woman given anti D

A

28 weeks, 34 weeks

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17
Q

what para is more at risk of pre eclampsia

A

primiparous woman- so needs 2 additional antenatal check ups in the last trimester

18
Q

from how many weeks is the woman given 3 weekly antenatal check ups

A

25 weeks

19
Q

at what weeks is a Rhesus negative woman given anti D

A

28 weeks,34

20
Q

what weeks are trimester 3

A

28- term

21
Q

what weeks are trimester 1

A

1-12

22
Q

what weeks are trimester 2

A

13-27

23
Q

what weeks are trimester 3

A

28- term

24
Q

when would transvaginal US be used

A

early pregnancy, good views of the cervix. not >12 weeks

25
Q

uses ultrasound

A

confirmation- miscarriage, ectopic; gestational age; fetal growth; multiple pregnancy; structural anomalies; placental localisation; amniotic fluid volumes; cervical length; CTG

26
Q

what is looked for for multiple pregnancy chorionicity on US

A

v (lambda) sign, thickened membranes separating the two embryos

27
Q

how long should a CTG be performed for and why

A

30 mins. as fetal deep sleep cyles

28
Q

what is US used for in suspected oligo/polyhydramnios

A

calculate amniotic fluid index.

29
Q

what are the normal accelerations on CTG

A

> 15 bpm in for 15 secs

30
Q

how long should a CTG be performed for and why

A

30 mins. as fetal deep sleep cyles

31
Q

what is looked for on the CTG

A

accelerations, decelerations, baseline variability, FHR

32
Q

what are the normal accelerations on CTG

A

?

33
Q

what should the baseline variability be

A

> 10bpm.- shows normally functioning autonomic nervous system

34
Q

when is the dating scan in a normal pregnancy

A

12 weeks

35
Q

what are tachycardias associated with

A

hypoxia, infection

36
Q

what should the baseline variability by

A

> 10bpm.- shows normally functioning autonomic nervous system

37
Q

when is the dating scan in a normal pregnancy

A

12 weeks

38
Q

in addition to the normal 2 scans what scans are needed for an at risk fetus

A

growth scans, amniotic fluid volumes, Doppler uterine artery scans. CTG used around labour

39
Q

what is Doppler US uterine arteries measuring

A

systolic and diastolic flows in uterine artery shows placental resistance. infarction placenta leads to increased resistance and less perfusion to the fetus

40
Q

what is Doppler US fetal vessels measuring

A

middle cerebral artery flow increases in IUGR and anaemia- redirection to the fetal head