Antenatal care Flashcards
What is the main purpose of antenatal care?
Identify mothers who need medical attention, to prevent maternal and fetal morbidity and mortality. Detect congenital fetal problems, plan the delivery, provide education and lifestyle advice
What are the most poorly appreciated risk factor for morbidity and mortality in pregnancy?
Language barriers, obesity and psychiatric disease
What does preconceptual care and counselling involve?
Health check (rubella and cervical smear abnormalities); chronic disease management (glucose control); medication can be optimised for pregnancies (some epilepsy medication); routine preconceptual administration of folic acid; advice regarding smoking, alcohol and drugs
When should the booking visit be ideally?
Before 10 weeks gestation
What is the purpose of a booking visit?
To screen for possible complications, assessing risk, decisions about type and frequency of antenatal care, check gestational age, appropriate prenatal screening.
What age of women have higher risk during pregnancy?
Under 17 and over 35
Which pregnancy complications have a small but significant recurrence rate?
Preterm labour, SGA, FGR, stillbirth, antepartum and postpartum haemorrhage, some congenital abnormalities, rhesus disease, pre-eclampsia and gestational diabetes.
Which gynaecology conditions increase risk during pregnancy
Subfertility, ART and previous uterine surgery (usually delivered by elective section)
Which medical conditions increase risk during pregnancy?
HTN, DM, autoimmune disease, haemoglobinopathy, thromboembolic disease, cardiac or renal problems, depression needs to be asked about
What would you ask about in the social history in a booking visit?
Smoking, drugs, alcohol. The possibility of domestic violence should always be considered
What is the 12 week US scan looking at?
Date of conception (using CRL), detects multiple pregnancy, nuchal translucency measurement, blood levels of beta-hCG and PAPPA
What blood tests are performed at the booking visit?
FBC (anaemia); serum antibodies (anti-D); glucose tolerance test; syphilis test; rubella immunity; HIV and hep B; haemoglobin electrophoresis;
What is the 18 week US scan looking for?
Looking for structured fetal abnormalities
What are some ‘minor’ conditions of pregnancy?
Itching, pelvic girdle pain, abdominal pain, heartburn, back ache, constipation, ankle oedema, leg cramps, carpal tunnel syndrome; vaginitis; tiredness
How does the genital tract change during pregnancy?
Uterus weight increases. There is muscle hypertrophy, increased blood flow and contractility. Cervix softens, may start to efface in late third trimester
