Antenatal care and screening

Question 1

Morning sickness affects how many people?

Answer 1

Affects 80-85%
Worse with higher HCG
Usually between weeks 4-16

Question 2

What are cardiac pregnancy problems?

Answer 2

CO increases by 30-50%

BP drops in 2nd trimester (fall in resistance, fall in viscosity, fall in sensitivity to angiotensin)

Question 3

What are urinary pregnancy problems?

Answer 3

Increased urine output (RPF, GFR increase and urea and creatinine decrease)
UTI due to urine stasis

Question 4

What are haematology pregnancy problems?

Answer 4

PV increases by 50% and RBCs by 25% = drop in Hb dilution
WBCs increase slightly
Platelet count falls by dilution

Question 5

What are respiratory pregnancy problems?

Answer 5

Progesterone reduces CO2 = increased tidal volume, increased RR and plasma pH. O2 consumption is increased by 20% but PO2 is unchanged

Question 6

How much folic acid do women need a day?

Answer 6

400mcg

Question 7

What happens in antenatal Examination?

Answer 7

Routine = mother feeling well and fetal movement after 20 weeks
BP
Urinalysis
Abdominal palpation
Listen to the fetal heart

Question 8

What is involved in abdominal palpation?

Answer 8

Symphyseal fundal height
Estimate the size of the baby
Estimate liquor volume
Determine fetal position
Listen to the fetal heart

Question 9

When is the first trimester ultrasound screening and what are they looking for?

Answer 9

5-6 weeks

Ensures viability, multiple pregnancy, abnormalities incompatible with life and syndrome screening

Question 10

What is nuchal Translucency?

Answer 10

NT measurements taken between crown rump lengths of 45-84mm
Increases with gestational age and the incidence of chromosomal and other abnormalities related to size rather than appearance of NT

Question 11

What happens in screening for downs syndrome?

Answer 11

Test only provides risk of their baby being affected (maternal RF’s, NT, PAPP-A and B-hCG)
Further tests need to be offered for definitive test (Chorionic Villus Sampling (10-14W), amniocentesis (15W+) and non-invasive parental testing)

Question 12

When is the second trimester ultrasound carried out and what are they looking for?

Answer 12

20 weeks
Detects foetal abnormality
Good for major structural abnormalities but poor for chromosomal abnormalities

Question 13

What are GI pregnancy problems?

Answer 13

GI motility is reduced due to increased progesterone and decreased motillin