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Y5 O&G > Antenatal Appointments > Flashcards

Antenatal Appointments Flashcards

1
Q

what is done at first contact with preg women (4)

A

identify high risk pt - BMI, PMH, smoker
review meds for preg safety
check VTE risk
advise folic acid & vit D

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2
Q

folic acid dose

A

400ug OD low risk or 5mg OD high risk

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3
Q

when is booking visit

A

8 to 12 weeks

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4
Q

what is done at booking visit (6)

A

RFs for pre-eclampsia
USS
Bloods - foetal screen for Downs, group, anaemia, RC ABs, HB-opathies, hep B, HIV, syphillis
Height / weight / BP / proteinuria
given hand held notes

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5
Q

what is given to prevent pre eclampsia

A

aspirin

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6
Q

when is OGTT done and what is it

A

75g 2hr OGTT at 24-28wks

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7
Q

cut offs for GDM tests

A

fasting 5.6
2hr 7.8

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8
Q

if OGTT is positive, what is the follow up and when is it

A

1 week joint diabetes and obs clinic

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9
Q

contrast LGA and macrosomia

A

LGA is proportional
macrosomia has large abdo circumference

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10
Q

what is done at 16wk visit

A

review all screening tests
pertussis / influenza vaccines
BP & proteinuria
discuss scan

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11
Q

who gets a 25wk scan and what does it sho

A

Primip
SFH - USS if <10 or >90 centile

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12
Q

28wk visit

A

2nd screening for anaemia and red cell alloantibodies
offer first anti D if neg
measure SFH
BP & proteinuria

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13
Q

who gets a 31wk visit and what happens

A

Primip
measure SFH
BP & proteinuria

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14
Q

34wk visit

A

offer 2nd anti D if neg
BP & proteinuria
SFH
birth plan preparation

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15
Q

36wk visit

A

BP & proteinuria
SFH
check presentation - offer ECV if breech
give info on breastfeeding, newborn care, Vit K etc

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16
Q

38wk visit

A

BP & proteinuria
SFH
give info on risks of prolonged preg after 42wks & Mx

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17
Q

who gets 40wk visit and what happens

A

Primip
BP & proteinuria
SFH
offer membrane sweep

18
Q

41wk visit

A

BP & proteinuria
SFH
offer membrane sweep & induction

19
Q

at which appts are blood tests done

A

8-12 wks
28 wks

20
Q

when is anti D given

A

28 and 34 wks

21
Q

when is BP and proteinuria checked

A

EVERY appt

22
Q

when are the scans done

A

12wk
20 wk

23
Q

how many appts do multips vs primips get

A

multips 7, primips 10

24
Q

when is the dating scan

A

10 to 13 weeks

25
Q

what is the dating scan for

A

gestational age and EDD
viability & location
detect multiple pregs
detect gross foetal abnormalities
NUCAL TRANSULENCY for downs

26
Q

what is nuchal translucency

A

lymph fluid accumulates behind neck

27
Q

radiological signs of multiple pregs & meaning

A

lamba sign = DC twins
T sign = MC twins

28
Q

when is anomaly scan

A

18 to 20 weeks

29
Q

what is the purpose of anomaly scan

A

locate placenta
CRL, BPD, femur length, AC
detect major abnormalities
- if present, allow for TOP, preparation, Mx in birth centre

30
Q

best and worst type of twins & what they mean

A

best = dichorionic / diamniotic - 2 bags, 2 placentas
worst = monochorionic / monoamniotic - one bag, one placenta

31
Q

why is MCMA twins the worst

A

risk of twin to twin transfusion syndrome
- necrosis of one twin, increased inflammation, early labour

32
Q

how is twin twin transfusion syndrom treated

A

intrauterine laser therapy

33
Q

when is the combined downs screening done

A

11 to 13+6 weeks

34
Q

what is the combined downs screening

A

nuchal translucency on USS
high serum hCG
low PAPPA

35
Q

if the booking is later in preg, when is downs screening done

A

15 to 20wks

36
Q

what is in the triple test

A

plasma bHCG
unconjugated estriol
AFP

37
Q

what is in the quad test

A

plasma bHCG
unconjugated estriol
AFP
inhibin A

38
Q

results of Downs screen for Downs / Turners

A

high HCG
high inhibin
(HIgh)

39
Q

results of downs screen for edwards

A

low HCG
low estriol
(HE is low)

40
Q

results of downs screen for patau

A

high AFP
(P in patau and AFP)

Y5 O&G (17 decks)

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