Antenatal Care

Question 1

Down’s Syndrome results in first trimester screen

Answer 1

High B-HCG and Nuchal translucency, low PAPP-A

Question 2

When to do the anatomy/morphology scan and what to check

Answer 2

MH guidelines say 20-22 week

Gestational age, fetal number, placental position, fetal anatomy l

Question 3

When to do OGTT (if previous RBG was normal)

Answer 3

24-28 weeks

Question 4

When to do SFH and auscultation of fetal heart

Answer 4

24 weeks and after

Question 5

How much weight should women of BMI 25-29 and above 30 gain?

Answer 5

6. 8-11.3

5. 9-9.1

Question 6

Diet guidelines

Answer 6

Additional 300kcal to baseline
When breastfeeding, additional 500kcal
High protein, low simple carb and fat, high fiber

Question 7

Folic acid guidelines

Answer 7

Standard: 0.5mg for 3 months preconception and 3 months after
Those taking anti-epileptics, previous NTD, pre-existing DM: 5mg
Can stop in 2nd trimester

Question 8

Iron guidelines

Answer 8

In 2nd and 3rd trimester, 30mg elemental iron per day recommended

Question 9

Vegetarians guideline

Answer 9

Zinc, vitamin B12 and iron supplementation

Question 10

When to do the first trimester screen and what is done

Answer 10

11-13 weeks

Maternal age, maternal serum for b-hcg and PAPP-A, ultrasound for nuchal translucency

Question 11

When is second trimester screen done and what is done

Answer 11

16-18 weeks

Quadruple screen

• maternal serum alpha fetoprotein
• unconjugated estriol
• hcg
• inhibin A

Question 12

When is CVS done and what are the complications

Answer 12

9-12 weeks

Preterm delivery
PROM
Fetal injury esp limb
Risk of miscarriage higher than amniocentesis

Question 13

When is amniocentesis done and what are the risks

Answer 13

15-20

Pain/cramping
Vaginal spotting
Amniotic fluid leakage
Symptomatic amnionitis

Question 14

When can cardiac activity be detected

Answer 14

5 weeks

Question 15

When is the earliest a pregnancy can be seen on TVS

Answer 15

4 weeks 3 days

Question 16

When should early dating scan be done

Answer 16

10 - 13+6 weeks

Measured with crown-rump length

Question 17

What does a biophysical profile include

Answer 17

Fetal breathing movements 
Gross body movements
Fetal tone
Reactive FHR
Amniotic fluid volume

Question 18

Assessment of fetal growth components and when to be done

Answer 18

Clinical: SFH and maternal weight gain

Ultrasound for fetal biométrica

• biparietal diameter
• head circumference
• abdominal circumference
• femur length
• body proportions

Serially at weekly or bi-weekly intervals

Question 19

Components of fetal well-being

Answer 19

Fetal movements 
FHR monitoring
CTG
Ultrasound
- amniotic fluid volume
- BPP 
- Doppler of Umbilical artery/MCA

Question 20

Indications of antenatal fetal surveillance

Answer 20

High-risk pregnancy
Post dates 
FGR
Preeclampsia or gestational HPT
Diabetes 
Fetal hydrops 
APH
Bad obstretics history 
Multiple pregnancy
PROM