Antenatal care

Question 1

Trimesters

Answer 1

first: <12 weeks
second: 13-26
third >27-birth

Question 2

booking visit weeks

Answer 2

8-12 weeks

Question 3

booking visit features

Answer 3

general information: diet, alcohol, smoking, folic acid, vitD, antenatal classes

BP, urine dipstick, check BMI

Question 4

booking bloods/ urine

Answer 4

FBC, blood group, rhesus status, red cell alloantibodies, haemoglobinopathies(thalassaemia and sickel cells)

hepB, syphilis
HIV
urine culture

Question 5

dating scan weeks

Answer 5

10-13+6

Question 6

dating scan features:

Answer 6

CRL,multiple pregnancies identified

Question 7

down syndrome testing

eeks

Answer 7

11-13+6 weeks

Question 8

antenatal appointment weeks

Answer 8

16 weeks

Question 9

anomaly scan weeks

Answer 9

18-20+6 weeks

USS

Question 10

OGTT date

Answer 10

24-28weeks

Question 11

anti-D injections date

Answer 11

28 and 34 weeks

Question 12

when is symphysis-fundal height measured

Answer 12

> 24 weeks

Question 13

vaccines in pregnant women

Answer 13

whooping cough 16 weeks

annual flu

Question 14

folic acid in pregnancy

Answer 14

Take folic acid 400mcg from before pregnancy to 12 weeks (reduces neural tube defects)

Question 15

effects of alcohol in pregnancy

Answer 15

Miscarriage

Small for dates

Preterm delivery

Fetal alcohol syndrome

Question 16

features of fetal alcohol

Answer 16

Microcephaly (small head)

Thin upper lip

Smooth flat philtrum (the groove between the nose and upper lip)

Short palpebral fissure (short horizontal distance from one side of the eye to the other)

Learning disability

Behavioural difficulties

Hearing and vision problems

Cerebral palsy

Question 17

smoking in pregnancy effects

Answer 17

Fetal growth restriction (FGR)

Miscarriage

Stillbirth

Preterm labour and delivery

Placental abruption

Pre-eclampsia

Cleft lip or palate

Sudden infant death syndrome (SIDS)

Question 18

flying in pregnancy

Answer 18

The RCOG advises flying is generally ok in uncomplicated healthy pregnancies up to:

37 weeks in a single pregnancy

32 weeks in a twin pregnancy

Question 19

risk factors for gestational diabetes

Answer 19

BMI above 30

Previous baby >4.5kg

Previous gestational diabetes

FH of diabetes

Family origin with a high prevalence of diabetes

Question 20

risk factors for pre-eclampsia

Answer 20

BP & urinalysis for protein

> 40

Nulliparity

Pregnancy interval >20 years

FH

BMI >30

Renal or vascular disease

Multiple pregnancy

Question 21

what conditions are women screened for?

Answer 21

rhesus negative
gestational diabetes
fetal growth restriction
venous thromboembolism
pre-eclampsia

Question 22

combined test down syndrome

Answer 22

Nuchal length
PAPP-A
bHCG
11-13+6

Question 23

quadruple test down syndrome

Answer 23

15-20 weeks
inhibin A
UE3 (oestriol)
HCG
aFP

Question 24

25 weeks

Answer 24

Routine care: BP, urine dipstick, symphysis-fundal height (SFH)

Question 25

28 weeks

Answer 25

Routine care: BP, urine dipstick, SFH Second screen for anaemia and atypical red cell alloantibodies. If Hb < 10.5 g/dl consider iron First dose of anti-D prophylaxis to rhesus negative women

Question 26

31 weeks

Answer 26

If primip | routine care

Question 27

34 weeks

Answer 27

Routine care as above Second dose of anti-D prophylaxis to rhesus negative women* Information on labour and birth plan

Question 28

36 weeks

Answer 28

Routine care as above Check presentation - offer external cephalic version if indicated Information on breast feeding, vitamin K, 'baby-blues'

Question 29

38 weeks

Answer 29

routine care as above

Question 30

40 weeks

Answer 30

routine care only if primip Discussion about options for prolonged pregnancy

Question 31

41 weeks

Answer 31

Routine care as above | Discuss labour plans and possibility of induction

Question 32

triple test down syndrome

Answer 32

14-20 weeks BHCG AFP serum oestriol

Question 33

chorionic villus sampling

Answer 33

US-guided biopsy of placental tissue testing is done earlier in pregnancy before 15 weeks

Question 34

amniocentesis

Answer 34

US-guided aspiration of amniotic fluid | after 15 weeks