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STG 2017 > ANTENATAL CARE > Flashcards

ANTENATAL CARE Flashcards

(50 cards)

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1
Q

What is ANC

A

ANC refers to the comprehensive care given to a pregnant woman so she safely goes through pregnancy, labour and perpeurium with the delivery of a healthy baby

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2
Q

What approach to ANC is admonished by the STG

A

Focused antenatal care with focus on quality rather than quantity

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3
Q

Least number of visits recommended by STG

A

4 comprehensive visits

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4
Q

Schedule for respective visits

A

Booking visits: Before the 14th to 16th week
1st Visit: 16-20 weeks
2nd Visit: 24-28weks
3rd Visit: 28-32 weeks
4th visit: About 36 weeks

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5
Q

The pregnant woman is advised to report to the hospital if she doesn’t deliver after —————— of her due date

A

2 weeks

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6
Q

Assessments done at booking visit

A

History
Maternal examination
Obstetric examinations
LMP and Gestational age
Investigations

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7
Q

Histories that are taken during the booking visit

A

Past medical history
Surgical history
Obstetric history
Family history
Social history

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8
Q

Maternal examinations conducted at booking visit

A

Examine all systems.

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9
Q

Obstetric examinations conducted at the booking visit.

A

Obstetric examination to confirm pregnancy
Measure SFH
Measure FHR

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10
Q

Purpose of checking FHR

A

To assess foetal wellbeing

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11
Q

Normal FHR

A

120 or 110 or 100 -160bpm

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12
Q

Assessment done at follow-up visits

A

Asess health of mother
Blood pressure (limit of 140/90mmHg)
Maternal examinations
Test urine albumin and proteins
Obstetric examinations
Check foetal activity

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13
Q

When is foetal activity checked

A

After 20 weeks ideally during second ANC visit

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14
Q

Investigations done during ANC visits

A

Full blood count
Fasting blood sugar
Urine and stool analysis
Ultrasound scans
Genetic tests
Infectious disease tests

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15
Q

Obstetric examinations done during follow-up visits

A

Fetal heart rate
Foetal heart sounds
Uterine size (SFH)
Lie, presentation and descent of presenting part in the 3rd trimester

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15
Q

Maternal examinations done at followup visits

A

Check for anemia, weight gain, preeclampsia and complications

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16
Q

When is stool analysis done

A

At the booking visit

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17
Q

When is urine analysis done

A

At each visit

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17
Q

Purpose of urine analysis

A

Test for proteinuria and glucosuria

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17
Q

Schedule for full blood count

A

0, 28 and 36 weeks

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17
Q

Tests used for Syphilis screening in pregnancy

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A

VDRL: Venereal Disease Research Laboratory
TPHA: Treponema pallidum hemagglutination
RPR: Rapid plasma reagin test

17
Q

Genetic tests that are done in pregnancy

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A

G6PD activity
Sickling
Blood group and antibody screen

17
Q

Ultrasound scans in pregnancy

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A

Early ultrasound scan
Fetal anomaly scan between 18-24 weeks
Late screening at 36 weeks

18
Q

Infectious diseases tested for in pregnancy

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A

Malaria using Blood film
Syphilis
HIV
Hepatitis B

18
Schedule for fasting blood glucose
0, 28 and 32 weeks
18
Purpose of early ultrasound scan
To rule our ectopic pregnancy To estimate foetal age and expected delivery date
19
Purpose of late screening scan
Placenta position Foetal wellbeing
19
Objectives for ANC care
Ensure good health throughout pregnancy, labour and perpeurium Detect and treat any condition Prevent malaria and anemia Deliver a healthy baby
20
Diabetes screening tests in pregnancy
FBG at 0,28 and 32 weeks Urine glucose
20
What urine glucose level warrants an OGTT test
1+/2+ on two occasions 3+/4+ on one occasion
20
Things to avoid in pregnancy
Alcohol Smoking Herbs and non-prescribed drugs
20
Non-pharmacologic management in ANC (malaria)
Encourage use of ITN Malaria prevention
20
Counselling in ANC
Danger signs and symptoms in pregnancy Pregnancy discomforts and management Healthy diet Breastfeeding and newborn care Family planning
21
When is exercise avoided in pregnancy
PROM Preterm labour in women with incompetent cervix in 2nd/3rd trim. Pregnancy induced hypertension
22
Routine ANC drugs
Anemia prevention Malaria prophylaxis Tetanus prophylaxis Deworming
23
Four categories of PMTCT
1. Primary prevention HIV among women of childbearing age 2. Preventing unintended pregnancies among women living with HIV 3. Preventing HIV transmission from pregnant woman to foetus 4. Treatment care and support for women living with HIV, their children and family.
24
When is mebendazole given in pregnancy
24-28 weeks
25
Malaria prophylaxis in pregnancy
SP (Sulmethoxazole-Pyrimethamine/ or Sulfadoxine-Pyrimethamine) 5 doses, 1 month apart Start at 16 weeks or first quickening, do not exceed 36 weeks
26
Anemia prophylaxis in pregnancy
Ferrous sulphate 200mg daily, 65mg elemental iron or Ferrous fumarate 200mg daily, 65mg elemental iron or Iron III hydroxide polymaltose, 100mg elemental iron + Folic acid 5mg daily
27
Passive tetanus prophylaxis in pregnancy
Passive IM Tetanol 0.5ml 1st dose from 20th week 2nd dose one month later
27
When is passive tetanus prophylaxis done
If patient hasn't received any anti-tetanus immunisation
28
Types of tetanus prophylaxis in pegnancy
Passive Active
29
Schedule for active tetanus prophylaxis
TT1 0.5ml SC or IM at any contact with pregnant woman TT2: Given one month later TT3: Given 6 months later TT4 and TT5: given in subsequent pregnancies
30
Medical conditions that make a pregnancy high risk pregnancy
Diabetes Hypertension Asthma Chronic cough eg. pulmonary TB Heart disease Thyrotoxicosis HIV Positivity Severe anaemia SCD
31
High risk pregnancies
Bleeding at any time before labour and after labour Some medical conditions Multigravidae Grand multiparity (>=5 children) Breach presentation Prolonged pregnancy Contracted pelvis Previous instrument delivery Previous uterine surgery eg. CS, myomectomy. Preterm labour Rhesus negative mother with a rhesus positive husband or antibodies
32
High risk pregnancy factors (foetus factors)
Uterine size smaller than gestational ag Uterine size larger than gestational age Foetal growth restriction Big baby at term Pat history of stillbirths or death within 1 week of birth Past history of miscarriages around same gestational age
33
What is meant by big baby at term
SFH is more than 39-40 cm at term EFW is 4 kg or higher
34
Prolonged pregnancy
when the pregnancy lasts longer than 42 weeks
35
What is contracted pelvis
pelvis too small for the baby to be delivered safely per vaginam
36
How can contracted pelvis be easily detected
when the mother is short (< 154 cm) has small feet (shoe size < 4½ UK)

STG 2017 (88 decks)

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