Antenatal care

Question 1

When is the ideal gestation for the booking appointment? (1)

Answer 1

< 10weeks (8-12 weeks)

Question 2

How many appointments will a primigravida and a multigravida mum have if there are no complications? (2)

Answer 2

First baby: up to 10

Multi: about 7

Question 3

Name 3 pieces of lifestyle advice given to women at their first appointment. (3)

Answer 3

Folic acid supplementation
Avoid alcohol
Use of NRT
Avoid soft cheeses and only drink pasteurised milk (prevent listeriosis)
Avoid contact sports, but continue exercise
medication review

Question 4

What gestations should the dating scan be undertaken? (1)

How can they assess the gestation at this stage? (1)

Answer 4

11 - 13+6 weeks

Crown - rump length

Question 5

What gestation should the anomaly scan be performed? (1)

Answer 5

18 - 20+6 weeks

Question 6

What is PAPP-A? (1)

Answer 6

Pregnancy associated plasma protein A

Question 7

What is the advice regarding folic acid supplementation? (2)

Answer 7

From 1 month pre-conception to 12/40.
Give 400mcg od
Give 5mg od if on anti-epileptics, diabetic or previous NTD

Question 8

What investigations should be performed at the booking visit? (4)

Answer 8

Mid stream urine culture
FBC
Blood group antibodies
Syphilis, HIV, Hep B
Rubella immunity
OGTT if previous GDM

Question 9

When is the combined test undertaken for Down’s syndrome? (1)
What factors are included? (3)

Answer 9

Nuchal translucency, PAPP-A and beta hCG at 11-13+6 weeks

Question 10

If a woman presents after 13+6 weeks and wishes to have screening for Down’s syndrome, what can she be offered? (1)

Answer 10

Quadruple test.

b-hCG, oestriol, AFP and inhibin A

Question 11

If a woman is found to be at higher risk of Down’s syndrome (1:150) what are the options for diagnostic testing? (2)

Answer 11

CVS: 15 weeks

NB both have 1% risk of miscarriage

Question 12

When is the foetal anomaly scan? (1)

Answer 12

20 weeks