Antenatal care Flashcards
(24 cards)
When does the booking visit typically occur?
Before 12 weeks gestation
What aspects of history should be discussed at the booking visit?
Past medical Obstetric Gynaecological/menstrual Family Social
What aspects of social history/lifestyle should be addressed at the booking visit? (5)
Smoking; alcohol; diet (Vit D, folate) ; exercise; occupation
Which examinations/procedures should be carried out at the booking visit? (5)
BMI Blood pressure Urine dipstick Abdo CVS
Booking bloods (5)
FBC ABO/Rh status Red cell alloantibodies Haemoglobinopathies Serologies
Immunological investigations arranged at booking visit
Syphilis, rubella, HIV, Hep B and C serology
What does the initial ultrasound confirm?
Foetal viability; number of foetuses; gestational age (crown-rump length)
Which routine procedures should be carried out at all subsequent antenatal visits?
Blood pressure proteinuria screen symphysis-fundal height measurement lie and presentation foetal heart auscultation
Four common classes of congenital abnormality
Heart defects; neural tube defects; abdominal wall defects; chromosomal abnormalities
Main risk factors for Downs Syndrome (2)
Maternal age; previous history
How is Downs risk assessed in a) first trimester b) second trimester
a) combined test (nuchal thickness + HCG/PAPP-A)
b) quadruple serum test (HCG, aFP, uE3, inhibin A)
When are further investigations for Downs syndrome warranted?
Likelihood ratio >1:250
What further investigations are carried out for Down syndrome and when?
Chorionic villus sampling (after 12 weeks)
Amnioscentesis (after 15 weeks)
When should the dating scan take place?
10-14 weeks
First-line treatment for nausea and vomiting antenatal
Antihistamines (promethazine)
When should the anomaly scan take place?
18-21 weeks
Nutritional advice in pregnancy:
a) vitamin A
b) vitamin D
c) folic acid
a) avoid excessive intake- teratogenic
b) 10 micrograms/day
c) 400 micrograms/day (5mg in those taking anti-epileptic drugs)
Risks of smoking during pregnancy (3)
Low birth weight
Pre-term birth
Stillbirth
Foods to avoid in pregnancy (three groups)
Soft cheese and pate (listeriosis)
Raw/partially cooked eggs/poultry (salmonella)
Liver (vitamin A)
In low-risk pregnancy, how is surveillance of the fetus achieved? (3)
Maternal vigilance for foetal movements in the latter half of pregnancy
Symphyseal-fundal height charting
Doppler auscultation of the foetal heart
Surveillance of high-risk pregnancies? (4)
Serial measurements of:
Foetal growth (head, abdominal, and estimated foetal weight)
Umbilical artery Doppler
Amniotic fluid volume
Biophysical parameters- HR, movements, tone and breathing
Abnormalities on scan: choroid plexus cysts, clenched hands, rocker bottom feet, small placenta
Edwards syndrome (Trisomy 18)
Trisomy 13
Patau syndrome
Trisomy 21
Downs syndrome
