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Flashcards in Antenatal care Deck (19):
1

How many appointments should there be in an uncomplicated:
1) nullip pregnancy?
2) multip pregnancy?

1 - 10
2 - 7

2

Preconception advice

Folic acid and vit D supplements
Nutrition, diet and food hygiene
Lifestyle factors
antenatal screening

3

When should booking appointment occur?

8-12 weeks
(ideally less than 10)

4

What non-invasive tests take place at booking?

Blood pressure, BMI, check for risk factors eg GDM, pre-eclampsia, psych hx, FGM, DV,

Urine checked for proteinuria and asympomatic bacteriuria

5

What are included in booking bloods?

ABO typing, RhD status, red cell alloantibodies FBC (anaemia), haeboglobin electrophoresis (haemoglobinopathies)
HepB, HIV, syphillis, rubella

6

When should dating scan take place? What is checked?

10-14 weeks
Measure CRL, Check intrauterine, check fetal poles, singleton/twins, Check NT and may/may not take bloods for combined test

7

1 When is combined test done?
2 What is included?
3 What is the cut-off for risk?

11-13+6/40
NT, PAPP-A, bHCG
1 in 150

8

What happens at 16wk appointment?

Discuss results of tests,
Measure BP and check for proteinuria
offer iron if anaemic
OGTT if previous GDM

9

When is anomaly scan and what does it look for?

Occurs at 18-20 weeks. Screening for structural anomalies eg cardiac defects, diaphragmatic hernia, check uterine artery flow etc

10

When is SFH measured?

every appointment after 24 weeks

11

When are the additional appointments nullips have and what takes place?

Occur at 25, 31 and 40 weeks
Standard BP, SFH and proteinuria check.
Discuss management of prolonged pregnancy and consider stretch and sweep at 40/40

12

After anomaly scan, when are the routine appointments?

28, 34, 36 and 38 weeks

13

What happens at 28 week appointment?

Discuss anomaly scan results,
Second screening for anaemia and red cell alloantibodies
OGTT if risk factors and no previous history of GDM
Anti-D to Rh neg mothers
Women should be offered acellular Pertussis vaccine between 28-38 weeks
BP, SFH and proteinuria check

14

What happens at 34 week appointment?

Second dose of Anti-D if indicated
Review results of 28-week bloods
BP, SFH and proteinuria check
Info on preparing for labour, discuss pain management etc

15

What happens at 36 week appointment?

Assess fetal presentation. Confirm malpresentation by USS
BP, SFH and proteinuria check
Offer uncomplicated breech singletons ECV
Counsel on breastfeeding, care of newborn, Vit K prophylaxis, newborn screening and postnatal self-care inc baby blues awareness

16

What happens at 38 weeks?

Assess foetal presentation,
BP, SFH and proteinuria check
Planning delivery, discuss options for prolonged pregnancy

17

What happens at 41 week appointment?

If havent given birth:
BP, SFH and proteinuria check
Offer membrane sweep or induction of labour

18

What if woman declines induction past 42 weeks?

Offer increased monitoring - twice weekly CTG and US of amniotic pool depth

19

What antivirals should be given to a woman with HIV?

BIHA says zidovudine and lamivudine
if 3rd agent needed, give nevirapine or efavirenz
IV zidovudine infusion during labour and delivery if presented late