Flashcards in Antenatal Care Deck (16)
What are the 3 steps of pre-pregnancy counselling?
-Routine screening for any problems
-Mx any problems
-General advice (pharm, behavioural)
What routine investigations should be conducted?
-Varicella Ab (in absence of definite PHx)
General advice (pharmacological) in pregnancy?
What are the 6 steps in the first antenatal visit?
1. Confirm pregnancy
2. Gestational age
3. Screening for problems
4. Mx of any problems
5. General advice
How is pregnancy confirmed?
-Hx: missed period, urinary frequency, breast tenderness, nausea
-PEx: uterine enlargement
-Ix: serum bHCG, urinary CG
What is the issue with urinary CG?
Cross reacts with LH --> FPs and FNs
What is the most accurate measure of gestational age?
-6-12w CRL (+/-3 days)
-12-20w BPD (+/-7d)
What is Naegele's Rule?
9months + 1 week from first day LNMP
-adjust up or down if cycle longer/shorter than 28d
-not reliable if cycle irregular or recently ceased OCP
Hx screen for potential problems?
-Meds and allergies
-FH and SHx
Ix screening for potential problems?
-Haematology: Hb, plt, MCV (anaemia, thalassemia)
-Blood bank: group, Abs
-Microbiology: Rubella, VZV, syphilis, Hep B/C, HIV, MSU MCS
-Cytology: pap smear
-Biochemistry: serum screen T21
-Imaging: 12w nuchal (T21)translucency, 19w morphology
General advice during pregnancy?
-Vitamin and mineral supplementation (iron, Ca, Vit D, folate)
-Exercise (moderate ok)
-working (usu cease ~34w)
-Medication (paracetamol, maxalon, penicillin OK)
what is the purpose of subsequent ante natal visits?
Early diagnosis and treatment of complications, especially:
-Pre eclampsia: HTN, proteinuria, oedema
-Placental insufficiency (poor growth, movements)
Antenatal visit frequency?
-Pre 28 weeks: 4 weekly
-28-36 weeks: 2 weekly
-36 weeks: weekly
PEx specifics subsequent antenatal visits?
-Fundal height: symphysis to top of fundus
-LIe and presentation
Ix at 28w?
-OGTT or OGCT
-+/- RHab and Anti D (if RH-ve)