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Flashcards in Antenatal Care Deck (16):
1

What are the 3 steps of pre-pregnancy counselling?

-Routine screening for any problems
-Mx any problems
-General advice (pharm, behavioural)

2

What routine investigations should be conducted?

-Rubella Ab
-Varicella Ab (in absence of definite PHx)
-Pap smear

3

General advice (pharmacological) in pregnancy?

-Folate
-Avoid teratogens

4

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
6. Booking

5

How is pregnancy confirmed?

-Hx: missed period, urinary frequency, breast tenderness, nausea
-PEx: uterine enlargement
-Ix: serum bHCG, urinary CG

6

What is the issue with urinary CG?

Cross reacts with LH --> FPs and FNs

7

What is the most accurate measure of gestational age?

US:
-6-12w CRL (+/-3 days)
-12-20w BPD (+/-7d)

8

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

9

Hx screen for potential problems?

-Age
-PHx
-Surgical Hx
-OHx
-GHx
-Meds and allergies
-FH and SHx

10

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

11

General advice during pregnancy?

-Diet
-Vitamin and mineral supplementation (iron, Ca, Vit D, folate)
-Exercise (moderate ok)
-Smoking
-Alcohol
-Sex
-working (usu cease ~34w)
-Medication (paracetamol, maxalon, penicillin OK)

12

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)

13

Antenatal visit frequency?

-Pre 28 weeks: 4 weekly
-28-36 weeks: 2 weekly
-36 weeks: weekly

14

PEx specifics subsequent antenatal visits?

-Weight gain
-BP
-Fundal height: symphysis to top of fundus
-LIe and presentation
-Auscultation
-Urinalysis

15

Ix at 28w?

-FBE
-OGTT or OGCT
-+/- RHab and Anti D (if RH-ve)

16

Ix at 36w?

-FBE
-GBS swap
-Anti D if Rh Neg