Antenatal Care Flashcards Preview

Jason's MD3 Women's > Antenatal Care > Flashcards

Flashcards in Antenatal Care Deck (37):
1

Routine

Routine screening
Mx of current probs

2

3 routine test you must do in pre preg Counselling?

Rubella
Varicella
Pap smear

3

Further assessment prepreg optimization?

DM - oral hypoglycaemia to insulin
Epilepsy - Poly to Mono therapy
Anticoagulation: switched from warfarin to LMW Heparin

4

DM woman how to change Rx prepreg?

Change from oral hypo glycaemics to INSULIN
Metformin ok

5

Prognostic advice for prepreg for renal failure?

Renal failure: creatinine >0.3: pulmonary HT (Mortality 50%)
Treat with surrogacy.

6

Counselling for prepreg?

Pharma: folate(500ug 3/12 before or 5mg) : avoid teratogens
Behavioural: Freq and timing:alcohol, smoking

7

Freq and timing to conceive?

Intercourse 48hrly or daily in the week before ovulation

8

Alcohol

Avoid Worse than cannabis, Heroin

9

6 steps in first antenatal visit

Confirm preg
Gestational age
Screening for probs
Mx of any probs
General advice (OSCE station)
Booking (planning model of care)

10

Pregnancy tests? Which is best?

Serum: hCG 100% (DO THIS.)G
Urinary hCG: cross reacts with LH
Lots of false positives and false negatives

11

Gestational Age? Best?

Ultrasounds 6-12 weeks: Crown rump length. +/-3 days
12-20wks: biparietal diameter. +/- 7 days

12

Naegle's rule breaks down when?

If cycle longer/shorter than 28 days
Not realizable if unrealizable cycle or recently stopped OCP

13

FHx Social Hx? prepreg?

Alcohol, smoking, illicit, marital, occupation

14

What does gynaecological exam involve?

External inspection
Speculum
Bimanual

15

TEsts at Antenatal visits?

Haematologic: Anaemia: Thal Minor!
Blood bank
Microbiology (rubella, varicella, syphilis, HepB,C, HIV
Cytology: pap
Biochem:
Imaging: U/S

16

Why check MCV?

Thal Minor
Anaemia

17

If preg woman is not immune to varicella?

Hyperimmune ZiG. IVIG

18

HIV in preg?

No breastfeeding, C-section, antiretrovirals

19

Biochem in first antenatal visit?

Trisomy 21 screen

20

Worst epilepsy drug in preg?

Valproate

21

General advice in first antenatal visit?

Diet -
Mineral vitamin supplementation
Exercise
Smoking
Alcohol
Sex
Working
Meds

22

Diet first antenatal?

Nutrition,
Listeria - Chicken
Avoid salads, soft serve ice cream

23

Why chicken get more likely food poisoning

Cause it's frozen, doesn't get cooked thoroughly

24

first antenatal mineral vitamin supplementation?

Iron, calcium, Vit D
Folate?
Iodine?

25

20% of population has this thrombophilia? How to avoid?

Hyperhomocysteinaemia
continue folate and multi it's

26

Exercise first antenatal advice?

Moderate not heavy

27

Heavy alcohol use is defined?

More than 2 SD per day

28

Working? first antenatal advice?

34 weeks, or earlier if increased BP

29

Meds first antenatal advice?

Penicillin.amoxyl
Paracetomol: PRN not regular
Maxalon

30

2 important conditions first antenatal visit?

Preeclampsia
Placental insufficiency

31

Mx in antenatal

General well being
Fetal movements >20 weeks
Oedema (preeclampsia, not ankle, look at fingers)

32

Women must have what EVERY visit?

Dipstick to check for protein

33

28 weeks

FBE
OGTT
Rh anti-D PRN

34

36 weeks tests?

FBE is low at 28weeks
GBS: penicillin or erythromycin
Anti-D PRN again

35

Mother who wants to deliver 2nd vaginally after C-section?

1/200 risk of death

36

If after 39 weeks gestation, risk of probs?

1/400 of perinatal death

37

PAPP-A should be what level?

Not below 0.42 MoM