Flashcards in Antenatal Care Deck (37):
Mx of current probs
3 routine test you must do in pre preg Counselling?
Further assessment prepreg optimization?
DM - oral hypoglycaemia to insulin
Epilepsy - Poly to Mono therapy
Anticoagulation: switched from warfarin to LMW Heparin
DM woman how to change Rx prepreg?
Change from oral hypo glycaemics to INSULIN
Prognostic advice for prepreg for renal failure?
Renal failure: creatinine >0.3: pulmonary HT (Mortality 50%)
Treat with surrogacy.
Counselling for prepreg?
Pharma: folate(500ug 3/12 before or 5mg) : avoid teratogens
Behavioural: Freq and timing:alcohol, smoking
Freq and timing to conceive?
Intercourse 48hrly or daily in the week before ovulation
Avoid Worse than cannabis, Heroin
6 steps in first antenatal visit
Screening for probs
Mx of any probs
General advice (OSCE station)
Booking (planning model of care)
Pregnancy tests? Which is best?
Serum: hCG 100% (DO THIS.)G
Urinary hCG: cross reacts with LH
Lots of false positives and false negatives
Gestational Age? Best?
Ultrasounds 6-12 weeks: Crown rump length. +/-3 days
12-20wks: biparietal diameter. +/- 7 days
Naegle's rule breaks down when?
If cycle longer/shorter than 28 days
Not realizable if unrealizable cycle or recently stopped OCP
FHx Social Hx? prepreg?
Alcohol, smoking, illicit, marital, occupation
What does gynaecological exam involve?
TEsts at Antenatal visits?
Haematologic: Anaemia: Thal Minor!
Microbiology (rubella, varicella, syphilis, HepB,C, HIV
Why check MCV?
If preg woman is not immune to varicella?
Hyperimmune ZiG. IVIG
HIV in preg?
No breastfeeding, C-section, antiretrovirals
Biochem in first antenatal visit?
Trisomy 21 screen
Worst epilepsy drug in preg?
General advice in first antenatal visit?
Mineral vitamin supplementation
Diet first antenatal?
Listeria - Chicken
Avoid salads, soft serve ice cream
Why chicken get more likely food poisoning
Cause it's frozen, doesn't get cooked thoroughly
first antenatal mineral vitamin supplementation?
Iron, calcium, Vit D
20% of population has this thrombophilia? How to avoid?
continue folate and multi it's
Exercise first antenatal advice?
Moderate not heavy
Heavy alcohol use is defined?
More than 2 SD per day
Working? first antenatal advice?
34 weeks, or earlier if increased BP
Meds first antenatal advice?
Paracetomol: PRN not regular
2 important conditions first antenatal visit?
Mx in antenatal
General well being
Fetal movements >20 weeks
Oedema (preeclampsia, not ankle, look at fingers)
Women must have what EVERY visit?
Dipstick to check for protein
Rh anti-D PRN
36 weeks tests?
FBE is low at 28weeks
GBS: penicillin or erythromycin
Anti-D PRN again
Mother who wants to deliver 2nd vaginally after C-section?
1/200 risk of death
If after 39 weeks gestation, risk of probs?
1/400 of perinatal death