Antenatal Care

Question 1

What vitamin should all women have in pregnancy and breastfeeding and at what dose

Answer 1

Vitamin D 10mcg

Question 2

Ideally when should screening for sickle and thalassaemia be done by

Answer 2

10 weeks

Question 3

What screening for downs screening is offered and when

Answer 3

Combined screening at 11-13+6

Triple or quad screening at 15-20 weeks if:
Combined missed
Unable to measure NT on USS

Question 4

When should booking occur by

Answer 4

Ideally 10 weeks

Question 5

How many anc appointments should low risk women get

Answer 5

Nulliparous 10

Multiparous 7

Question 6

When and how should gestational age be assessed

Answer 6

USS CRL at 10-13+6

HC if CRL >84mm

Question 7

How is listeriosis avoided

Answer 7

Pasteurised or UHT milk
No ripe/soft cheese
No pate inc vegetable pate
No uncooked/undercooked ready meals

Question 8

How is salmonella avoided

Answer 8

Raw/partially cooked eggs

Raw/partially cooked meat

Question 9

What is 1 unit of alcohol

How much can you have in pregnancy

Answer 9

1/2 pint, 1 shot

Small wine = 1.5 units

No more than 1-2 weekly

Question 10

How should seatbelts be applied

Answer 10

Above and below the bump not over it

Question 11

When should N&V resolve

Answer 11

16-20 weekdays

Question 12

What is considered normal Hb

Answer 12

Booking 110

28 week 105

Question 13

When should sickle and thalassaemia screening be done as routine

Answer 13

Feral prevalence >1.5 cases per 10,000 pregnancies

Otherwise family origin questionnaire can be used

Or if MCV <27 picograms

Question 14

What at the anomaly scan should print referral for an FMU scan

Answer 14

NT >6mm

>2 soft markers

Question 15

When should a placental localisation scan be done

Answer 15

At 32 weeks only if the placenta covered the int os at the anomaly

Question 16

If women decline induction when and what monitoring should be offered

Answer 16

2x weekly CTG and weekly deepest pool

Question 17

At 11-13+6 what does an A wave and tricuspid regurge indicate an increased risk of

Answer 17

Aneuploidy

Question 18

What % of PET can be predicted from the booking Hx

Answer 18

47%

With a false + rate of 10%

Question 19

What % of women take the correct pre conception folic acid

Answer 19

20-50%

Question 20

What is the incidence of RBC Ab

Answer 20

1:80

Question 21

What is the incidence of a cute appendicitis in pregnancy

Answer 21

1:800 - 1:1500

Most common in 2nd trimester

Question 22

If US imaging for appendicitis in pregnancy is inconclusive, what imaging is second line

Answer 22

MRI

sensitivity 90% specificity 98%

Question 23

What is the 1st line malaria prophylaxis in areas of chloroquine resiStance

Answer 23

Mefloquine

Question 24

What investigation should be done for a 1st presentation of reduced FM

Answer 24

Auscultation with Doppler, CTG not indicated

Question 25

What % of twins are monochorionic

Answer 25

33%

Question 26

What is the perinatal mortality in the whole uk and what is it in monochorionic twins

Answer 26

UK 7 per 1000 MC twins 300-700 per 1000 A 30-70% increase

Question 27

What risks are reduced by antenatal steroids and by how much

Answer 27

Death 31% RDS 44% Intraventricular haemorrhage 46%

Question 28

Doxorubicin & epirubicin What type of drugs are they A Hx of use should prompt what investigation antenatally

Answer 28

Anthracyline chemotherapy agents used in breast Ca Cause dose dependant LV dysfunction so an echo is required

Question 29

By how much does domestic violence increase maternal mortality

Answer 29

3x

Question 30

What level of anti-D should trigger referral to FMU How often should levels be measured

Answer 30

>4 Levels 4-15 correlate with a moderate risk of HDFN Once detected they should be checked every 4 weeks till 28 weeks, then 2 weekly till delivery

Question 31

Regarding anti-D, what is the window for optimal timing to prevent sensitisation

Answer 31

72hr

Question 32

If placenta praevia is suspected at the anomaly scan, what follow up imaging should be done and when

Answer 32

Colour flow Doppler at 32 weeks MRI is used if scan is not diagnostic

Question 33

I'm sepsis, what fluids should be given if lactate is >4

Answer 33

Crystalloid 20ml/kg

Question 34

When should caution be used with acyclovir

Answer 34

<20 weeks

Question 35

What is the risk of HSV infection if primary infection occurs within 6 weeks of delivery

Answer 35

30-60%

Question 36

How long is the incubation period for HSV

Answer 36

7 days

Question 37

What % of pregnancies are complicated by PPROM

Answer 37

2%

Question 38

Regarding PPROM at what gestation should delivery be considered

Answer 38

34 weeks

Question 39

What is the risk of prom at the time of Cx stitch insertion

Answer 39

<1%