Antenatal Care

Question 1

What is sensitivity?

Answer 1

true positive/ (positive + false negative)

Question 2

What is specificity?

Answer 2

true negative/ (negative + false positive)

Question 3

What is done at the booking visit?

Answer 3

full history; exam- BMI; CVS; abdomen; Ix

Question 4

What is Naegele’s Rule?

Answer 4

estimated due date based on LMP

Question 5

When is the booking visit?

Answer 5

around 12 weeks

Question 6

What investigations are done at the booking visit?

Answer 6

Hb; ABO; Rhesus; syphilis; HIV; hep B and C; UA; US

Question 7

What is looked at on US at the booking visit?

Answer 7

confirm viability; singleton/mulitple pregnancy; estimate gestational age; major structural abnormalities; offer Down’s screening

Question 8

What is the purpose of UA?

Answer 8

look for asymptomatic bacteruria; gestational DM; pre-eclampsia

Question 9

How many pregnancies at the booking viist US won’t be viable?

Answer 9

1 in 5

Question 10

What is the function of the yolk sac?

Answer 10

supports pregnnacy until placenta

Question 11

What is done at follow up visits?

Answer 11

history- physical and mental health; fetal movements; BP and UA; symphysis-fundal height; lie and presentation; fetal heart auscultation

Question 12

When is a transverse lie a problem in pregnnacy?

Answer 12

36/37 weeks

Question 13

What are the problems with transverse lie?

Answer 13

cord prolapse; malposition eg breech

Question 14

What is the still birth rate in pregnnacy?

Answer 14

1 in 200

Question 15

What is done in an anomaly risk assessment in the first trimester?

Answer 15

increased nuchal thickenss

Question 16

What blood test is done for fetal anomlaies in the 2nd trimester?

Answer 16

hCG and AFP

Question 17

What is considered high risk for Down’s?

Answer 17

more than 1 in 250

Question 18

What is placental praevia?

Answer 18

placenta is low lying in the womb and covers all or part of hte cervix

Question 19

What is done is placental praevia is seen at a scan between 18-20+6 weeks?

Answer 19

offered abdo scan at 32 weeks

Question 20

When is nuchal thickness measured on USS?

Answer 20

11-13+6 weeks

Question 21

What is nuchal thickness?

Answer 21

<3.5mm

Question 22

What tests is nuchal thickness combined with in the first trimester for Downs screening?

Answer 22

HCG and PAPP-A

Question 23

What is used to estimate gestation before 13 weeks?

Answer 23

crown-rump length

Question 24

What should be used to estimate gestation after 13 weeks?

Answer 24

head circumference

Question 25

What is second trimester screening for Down's?

Answer 25

maternal age+ biochemical markers- AFP; hCG; uncojugated oestradiol and inhibin A

Question 26

When is the second trimester screening for Down's?

Answer 26

between 14-20 weeks

Question 27

Who gets the second trimester screening for Down's?

Answer 27

those who missed the first trimester offer

Question 28

What is the miscarriage rate with amniocentesis?

Answer 28

1%

Question 29

When is amniocentesis performed?

Answer 29

after 15 weeks

Question 30

When is chorionic villous sampling carried out?

Answer 30

after 12 weeks

Question 31

What is them iscarriage rate with chorionic villous sampling?

Answer 31

2%`

Question 32

When is maternal anaemia screened for?

Answer 32

booking and 28 weeks

Question 33

What questions are used to screen mental health in pregnnacy?

Answer 33

new feelings or thoughts which make you disturbed or anxious? thoughts of suicide or self-harm? feeling incompetent as a mother, feeling distnaced or estranged; feel getting worse?

Question 34

What are the risk factors for gestational DM?

Answer 34

BMI >30; previous macrosomic baby (>4.5kg); Fhx; minority ethnic family origin

Question 35

Who should be offered testing for gestational DM?

Answer 35

woman with any one risk factor for GDM

Question 36

What is the fasting plasma glucose for GDM?

Answer 36

>5.6mmol

Question 37

What is the 2hour plasma glucpse level for GDM?

Answer 37

>7.8mmol

Question 38

Who should be sent for ultrasound measuremtn of fetal size?

Answer 38

women with single SFH below 10th centile or slowing or static growth

Question 39

What could make SFH inaccurate?

Answer 39

BMI >35; large fibroids; hydramnios

Question 40

What is the treatment for women at high risk of pre-eclampsia?

Answer 40

75mg of aspiring from 12 weeks to birth

Question 41

What are the high risk factors for pre-eclampsia?

Answer 41

HT disease in prev pregnnacy; CKD; AI disease eg SLE or EPS; T1 or T2DM; chronic HT

Question 42

What are the moderate risk factors for pre-eclampsia?

Answer 42

first pregnancy; age 40 or more; pregnnacy interval of >10 years; BMI >35; Fhx; multiple pregnnacy

Question 43

When should a booking appt in pregnnacy be carried out?

Answer 43

ideally by 10 weeks

Question 44

What should be done at 16 weeks?

Answer 44

review screening tests etc; BP and UA

Question 45

What should be carried out at 18-20 weeks?

Answer 45

USS anomaly scan

Question 46

Who should get an appt at 25 weeks?

Answer 46

nulliparous women

Question 47

When is the second appt for all pregnant women?

Answer 47

28 weeks

Question 48

What is done at the 28 week appt?

Answer 48

second screening for anaemia and blood group abs; offer anti-D; BP and UA; SFH;

Question 49

Who should get an appt at 31 weeks?

Answer 49

nulliparous women