Antenatal Care

Question 1

What is the aim of antenatal care

Answer 1

• risk assessment
• health promotion
• medical\psyychological intervention
• plan for birth

Question 2

Each trimester is ….. weeks

Answer 2

1st and 2nd: 14

3rd: 12

Question 3

First trimester is from week … to week …

Answer 3

1-13

Question 4

Second trimester is from week … to week …

Answer 4

14-27

Question 5

Third trimester is from week … to week …

Answer 5

28 to 40

Question 6

What are the laboratory tests that you will order for the first visit of antenatal care?

Answer 6

1- CBC - ABO - Rh typing
2- Urine (analysis\culture)
3- rubella, syphlis, HBV, HIV
4- Pap smear

Question 7

CBC and platelet count measurement during antenatal visit, is important to:

Answer 7

Know Hb baseline, as in pre-eclampsia there’s is drop of platelet count.

Question 8

Urine analysis and culture measurement during antenatal visit, is important to:

Answer 8

1- look for UTI (asymptomatic bacteruria)

2- measure glucose\protein (pre-eclampsia)

Question 9

What are the complications of UTI in pregnant lady?

Answer 9

1- preterm labor
2- rupture of membrane
3- ascending infection (pyelonephritis)

Question 10

For specific patients, there are other lab investigations, these are:

Answer 10

Chlamydia, gonorrhea, TSH, TB, DM

Question 11

When to start treating patient for hypothyroidism during pregnancy?

Answer 11

Low T3, T4 - or - symptomatic

Question 12

What is the role of US in first visit

Answer 12

1- dating 
2- location
3- viability
4- number 
5- check uterus\ovaries

Question 13

When is the best time to do the first ultrasound

Answer 13

Between 7-9 weeks (fetal pool, gestational sac, crown lump lenght)

Question 14

What are the methods used to confirm pregnancy?

Answer 14

1- HCG (blood or urine)

2- US (when HCG>1500)

Question 15

What is the percentage of HCG to be positive in urine test?

Answer 15

> 25

Question 16

When does blood test become positive

Answer 16

After 6-8 days of ovulation, before her next missed period

Question 17

What is the HCG value at time of missed period?

Answer 17

100

Question 18

How to differentiate between normal pregnancy, abortion and ectopic pregnancy using HCG?

Answer 18

During the first 30 days of pregnancy, HCG doubles every 2 days.

• US shows no fetus
• measure HCG and repeat after 2 days
• if double: normal - if no double: Ectopic\abortion

Question 19

What is biochemical pregnancy

Answer 19

Pregnancy confirmed only by HCG and no US

Question 20

how to determine gestational age in

• regular period
• irregular period

Answer 20

• Nealges rule (+7d-3m+1y)

- dating US

Question 21

Dating US is only accurate in:

Answer 21

The first trimester (1 or 2 days error)

Question 22

What is the error rate in 2nd and 3rd trimester?

Answer 22

• 2nd: 1w

- 3rd: 2\3 w

Question 23

What are the methods for screening for common genetic disorders

Answer 23

• blood: triple & quadraple test - free fetal DNA

- US: nasal bone - NT - anomaly scan

Question 24

What are the methods for diagnosis for common genetic disorders

Answer 24

Amniocentesis, CVS, cordocentesis

Question 25

Which test of diagnosis for genetic abnormalities is usually done early, and which one is done late?

Answer 25

Early: amniocentesis Late: CVS

Question 26

From where is sample taken in amniocentesis, cvs, and cordocentesis

Answer 26

- amniotic fluid - placenta - Umbilical cord

Question 27

What are the complications of cordocentesis?

Answer 27

Bleeding and IUFD

Question 28

When to preform - GDM screening - GBS screening - Rh titer

Answer 28

- 24 to 28w - 35 to 37w - 24 to 28w

Question 29

What are the safe and unsafe vaccines during pregnancy?

Answer 29

- Dtap, HBV, flu | - live attenuated like MMR

Question 30

What are the dates for | First, second, and third trimester US

Answer 30

- 12wks - 20wks - 32wks then as needed

Question 31

What to look for in the 2nd trimester US?

Answer 31

Anomaly (conginital) - organs easily demonstrated

Question 32

What to look for in 3rd trimester US?

Answer 32

- Growth scan - Placental localization (no previa\accreta) - fetal wellbeing - presentation (cephalic\breach)

Question 33

Nutritional assessemnt during pregnancy:

Answer 33

Calcium and iron

Question 34

What is the average weight gain during pregnancy

Answer 34

12kg, more in underweight, less in overweight

Question 35

What causes nausea & vomitting during pregnancy?

Answer 35

B-hcg (from 1st trimester to 20wks)

Question 36

What causes heart burn in pregnancy

Answer 36

- Progestrone causes muscle sphincter relaxation | - HCG

Question 37

What are the common symptoms of pregnancy

Answer 37

``` 1- N&V 2- heart burn 3- constipation 4- hemorrhoid 5- leg cramps 6- backaches ```

Question 38

Warning symptoms during pregnancy

Answer 38

Vaginal bleeding, headache, blurred vision, abdominal pain, decrease fetal movement, abnormal vaginal discharge

Question 39

What is the minimum recommended visits for ANC?

Answer 39

4 | Confirm, anomaly scan, plan delivery 28, time of delivery