Antenatal Care

Question 1

when should folic acid supplements be taken in pregnancy

Answer 1

before conception until 12 weeks gestation

Question 2

what does folic acid supplementation prevent

Answer 2

neural tube defects

Question 3

what is the recommended dose of folic acid

Answer 3

400 micrograms

Question 4

what groups of people are suggested to take a higher dose (5mg) of folic acid

Answer 4

diabetes 
epilepsy and taking AEDs
BMI >30
previous pregnancy with neural tube defect
family history of neural tube defect

Question 5

what are some of the features of a child with foetal alcohol syndrome

Answer 5

learning and behavioural needs
poor growth
facial abnormalities

Question 6

consuming alcohol in pregnancy also increases risk of what adverse outcome

Answer 6

IUGR
stillbirth 
SIDS
microcephaly 
neonatal abstinence

Question 7

nicotine consumption in pregnancy increases the risk of what adverse outcomes

Answer 7

miscarriage
IUGR
SIDS

Question 8

what is the recommended limit of alcohol in pregnancy

Answer 8

0 - no amount is safe

Question 9

when should the booking visit during pregnancy be carried out

Answer 9

ideally before 10 weeks but no later than 12

Question 10

what is the aim of the booking visit

Answer 10

to identify high risk pregnancies

to identify if the pregnancy is viable

Question 11

outline some of the main areas that are assessed in the booking visit

Answer 11

blood group and rhesus D antibodies
screen for haemoglobinopathies, anaemia, HIV, syphilis, Hep B
offer trisomy screening
blood pressure and urine for proteinuria
check viability of pregnancy/gestational age

Question 12

how is the gestation of a pregnancy assessed at the booking visit

Answer 12

crown rump length can be measured between 10 and 14 weeks

head circumference is for CRL >84mm

Question 13

when is head circumference used to measure gestational age

Answer 13

from 11-16 weeks

Question 14

when should the screening test for trisomy be completed

Answer 14

between 11 and 13+6 weeks

Question 15

what conditions are screened for in the trisomy screening test

Answer 15

Trisomy 13 - Patau’s
Trisomy 18 - Edward’s
Trisomy 21 - Down’s

Question 16

what is involved in the trisomy screening test

Answer 16

blood test and US

Question 17

what bloods tests are carried out in trisomy screening

Answer 17

AFP
PAPPA
HCG
AFP typically low with trisomy and other 2 are raised

Question 18

what is assessed on the US in trisomy screening

Answer 18

nuchal thickness, the amount of fluid collecting at the nape of foetus’ neck
the larger the NT, the more likely a trisomy is

Question 19

if a woman is detected as high risk for trisomy, what are her next options

Answer 19

no further testing
NIPT
diagnostic testing

Question 20

what 2 tests are involved in diagnostic testing for trisomy

Answer 20

chorionic villous sampling

amniocentesis

Question 21

how does chorionic villous sampling take place and when can it take place

Answer 21

takes place between 11-4 weeks

sample of placental tissue either transcervically or transabdominally

Question 22

how does amniocentesis take place and when can it take place

Answer 22

can be carried out after 15 weeks to enable the amniotic sac to adequately fill with fluid
sample of the amniotic fluid obtained for genetic testing

Question 23

out of CVS and amniocentesis which has greater risk of miscarriage

Answer 23

CVS, also risk of amniotic fluid embolism

Question 24

what is NIPT

Answer 24

non-invasive prenatal testing is a second screening test

analyses cell free DNA in the mothers blood from the foetus

Question 25

when is the foetal anomaly scan carried out

Answer 25

between 18 and 21 weeks

Question 26

what foetal anomalies are screening for in the anomaly scan

Answer 26

spina bifida 
acencephaly 
gastroschisis 
exomphalos 
cardiac abnormalities 
cleft lip 
bilateral renal agesis 
diaphragmatic hernia

Question 27

when is the whooping cough vaccine offered to pregnant women

Answer 27

28-32 weeks

Question 28

what is exomphalos

Answer 28

GI defect with bowel covered by sac of amnion

Question 29

gastroschisis

Answer 29

matted loops of bowel outside body with no covering