Antenatal care and Screening Flashcards
What is the point in doing antenatal screening?
- Detect and manage pre-existing maternal disorders.
- Prevent or detect and manage maternal complications of pregnancy.
- Any foetal complications of pregnancy
- Congenital foetal problems
- Offer reproductive choice.
When is the booking visit?
8-12 weeks
What disorders should ideally be screened for before 10 weeks?
Sickle cell anaemia and Thalassaemia trait.
What is screened for at your booking visit?
- haemoglobinopathies
- Hep B and C
- HIV
- Syphilis
- Red cell antibodies
- Anaemia
- Number of Foetuses
- Viability
- PMH, PSH, Obstetric Hx, meds, allergies, SH, FH, Past mental health.
- FGM
- BMI
- Trisomy screening offered.
When is the Anomaly scan done?
at 18-21 wks
What sort of anomalies is the anomaly scan used to identify?
- Cleft, Heart, NTD, Limb defects, Placental Site, Diaphragmatic hernia, Abdoominal wall defects, lung abnormalities, brain abnormalities, Urinary tract abnormalities.
What is checked at 28 weeks.
- Red cell antibodies
- Anaemia
Also anti-D tx given now if necessary.
When is the Dating scan done?
11 - 14 wks.
What kind of things are checked at every appointment?
- BP
- Urine (UTI, PET, Diabetes)
- Macrosomnia/IUGR
- Mental Health
- Abuse and support
What is Naegele’s rule?
- Predicts an estimated due date based on the ONSET of the women’s last menstrual period.
- Add 9 months and 7 days to arrive at the due date (280 days)
When would Placental site be checked and when could Placenta Previa be diagnosed?
Identified at anomaly scan (18-21wks)
If placenta previa is diagnosed recheck is at 32 wks.
What Trisomy mutations are screened for in pregnancy?
- Downs
- Edwards
- Patau’s
How is Trisomy screening done antenatally for Downs?
The Combined Test is preferred:
- Done between weeks 11-14
- Combined Nuchal thickness and a Maternal blood test to give a risk score.
Blood test includes:
- b-hCG (higher result = Higher risk)
- PAPPA (Lower result = Higher risk)
What happens if mothers miss the testing between 11 and 14 wks? what can they be offered to screen for downs?
The Quadruple test
- Uses maternal age + Biochemical markers (AFP, hCG, UE3 (oestriol) and Inhibin A)
What score indicates a high risk of Downs and requires further testing?
A risk score of >1:150
