Antenatal care and screening Flashcards
What are some general health measures advised in pre-pregnancy counselling?
Improve diet Optimise BMI Reduce alcohol consumption Smoking cessation advice Folic acid Up to date cervical smear
Can HbA1c levels affect pregnancy?
Yes
Pregnancy is advised against when HbA1c is significantly elevated
How does cardiac disease affect pregnancy?
Significant cardiac disease can be associated with maternal mortality
ACE inhibitors should be avoided during pregnancy
How does epilepsy affect pregnancy?
Sodium valproate should be avoided in pregnancy
How is a patient with previous pre-eclampsia managed?
150mg aspirin daily during pregnancy and regular BP monitoring
How is a patient with previous gestational diabetes managed?
HbA1c at booking
OGTT at 28 weeks
How is a patient with previous DVT or PE managed?
Consider antenatal thromboprophylaxis and 6 weeks post natal treatment
How may a previous caesarean section affect delivery?
Must review to determine safest mode of delivery this time
Usually if it was just one c section for a non-recurring cause such as breech presentation then it should be fine
After 2 previous c sections we usually do the same for any more
What are the main maternal concerns in antenatal care?
Raised BP
Urinalysis
Mental health
Birth planning
What are the main foetal concerns in antenatal care?
Screening
Reduced foetal movement
Malpresentation
Which diseases are screened for in routine antenatal care?
Rubella
Hep B
Syphilis
HIV
When is iron deficiency anaemia and isoimmunisation screened for?
In 1st trimester and at 28 weeks
What are the aims of the first visit scan?
Ensure pregnancy is viable
Check for multiple pregnancies
Identify abnormalities incompatible with life
Offer Down’s syndrome screening
When is the first scan ideally performed?
Between 11 and 14 weeks
What are the main factors affecting the likelihood of down’s syndrome?
Maternal age
Family history
