Antenatal Care, Fetal Wellbeing and Medical Disorders in Pregnancy Flashcards
Smoking - Associated Risks
Fetal growth restriction
Preterm labour
Abruption
Intrauterine fetal death
Risk factors for screening for Gestational Diabetes
BMI >30kg/m2 Previous baby weighing 4.5kg or above Previous GDM First degree relative with DM Family origin from high prevalence area (South Asian, black Caribbean and Middle Eastern)
Early Pregnancy Disorders
Classical Symptom Triad
Amenorrhoea
Pelvic or lower abdominal pain
Vaginal bleeding
1st Trimester
Antenatal Investigations
US scan
Urine MCS
FBE, blood group and antibodies, iron studies, vitamin D
Serology - varicella, rubella, syphilis, Hep B/C, HIV
Combined maternal serum screening at 10 and 12 weeks (Trisomy 21 and 18) - PRIVATE ONLY
2nd/3rd Trimester
Antenatal Investigations
USS
Urine MCS
FBE, blood group and antibodies, iron studies, vitamin D
GTT
GBS vaginal swab
Combined maternal serum screening at 12 and 12-14 weeks (Trisomy 21 and 18 and neural tube defects)
Rhesus negative
Management
Prophylaxis with 625IU of anti-D at 28 and 34 weeks
If sensitisation event occurs (CVS, miscarriage, termination, haemorrhage, trauma) give anti-D within 72hrs (250IU in 1st trimester, 625IU in 2nd/3rd trimester)
At delivery do Kleihauler test - if baby is Rhesus + give 625IU anti-D 30-120 mins after delivery
Hepatitis B management
Screening of household contacts and vaccination, protected sex until then
No risk of fetal abnormalities from mother’s infection
Notifiable to Department of Health
Check LFT’s throughout pregnancy and INR prior to delivery
Avoid fetal scalp testing and excise normal precautions during delivery
Baby to receive HepB IG immediately after birth and HepB vaccination within 24hrs, with repeat vaccinations at 2, 4 and 6 months and serological testing in 12 months with a paediatrician
CMV in pregnancy
Child with calcifation in brain and microcephaly
