Antenatal care screening Flashcards
(38 cards)
what is antenatal care
Antenatal care (ANC) can be defined as the care provided by skilled health-care professionals to pregnant women and adolescent girls in order to ensure the best health conditions for both mother and baby during pregnancy. The components of
ANC include: risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion
aim of antenatal care
Aim is to prevent, identify and manage conditions that cause maternal and neonatal morbidity, and which may result in or contribute to maternal mortality, stillbirth and neonatal death
what does antenatal care start with
pre-conceptional care
Opportunity to assess perspective parents health & provide information to help them make choices.
organisation of antenatal care
maternal characteristics where additional care is required
PMH examples where additional care is required
obstetric issues where additional care is required
WHO screening principles
Respond to a recognised need
Objectives defined
Target population
Integrate education, testing, services and management
Quality assurance
Ensure informed choice, confidentiality, autonomy
Promote equity and ensure access
Benefits outweigh harm
differences between screening and diagnostic tests
what is screening
Screening (think of a sieve) is the process of identifying healthy people who may have an increased chance of a disease or condition.
The screening provider then offers information, further tests and treatment. This is to reduce associated problems or complications.
Screening should always be a personal choice.
what is diagnosis
Diagnosis involves interpreting the history, clinical observations, laboratory test results, or imaging studies—all of which are “tests” undertaken to help doctors refine their estimate of the probability that a patient has a particular condition.
6 NHS antenatal and newborn ANNB screening programmes
Fetal anomaly screening (FASP)
Infectious diseases in pregnancy screening (IDPS)
Sickle cell and thalassaemia screening (SCT)
Newborn and infant physical examination (NIPE)
Newborn blood spot screening (NBS)
Newborn hearing screening (NHSP)
what will fetal anomaly screening screen for
Edwards’ syndrome (T18)
Patau’s syndrome (T13)
anencephaly
spina bifida
cleft lip
congenital diaphragmatic hernia
gastroschisis
exomphalos
congenital heart disease
bilateral renal agenesis
lethal skeletal dysplasia
limitations of screening
Screening is not a diagnostic test
Expectation
False negative
False positives
when is booking appointment
before 10 weeks gestation
0-12 weeks screening
Infectious diseases including HIV, hepatitis B and syphilis (blood test) Reoffer at 20weeks if initially declined. No longer screen for Rubella
preconception, 12 weeks screening
Sickle cell disease and thalassaemia (blood test)
screening trisomy
Screening Trisomy 21 (Down’s syndrome) is offered to all pregnant women from 11 weeks and two days’ gestation, up to 20 weeks’ gestation (blood test and scan)
screening Edwards syndrome and Pataus
Screening for Edward’s syndrome & Patau’s syndrome is offered to all pregnant women from 11 weeks and 2 days gestation to 14 weeks and one day gestation only (blood test and scan)
advice given in booking appointment
Folic acid / vitamin D / Exercise / smoking – CO monitoring / Alcohol.
Maternal VTE assessment
Mental health assessment
BMI / BP / Urine
Growth assessment – Symphysio fundal height chart
Screening
aim of booking appointment
e aim of the booking visit is to facilitate planning of immediate antenatal care and to formulate a plan for ongoing antenatal care.
It is also an important opportunity to screen women for potential adverse pregnancy outcomes
Due to large vols of info needed the booking appointment may be divided into two parts
Hospital Trusts have an online tool for information gathering prior to face to face appointment. Completed by the patient.
taking history at booking appointment
* her general health and wellbeing
* whether she has any concerns that she would like to discuss – also ask her partner about this, if present
* her obstetric history, and the medical and family history of both biological parents
* previous or current mental health concerns, including any severe mental illness, trauma or psychiatric treatment
* current and recent medicines, health supplements and herbal remedies
* allergies
* her nutrition and diet, physical activity, smoking status, alcohol consumption and recreational drug use
* her occupation, discussing any risks and concerns
* her family and home situation – if she is alone, also ask about domestic abuse
* her support network, including other people who may be involved in the baby’s care
* any health or other issues affecting her partner or family members that may be significant for her health and wellbeing
* contact details for her partner and her next of kin.
If a woman books late in pregnancy, also ask about the reasons for the late booking because it may reveal social, psychological or medical issues that need to be addressed.
sickle cell and thalassaemia screening
trisomy screening process
