Antenatal care timetable (Complete)

Question 1

How many antenatal visits are required during pregnancy?

Answer 1

First pregancy: 10 appointments

Subsequent pregnancies: 7 appointments

Question 2

Summarise the antenatal care timetable

Answer 2

8-12 weeks: Booking appointment

10-13 + 6 weeks: Early scan to confirm dates

11-13 + 6 weeks: Combined screening for Down’s, Edward’s and Patau

16 weeks: Informed about anomaly results + routine checkup (BP + urine dipstick)

18-20 + 6 weeks: Anomaly scan

25 weeks (if primip): Routine care (BP, disptick, fundal-symphysis height)

28 weeks: Routine care + anaemia + first dose anti-D immunoglobulin in rhesus -ve woman

31 weeks: Routine care

34 weeks: Routine care + second dose anti-D + labour plan

36 weeks: Routine care + check presentation + postnatal advice

38 weeks: Routine care

40 weeks; Routine care + discuss options for prolonged pregnancy

41 weeks: Discuss induction of labour

Question 3

Antenatal visits are conducted by which healthcared proffesionals?

Answer 3

Midwives

Consultants only required if there are complications

Question 4

First antenatal appointment is knon as?

Answer 4

Booking appointment

Question 5

Booking appointment is typically carried out at which weeks of gestation?

Answer 5

8-12 weeks (ideally <10)

Question 6

What is the purpose of the booking appointment?

Answer 6

Estabilish care and rapport

Advice and education

Gather medical and social history

Risk assessment

• Identify high-risk pregnancies
• Midwives will usually ask the partner to wait outside the room towards the end of the consultation to check for safeguarding concerns

Arrange scans and further tests

Question 7

What investigations are conducted during booking appointment?

Answer 7

Bedside:

Basic obs: Check for hypertension

Urine dipstick: Check for proteinuria or infections

Height and weight: Calculate BMI

Bloods:

FBC: Check anaemia

Blood group and Rhesus status: Check if rhesus -ve

Infection screen

• HIV
• Hep B
• Syphillis

Question 8

What infections are screened for at booking appointment?

Answer 8

HIV

Hep B

Syphillis

Question 9

What additional investigations are offered to select individuals depending on medical background?

Answer 9

TFTs

• For women with thyroid conditions or symptoms

Vitamin D

• In women at risk (e.g. dark skin, nutritional deficiency)

HbA1c

• For women at high-risk of diabetes

Haemoglobin electrophoresis

• For suspected haemoglobinopathies

Question 10

When is early scan appointment arranged?

Answer 10

10-13+6 weeks

Question 11

What is the purpose of the early scan appointment?

Answer 11

To confirm dates

Exclude multiple pregnancy

Question 12

When is combined screening test conducted?

Answer 12

11-13+ 6 weeks

Downs syndrome + Edwards + Patau

Question 13

When is anomaly scan conducted?

Answer 13

18-20 + 6 weeks

Question 14

When does symphysis-fundal height start to become routinely assessed?

Answer 14

Primip: 25 weeks

Previous pregnancy: 28 weeks

Question 15

What additional investigations/management occurs at 28 weeks?

Answer 15

Alongside routine care + SFH:

Second anaemia screen + atypical red cell alloantibodies

First-dose anti-D immunoglobulin in rhesus -ve woman

Question 16

Discussion of labour occurs at which antenatal appointment?

Answer 16

34 weeks

Question 17

Assessment for presentation occurs at which antenatal appointment?

Answer 17

36 weeks

(Offer ECV if breech)