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Flashcards in Antenatal screening Deck (20)
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1
Q

when is the first visit

what is given

A

at conception - lifestyle advice

folic acid

2
Q

when is booking and when is it done

A

between 8-12 weeks of gestation (usually 12)
info about screening tests
FBC, antibodies, glucose, syphilis, rubella

3
Q

what happens at week 16

17

A

AP or triple test

US

4
Q

what happens at week 28

A

Anti d if rhesus neg

5
Q

what happens at week 34

A

Additional Anti d if required

6
Q

what history is taken at the booking visit

A

menstruals - may have irregular cycles so gestation age may be wrong
medical - DM, thyroid
Social - alcohol, smoking,drugs
obstetric - post partum haemorrhage
family - DM, congenital abnormaliities, genetic disorders, chromosomal disorders

7
Q

what examination is done at the booking visit

A

Height, weight, BP, CVS, abd

8
Q
what is the size of the uterus at 12 weeks 
16
20
28
36
A

level of the pubic symphysis
mid way between the PS and the umbilicus -16
umbilicus -20
36 -

9
Q

Investigations done at the booking visit

A

Hb, ABO for rhesus
screening for syphilis, rubella, HIV, hep b and c
urinalysis: MSSU C andS

10
Q

what is looked for in a US

A

US: to confirm viability, number of fetuses, confirm gestation date, pick up any gynaecological abnormalities

11
Q

Follow up history in antenatal management

A

physical and mental health

fatal movements

12
Q

exam in follow up visits

A
BP and urinalysis 
symphysis - fundal height
lie and presentation 
engagement of presenting part
fetal heart auscultation
13
Q

What can be done if the baby is rhesus pos

A

blood transfusion in utero

14
Q

what can be done if the baby has cardiac arrhythmia

A

in utero medication

15
Q

Downs risk assessment in the first trimester

A

measure of skin thickness behind metal neck
measured at 11-13 and 6 weeks
combined with HCG and PAPPA

16
Q

downs risk assessment at second trimester

A

blood samples at 15-20 weeks

assay of HCG and AFP

17
Q

downs risk assessment in both first and second trimester

A

incorporation of these measurements with maternal age and gestation to give personal risk
>1:250 high risk and required further investigation

18
Q

what increases the risk of downs syndrome regardless of maternal age

A

a low AFP and a high HCG

19
Q

what are the two specific diagnostic tests for down syndrome that can be done

A

amniocentesis - after 15 weeks and carries a miscarriage rate of 1%
chorionic villus sampling - after 12 weeks and carries a miscarriage risk of 2%

20
Q

what test can be done if suspected fatal anaemia

A

cordocentesis