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Flashcards in Antenatal screening Deck (20):
1

when is the first visit
what is given

at conception - lifestyle advice
folic acid

2

when is booking and when is it done

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

3

what happens at week 16
17

AP or triple test
US

4

what happens at week 28

Anti d if rhesus neg

5

what happens at week 34

Additional Anti d if required

6

what history is taken at the booking visit

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

what examination is done at the booking visit

Height, weight, BP, CVS, abd

8

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

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

9

Investigations done at the booking visit

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

10

what is looked for in a US

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

11

Follow up history in antenatal management

physical and mental health
fatal movements

12

exam in follow up visits

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

13

What can be done if the baby is rhesus pos

blood transfusion in utero

14

what can be done if the baby has cardiac arrhythmia

in utero medication

15

Downs risk assessment in the first trimester

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

16

downs risk assessment at second trimester

blood samples at 15-20 weeks
assay of HCG and AFP

17

downs risk assessment in both first and second trimester

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

18

what increases the risk of downs syndrome regardless of maternal age

a low AFP and a high HCG

19

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

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

what test can be done if suspected fatal anaemia

cordocentesis