Intro Flashcards
(46 cards)
What 4 purposes does the 12-week pregnancy dating scan have?
- Find out how many weeks pregnant and also EDD
- Find out how many babies pregnant with
- Find out if baby is growing in correct place
- Find out about baby’s development
At which gestational age is the pregnancy dating scan carried out at?
12 weeks
At what gestational age does the initial booking clinic occur?
Before 10 weeks gestation
What education topics are covered at the booking clinic?
What to expect at different stages of pregnancy
Lifestyle advice in pregnancy (e.g. not smoking)
Supplements (e.g. folic acid and vitamin D)
Plans for birth
Screening tests (e.g. Downs screening)
Antenatal classes
Breastfeeding classes
Discuss mental health
What booking bloods are taken at the booking clinic?
Blood group/antibodies/rhesus D status
FBC (anaemia)
Thalassemia/Sickle cell
Rubella IgG
Chromosomal abnormalities and Hb-opathies
Also offered HIV/Hep B/Syphilis screening
What test is done for Down’s syndrome and at what gestational age?
Combined test - 11 weeks onwards
Involves ultrasound scann with blood test
Which conditions does the 11 week combined test screen for?
Down’s syndrome
Edward’s syndrome
Patau’s syndrome
Nuchal translucency scan tests for which condition?
Down’s syndrome, Edward’s, Patau’s
If nuchal translucency test is not possible, which blood screening test can be offered later (14-20 weeks)?
Quadruple test
Only screens for Down’s and is not as accurate as combined test
Or even later… Mid-pregnancy scan
Aside from blood tests, what other measurements are taken during the booking clinic?
Weight, height, BMI
Urine (?protein, ?bacteria)
BP
What psychosocial issues are discussed during booking clinic? (List 2)
FGM
Domestic violence
Booking clinic tests for following risk factors:
Rhesus -ve Gestational diabetes Fetal growth restriction VTE Pre-eclampsia
If the following are positive what will you give for each?
Rhesus -ve: anti-D prophylaxis
GDM: OGTT test
FGR: additional growth scans
VTE: prophylactic LMWH
Pre-eclampsia: aspirin
In Down’s syndrome, what nuchal translucency thickness is expected?
Greater than 6mm
In the combined test, which 2 blood tests are used?
If positive, what would you expect for each?
Beta-HCG - higher result
PAPPA (pregnancy-associated plasma protein A) - lower result
Triple test is performed between which gestation age?
14-20 weeks gestation
Which tests does the triple test include?
If positive, what would you expect for each?
Only 3 blood tests:
Beta-HCG - higher
Alpha foetoprotein (AFP) - lower
Serum oestriol - lower
What extra blood test does the quadruple test include (compared to the triple test)?
If positive, what would you expect for this test?
Inhibin A
Higher = greater risk
If the Down’s syndrome risk is great (shown by screening), what 2 invasive antenatal tests can be offered for the woman?
Amniocentesis
Chorionic villus sampling
Foetal cells are sampled and karyotyped for definitive Down’s diagnosis?
What alternative non-invasive test can be offered for Down’s?
NIPT
Non-invasive prenatal testing. Blood test from mother containing fragments of foetal DNA.
First trimester is from which gestational ages?
Start of pregnancy -> 12 weeks
Second trimester is from which gestational ages?
13 weeks -> 26 weeks
Third trimester is from which gestational ages?
27 weeks -> birth
At which age do foetal movements start?
20 weeks
Which measurement allows an accurate gestational age to be taken?
Crown - Rump length (CRL)
