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Flashcards in Normal Antenatal Progress Deck (10):
1

Folic acid

400 micrograms / day whilst trying to conceive and for 12 weeks after conception
5mg for women with epilepsy, diabetes and other conditions

Some women are also offered vitamin d supplements - Asian women?

2

Smoking

Premature birth
Low birth weight
SIDS
Miscarriage
Breathing problems in first 6 months

3

Planning pregnancy

Supplements
Smoking cessation
No alcohol consumption
Vaccinations and infections - second dose of MMR if not had
Medical conditions - optimise before conception
Testing for sickle cell and thalassaemia

4

Booking visit - midwife

To identify whether the woman may need extra input during pregnancy

Patient demographics, detail of partner, PMH, surgical history, medications and allergies, FH, smoking (current / in last 12 months / someone at home), alcohol history, drug use, obs and gynae hx including smears, LMP

5

Booking visit investigations

Weight and height, measure BP, dip urine

Bloods - Hb, platelets, HIV, Syphylis, hep B screen, blood group and antibody status, sickle cell and thal (if high risk)

6

OGTT test at 26-28 weeks if high risk of diabetes

BMI > 30
Certain ethnic origins
FH - 1st degree
PCOS
Previous baby > 4.5kg at birth
Previous GDM

7

Scans and screening

12 week dating scan
20 week anomaly scan

Screening for DS (not diagnostic) - usually at 12 weeks

8

'Sensitizing events' - passage of fetal blood cells into maternal circulation

Spontaneous miscarriage
Termination
Invasive procedures
Traumatic events
Placental abruption
Fetomaternal haemorrhage
Blood transfusions

PROPHYLACTIC ANTI-D AT 28 WEEKS

9

Maternal mortality - death whilst pregnant or within 42 days of birth

Direct - sepsis, preeclampsia, thrombosis, amniotic fluid embolus, early pregnancy, haemorrhage, anaesthesia

Indirect - cardiac, neurological, psychiatric, malignancy

10

Physiological Changes during Pregnancy

Hyperventilation (due to increased pressure)
Increase in CO, drop in BP
Peripheral oedema (increased plasma volume)
Anaemia
Hypercoaguable state
Increased BMI, stretch marks, lower back pain, lordosis, carpal tunnel, sciatica, muscle cramps
Increased skin pigmentation
Breast enlargement, areolar pigmentation
Increased urinary frequency
Reflux