Routine antenatal assessment in the absence of complications (RANZCOG) Flashcards Preview

General obstetrics > Routine antenatal assessment in the absence of complications (RANZCOG) > Flashcards

Flashcards in Routine antenatal assessment in the absence of complications (RANZCOG) Deck (8)
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1

First antenatal visit:
- Gestation
- Aims of visit

Review by 10/40

Aim of visit:
- Confirm pregnancy and establish best estimate of gestational age/dates
- If dates known and low risk pregnancy, USS not required prior to 12/40
- Identify any medical/obstetric/fetal/psychosocial concerns and create a plan for the management of any identified concerns
- General advice regarding common issues of concern in early pregnancy
- Plan schedule for antenatal visits

2

What is involved in first clinical assessment?

- Height, weight, BMI and booking BP
- FBC
- G&H with antibody screen
- Rubella antibody screen
- Syphillis serology
- MSU
- Selective testing for chlamydia and gonorrhoea
- HIV
- Hep B and C
- Varicella
- Cervical screening

3

What other tests can be considered?

- Haemaglobinopathies if high risk or low MCV on FBC
- Maternal mental health screening
- Family violence screen

4

What general advice should women be given?

- Avoid potential teratogens (alcohol, high dose X-rays, certain medications)
- Lifestyle advice: Stop smoking, alcohol use, recreational drugs.
- Dietary advice for optimal weight gain, exercise
- Travel/work precautions
- Influenza and pertussis vaccinations (20-32/40)
- Vitamin and mineral supplements
- Prevention of CMV and other teratogenic infections
- model of care, expected frequency etc
- sleeping on side from 28/40
- Labour plan from 36/40

5

How to monitor growth in low risk pregnancy?

SFH measurement, plot on CGC and refer for growth scans if abnormal

6

What USS are recommended for all women in pregnancy?

- 12-13+6/40: confirm gestation, location, number of fetuses, NT and gross fetal anatomy

- 20/40: fetal morphology and placental location

7

When should Hb and plt count be repeated?

28/40

8

Tests of fetal wellbeing after 41/40?

Lack of good evidence to support but:
- Counsel re monitoring of FM
- Consider 2x weekly CTG
- consider growth and LV