Flashcards in Routine antenatal assessment in the absence of complications (RANZCOG) Deck (8)
First antenatal visit:
- 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
What is involved in first clinical assessment?
- Height, weight, BMI and booking BP
- G&H with antibody screen
- Rubella antibody screen
- Syphillis serology
- Selective testing for chlamydia and gonorrhoea
- Hep B and C
- Cervical screening
What other tests can be considered?
- Haemaglobinopathies if high risk or low MCV on FBC
- Maternal mental health screening
- Family violence screen
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
How to monitor growth in low risk pregnancy?
SFH measurement, plot on CGC and refer for growth scans if abnormal
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
When should Hb and plt count be repeated?