2 - Obs - Antenatal Care - The Booking Visit 2 Flashcards
what 2 Ix are always done? what else is routinely tested?
bloods, USS
urine, antibody screen, serology for syphilis, Rubella IgG, Hb, chromosomal abnormalities
why is urine tested? how is it tested?
microscopy and culture - aSx bacteruria in preg commonly -> pyelonephritis
urinalysis - for glucose, protein, nitrites (screen for DM, renal disease, infection)
what is also screened for and why?
screen for infections implicated in preterm labour -> chlamydia/BV for those at incr risk
when should USS scan be done? all pregs <14wks dated using what? unless?
between 11 + 13+6 weeks gestation - using crown Rump Length unless IVF
what else does the USS detect? and allows screening for? how? in conjunction with?
multiple pregs
allows screening for chromosomal abnormalities with nuchal translucency measurement - with blood levels of HCG B-subunit and a preg assoc plasma protein A
why FBC done? What diseases are screened for in blood? why?
ID anaemia
syphilis - serious fetal implications
HIV and Hep B - so counselling can be given
What else is looked for in blood?
serum Abs
glucose tolerance test
rubella immunity - vaccine offered postnatally
Hb electrophoresis (sickle cell, thalassaemia)
when should folic acid supplements continue till? how much given?
Vit D recommended for who? who much?
until at least 12 wks - 0.4mg/day
10mcg/d for >30 BMI, south asian, afro caribbean
when is coitus CI’d? how should mum sleep? best exercise?
if placenta previa or membranes ruptured
left lateral position
swimming ideal
what are the 2 care options in the UK
community care - midwife run - can be referred to hosp if needed
consultant led care - degree of involvement depends on risk + occurrence of complx
what else risk assessed?
VTE disease risk - need for thromboprophylaxis?
