5. Antenatal Screening

Question 1

How to screen for baby’s growth?

Answer 1

Symphysio-fundal height measurements

Question 2

1st visit blood test

Answer 2

• Anaemia
• Haemoglobinopathy
• RhD Isoimmunisation
• Syphilis
• HIV
• Rubella
• Hep B
• Blood sugar

Question 3

How to screen for diabetes in pregnancy

Answer 3

OGTT

Question 4

Screening for Anaemia

Answer 4

• at booking and 28 weeks

- Hb 11% at booking or 10.5% at 28 weeks should be investigated

Question 5

Screening for Down syndrome

Answer 5

1st trimester: NT scan + blood test

2nd trimester: anomaly scan + blood test

Question 6

Urine tests screening

Answer 6

UTI, Pre-eclampsia, Diabetes

Question 7

Screen for atypical RBC alloantibodies

Answer 7

at booking and 28 weeks

Question 8

Haemoglobinopathy screen

Answer 8

• Pre conception

- At booking (Sickle cell and thalassemia booking)

Question 9

Foetal anomaly scan

Answer 9

18-20+6 weeks

Question 10

Spina bifida US signs

Answer 10

Lemon and Banana sign

Question 11

Down Syndrome

Answer 11

Trisomy 21

Impairment of cognitive ability and physical growth and facial appearance

Question 12

Down Syndrome features

Answer 12

Small ears, protruding tongue, short, single crease across the palm, life expectancy 60years,

Question 13

Soft markers associated with Down

Answer 13

• Ventriculomegaly
• Choroid plexus cyst
• Hyperechogenic bowel
• ‘Sandal gap’
• Polydactyly

Question 14

1st trimester screen for Downs

Answer 14

Combined test: 
Nuchal scan (NT) + bHCG + PAPP-A

Question 15

2nd trimester screen for Downs (levels in detected Downs)

Answer 15

Triple/Quadruple test – AFP (low sensitivity) + B hCG (high) + Oestriol (low) + Inhibin A (high)

Question 16

Infection screening in pregnancy - offered

Answer 16

Hepatitis B, HIV, Rubella, Syphilis

Question 17

Infection screening in pregnancy - not offered!

Answer 17

Hepatitis C, CMV, Chlamydia, Group B streptococcus, Toxoplasma

Question 18

Risk factors for GDM

Answer 18

BMI>30, previous macrosomic baby>4.5kg, previous GDM, FHx of diabetes, Origin (south asian, black carribean, middle east)

Question 19

Pre-eclampsia screening

Answer 19

BP measurement and urine analysis at every antenatal visit

Question 20

Risk factors for Pre-eclampsia

Answer 20

Age>40 years, Nulliparity, Pregnancy interval>10 years, BMI>30, Multiple pregnancy,

Question 21

When are symphysio-fundal height measurements taken?

Answer 21

Recorded at each visit from 24weeks

Question 22

Screening in suspect cases of IUGR

Answer 22

Serial USS

Question 23

Foetal presentation assessment

Answer 23

Abdominal palpation after 36 weeks