antenatal

Question 1

how long should folic acid be taken for?

Answer 1

before conception until 12 weeks

Question 2

when should 5mg of folic acid be given instead of 400 micro grams

Answer 2

diabetics, on anti-epileptics, BMI>30, prev child with neural tube defect, personal or partner history of it

Question 3

name some common drugs contraindicated in pregnancy

Answer 3

warfarin, ACEI, some anti-epileptics, carbamazepine and lithium

Question 4

when is a booking visit carried out?

Answer 4

10-12 weeks (first appointment )

Question 5

what is carried out at a booking appointment?

Answer 5

BP, BMI, rhesus status, blood group and Hb-screened for haemoglobinopathies, HIV, syphilis and Hep B/C.

downs screening

ultrasound

Question 6

how is down’s syndrome screened for at the booking appointment ?

Answer 6

PAPP-A AND HCG levels

nuchal translucency on ultrasound

Question 7

when is glucose checked in pregnancy ?

Answer 7

at booking if risk factors otherwise at 28 weeks

Question 8

what is checked at 24 week appointment ?

Answer 8

BP, urine, abdopalpation ans SFH, foetal heart auscultation

Question 9

when is anti D given if rhesus negative ?

Answer 9

28 weeks

Question 10

when is the extra scan that primiparous women get that multiparous do not?

Answer 10

scan at 31-32wks

Question 11

what trisomy screenings are offered (number and syndrome)

Answer 11

21 - downs syndorme
13 - Pataus
18- edwards

Question 12

what is rhesus D?

Answer 12

rhesus is a blood group system to classify antigens found on RBC’s one of which is D antigen

Question 13

what Ig do rhesus negative mothers form on first exposure to rhesus D antigen ? why does this not harm the baby?

Answer 13

IgM - too big to cross placenta

Question 14

what can happen in second pregnancy to baby if rhesus negative mother ?

Answer 14

haemolytic disease of the newborn

Question 15

when should rhesus D immunoglobins be given after sensitising event ?

Answer 15

within 72hrs or after birth

Question 16

how does the rhesus D immunoglobulin work?

Answer 16

given to mother so that when babies rhesus positive RBC’s cross placenta they can inactivate them before mother can launch immune response

Question 17

give examples of sensitising events

Answer 17

where foetal and mothers blood transfuses e.g. 
CVS
amniocentesis 
placental abruption
abdo trauma
foetal death
ToP
ectopic
delivery

Question 18

when is the foetal anomaly scan carries out

Answer 18

20 weeks

Question 19

when is cvs done? and what is miscarriage rate

Answer 19

11-13+6 wks 2%

Question 20

when is amniocentesis done? miscarriage rate ?

Answer 20

only after 15 weeks and 1%

Question 21

risk factor of cvs?

Answer 21

amniotic fluid embolism