Antenatal and Earl Pregnancy

Question 1

When can you do a combined antenatal screen?

Answer 1

11-13+6 weeks

Question 2

When can you do a quadruple screen?

Answer 2

15-20 (16 weeks)

Question 3

What consists of a combined antenatal screen?

Answer 3

1. Free B-HCG, 2. NT & 3. PAPP-a

Question 4

What does the combined and quadruple antenatal screen, screen for?

Answer 4

Downs, Edward’s, Palau

Question 5

Patau is what trisomy?

Answer 5

13

Question 6

Edward’s is what trisomy?

Answer 6

18

Question 7

Down’s syndrome is what trisomy?

Answer 7

21

Question 8

Quadruple antenatal screen consists of?

Answer 8

1. HCG, 2. Inhibin A, 3. Alpha foetoprotein, 4. Unconjugated oestriol

Question 9

When is foetal alpha protein raised?

Answer 9

Neural tube defects

Question 10

What is amniocentesis

Answer 10

Procedure where a fine needle is used to aspirate amniotic fluid from the uterus and tested for definitive diagnosis of trisomy’s

Question 11

What is chorionic villus sampling?

Answer 11

Fine needle sampling either transcervically or transabdominally whereby placental tissue is collected

Question 12

What are risks of amniocentesis and chorionic villus sampling?

Answer 12

1 in 100 miscarriage

Question 13

Increased HCG, thickened NT and decreased papp-a is suggestive of what trisomy?

Answer 13

Downs

Question 14

Decreased HCG, foetal alpha protein, decreased oestriol BUT normal inhibin A is suggestive of?

Answer 14

Edward’s

Question 15

Decreased alpha, oestriol and increased hCG & inhibin is suggestive of?

Answer 15

Downs

Question 16

What is NIPT

Answer 16

Non-invasive prenatal screening test. High specificity (99%) and sensitivity offered for high risk patients. Private right now being trialled

Question 17

What antenatal screen can revel gender?

Answer 17

NIPT

Question 18

What does biophysical profiling assess? (5)

Answer 18

Foetal HR, breathing, amniotic fluid, movement and tone

Question 19

What year was the antenatal care NICE doc produced?

Answer 19

2008

Question 20

What is a msu sample?

Answer 20

Asymptotic bacteruria done in all early pregnancy

Question 21

What is hyperemesis gravidarum

Answer 21

Severe ‘morning’ sickness during early pregnancy occurs in 1-3%

Question 22

What are risk factors of hyperemesis gravidarum?

Answer 22

Lifestyle:
- smoking
- obesity

Biochemical:
- increased B-HCG
- trophoblastic disease

Complicated pregnancy:
- nulliparity
- multiple pregnancy (twins/triplets)

FAMILY/PERSONAL HISTORY

Question 23

3 key criteria for diagnosing hyperemesis gravdarum

Answer 23

1. 5% pre-pregnancy weight loss
2. Dehydration
3. Electrolyte imbalance

Question 24

What scoring system is used for n&v severity?

Answer 24

PUQE
(Pregnancy unique quantification of emesis)

Question 25

what 3 key things does PUQE test?

Answer 25

- duration of nausea - number of retching episodes in 24hrs - number of vomiting periods

Question 26

What are simple measures in regards to n&v in pregnancy

Answer 26

1. Rest 2. Avoid triggers 3. Ginger 4. Bland plain food

Question 27

What’s first line medication for pregnancy sickness?

Answer 27

1. Anthistamines (cyclizine) 2. Phenothiazines 3. Combination drug (doxylamine/pyridoxine)

Question 28

What is second line medication for sickness in pregnancy?

Answer 28

Oral ondansetron, oral metoclopromide/domperidone

Question 29

Risk of ondansetron?

Answer 29

Cleft lip in baby

Question 30

Risk in metoclopromide/domperidone?

Answer 30

Can’t be used more than 5 days

Question 31

What is needed if dehydrated with sickness?

Answer 31

Admission with normal saline IV and added potassium

Question 32

What are the periods that N&V peaks

Answer 32

9 weeks, 16-20 weeks

Question 33

How many pregnancies experience n&v?

Answer 33

60-80%

Question 34

When is Chorionic villus screening usually offered?

Answer 34

11-13+6 weeks