Antenatal booking Flashcards
focussed current pregnancy questions
how & when was pregnancy confirmed
planned/unplanned
first date LMP
regular partner - safe & happy in relationship
symptoms - N/V, tiredness, headaches, visual changes, abdo pain, PV bleeding
quick general hx survey
gynae hx
menstrual hx
obs hx - pregs // children: termination & miscarriage
contraception hx
cervical smear hx
PMH - epilepsy, DM, HTN, STIs, MH
DH + allergies - anticonvulsants, ACEi, lithium
FH
SH
general pregnancy advice
avoid smoking/alcohol
folate supplements until 12 weeks
iron/vitD supplements
healthy diet (avoid pate, soft cheese, vitamin A, raw meat/eggs/shellfish)
regular exercise
outline plan for future of pregnancy
<10 weeks - sickle cell & thalassaemia
8-12 week booking appt - blood group, Rh status, FBC, rubella, HIV/HepB/Syphillis
8-14 week dating scan
18-21 week anomaly scan
Down’s screening - 11-14 week combined vs 14-20 week quadruple
3-weekly appointments starting at 25w
BP & urine check at every appt (including today’s)
Discuss birthing options & midwifery vs consultant led
conditions we test for
pre-eclampsia at every appointment
GD at booking & 28w
Vaccinations to offer pregnant women
whooping cough (>16w)
influenza
avoid this vaccine
MMR // rotavirus (live)
routine examinations at booking appt
FBC // ferritin
BMI measurment
urine dipstick
red cell alloantibodies
HepB//HIV//syphillus
meds cannot take
NSAIDs - esp in 3rd trimester: ibuprofen // paracetamol
BBs (except labetolol/methyldopa) - neo hypo // IUGR // neo bradycardia
ACEi/ARB/Thiazides
Opiates - neo abstinence syndrome if mum withdrawal
Warfarin // isoterintoin - teratogens
Lithium - esp first trimester
sodium valproate // phenytoin
meds safe to use
lamotrigine // levetiracetam // carbamazepine
SSRIs & levothyroxine - benefits v risks
EXTRA
brief counselling on sickle cell
attacks of severe pain
serious/life-threatening
anaemic
lifelong med
EXTRA
brief counselling on thalassaemia
autosomal recessive
need 4-6 weekly transfusions
lifelong
RFs: mediterranean, african, middle eastern, SE Asia, s america
diagnosed during preg. & heel prick at 5-8 days
EXTRA
brief counselling if HIV +ve
if +ve –> partner & children should be tested
having test doesn’t affect insurance, but result might
we do NOT routinely screen for
hep C // chlamydia // GBS