Antenatal Care

Question 1

What are the visiting week for antenatal

Answer 1

The first visit or initial visit should be made as early is pregnancy as possible.

Return Visits:

—Once every month till 28 w.

—Once every 2 weeks till the 36 w

—Once every week, till labor.

Question 2

Frequency of antenatal care

Answer 2

—Nulliparous with an uncomplicated pregnancy, a schedule of 10 appointments.

—

—Parous with an uncomplicated pregnancy, a schedule of 7 appointments.

Question 3

How many fetal kick count?

Answer 3

¡The pregnant woman reports at least 10 movements in 12 hours.

Absence of fetal movements precedes intrauterine fetal death by 48 hours

Question 4

Total weight and height during pregnancy?

Answer 4

—Height of over 150 cm indication of an average-sized pelvis

The approximate weight gain during pregnancy is 12 kg.; 2kg in the first 20 weeks and 10 kg in the remaining 20 weeks (1.5 kg per week until term

Question 5

What is symphysis and when should be measured?

Answer 5

—Symphysis–fundal height should be measured and recorded at each antenatal appointment from 24 weeks.

Question 6

When do you check fetal presentation

Answer 6

—Fetal presentation should be assessed by abdominal palpation at 36 weeks.

Question 7

When do you hear fetal heart sound? How can it be heard?

Answer 7

—Fetal heart sound is heard by sonicaid as early as 10thweek of pregnancy.

—

—Fetal heart sound is heard by Pinard’ s fetal stethoscope after the 20thweek of pregnancy.

Question 8

Why urine be tested?

Answer 8

¡Urine should be tested for ketones and protein.

Question 9

Urinary frequency relief measures?

Answer 9

Urinary frequency

RELIEF MEASURES:

÷Decrease fluid intake at night.

÷Maintain fluid intake during day.

÷Void when feel the urge.

Question 10

Nasal stuffiness and estrogen - cause and management

Answer 10

ETIOLGY: Elevated estrogen levels

¡RELIEF MEASURES :

÷Avoid decongestants.

Use humidifiers, and normal saline drops

Question 11

Ptyalism? Excessive saliva?

Answer 11

ETIOLGY: Unknown

RELIEF MEASURES:

÷Perform frequent mouth care.

÷Chew gum.

÷Decrease fluid intake at night.

÷Maintain fluid intake during day.

Question 12

Management of nausea and vomiting

Answer 12

• most cases of nausea and vomiting in pregnancy will resolve spontaneously within 16 to 20 weeks.
• that nausea and vomiting are not usually associated with a poor pregnancy outcome.
• non-pharmacological:
• ginger
• P6 (wrist) acupressure
• pharmacological: antihistamines.

÷dry crackers or toast before rising in morning.

÷ Eat small, frequent meals.

÷Avoid sudden movements. Get out of bed slowly

÷Breath fresh air to help relieve nausea.

÷Avoid food or smells that exacerbate condition.

Question 13

Vericosities management

Answer 13

÷Rest in sims’ position.

÷Elevate legs regularly.

÷Avoid crossing legs.

÷Avoid long periods of standing

Question 14

Hemorhoide. management

Answer 14

RELIEF MEASURES:

÷Maintain regular bowel habits.

÷Use prescribed stool softeners.

÷Apply topical or anesthetic ointments to area.

Question 15

Constipation management

Answer 15

÷Maintain regular bowel habits.

÷Increase fiber in diet.

÷Increase fluids.

÷Find iron preparation that is least constipating

Question 16

Backache measures

Answer 16

÷Wear shoes with low heels.

÷Walk with pelvis tilted forward.

÷Use firmer mattress.

÷Perform pelvic rocking or tilting

Question 17

LEG CRAMP MANAGEMENT

Answer 17

¡RELIEF MEASURES:

÷Extend affected leg and dorsiflex the foot.

÷Elevate lower legs frequently.

÷Apply heat to muscles.

Question 18

Faintness managment

Answer 18

RELIEF MEASURES:

• Rise slowly from sitting to standing.
• Evaluate hemoglobin and hematocrit.
• Avoid hot environments

Question 19

When should pregnant women have ultrasound?

Answer 19

—Pregnant women should be offered an early ultrasound scan between 10 weeks 0 days and 13 weeks 6 days to determine gestational age and to detect multiple pregnancies.

Question 20

Why combined test is used?

Answer 20

The ‘combined test’ (nuchal translucency, beta-human chorionic gonadotrophin, pregnancy-associated plasma protein-A) should be offered to screen for Down’s syndrome between 11 weeks 0 days and 13 weeks 6 days

Question 21

Risk factors for gestational diabetes

Answer 21

—body mass index above 30 kg/m2

—previous macrosomic baby weighing 4.5 kg or above

—previous gestational diabetes (refer to ‘Diabetes in pregnancy

—family history of diabetes (first-degree relative with diabetes)

—family origin with a high prevalence of diabetes:

¡South Asian (specifically women whose country of family origin is India, Pakistan or Bangladesh)

¡black Caribbean

¡Middle Eastern (specifically women whose country of family origin is Saudi Arabia, United Arab Emirates, Iraq, Jordan, Syria, Oman, Qatar, Kuwait, Lebanon or Egypt).

Question 22

When is screening for sickle cell performed?

Answer 22

Screening for sickle cell diseases and thalassaemias should be offered to all women as early as possible in pregnancy (ideally by 10 weeks

Question 23

When is anemia screening is performed

Answer 23

—Screening shouldtake place early in pregnancy (at the booking appointment).

—at 28 weeks when other blood screening tests are being performed.

At 36 weeks

Answer 24

11 g/100 ml at first contact and 10.5 g/100 ml at 28 weeks) should be investigated and iron supplementation considered

Question 25

When is anti-D given ?

Answer 25

—Women should be offered testing for blood group and rhesus D status in early pregnancy.

—To give anti-D at 28 weeks and post delivery if the baby (+)

Question 26

Hepatitis B, Rubella or hepatitis C which should be performed routinely?

Answer 26

HEP B- not done routinely

Rubella and Hep B is done done routinely

Question 27

Folic acid recommendation?

Answer 27

—Start before conception and throughout the first 12 weeks.

—reduces the risk of having a baby with a neural tube defect (for example, anencephaly or spina bifida).

—The recommended dose is 400 micrograms per day.

Question 28

Vitamin D recommendation

Answer 28

women at greatest risk are following advice to take this daily supplement. These include:

—

—women of South Asian, African, Caribbean or Middle Eastern family origin

—women who have limited exposure to sunlight, such as women who are predominantly housebound, or usually remain covered when outdoors

—women who eat a diet particularly low in vitamin D, such as women who consume no oily fish, eggs, meat, vitamin D-fortified margarine or breakfast cereal

women with a pre-pregnancy body mass index above 30 kg

Question 29

What dose of vitamin A is teratogonic?

Answer 29

Vitamin A supplementation (intake above 700 micrograms) might be teratogenic and should therefore be avoided

Question 30

Iron is routine or not? Dont confused with folic acid?

Answer 30

—Iron supplementation should not be offered routinely to all pregnant women. It does not benefit the mother’s or the baby’s health and may have unpleasant maternal side effects.