Antenatal care Flashcards
US scan timings:
a) dating + detection of multiple pregnancy
b) anomaly scan
c) if placenta praevia on previous scans
a) 10-14 weeks
b) 18-21 weeks
c) 32 weeks
Routine checks at antenatal appts? (5)
BP Urinalyssi Fundal height (from 24 weeks) Fetal heart sounds (from 12 weeks) Fetal lie/presentation (from 38 weeks)
When are rhesus-negative mothers tested for anti-D antibodies?
Booking, 28 weeks and two-weekly thereafter
When is routine anti-D prophylaxis given?
either single dose 1500 at 28 weeks, or two doses of 500 at 28 and 34 weeks
Situations where anti-D is given for non-sensitized women? (9)
Threatened/completed miscarriage (usually only after 12 weeks unless heavy/prolonged bleeding) Termination of pregnancy Ectopic pregnancy Invasive prenatal procedures (e.g. CVS, amnio) Antepartum haemorrhage External cephalic version Abdominal injury Intra-uterine death Post-natal prophylaxis
Rough way to estimate due date?
date of LMP + 1 year + 7 days - 3 months
Pre-pregnancy genetic screening should be considered for which ethnic groups/associated diseases?
Ashkenazi Jews- Tay-Sachs disease
Afro-Carribean- sickle cell
When is chorionic villus sampling carried out?
11-14 weeks
When is amniocentesis carried out?
Greater than 15 weeks gestation
Screening tests for Down’s syndrome? (2)
Combined test- 10-14 weeks. Maternal blood for hCG and PAPP-A, an US measurement of nuchal translucency
Quadruple test- 14-20 weeks. Maternal blood for hCG, AFP, uE3 and inhibin A
Trisomy 13
Patau syndrome
Trisomy 18
Edward syndrome
How are Patau and Edward syndrome screened for?
Combined test at 10w-14w; alternatively at routine anomaly scan
What value constitutes a positive screening test for Downs syndrome?
risk > 1/150
Screening for gestational diabetes? (2)
If previous DM or PCOS- 2hr OGTT at 16-18 weeks, repeated at 28 week if first test is normal
Other risk factors- offer OGTT at 24-28 weeks
