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Year 4 Gynae > Antenatal care > Flashcards

Antenatal care Flashcards

1
Q

Booking appointment routine tests

A

Bloods

  • electrophoresis - haemoglobinopathy - sickle cell and beta thalassaemia
  • FBC - anaemia
  • Rhesus status + ab
  • Blood group

STI screening
- HIV, syphilis, Hep B

Urinanalysis - MSU

  • glycosuria
  • proteinuria
  • haematuria
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2
Q

When to do an anomaly scan

A

USS at 18 - 22wks + 6days

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3
Q

Down syndrome combined test

A

USS nuchal translucency

PAPP -A

beta - HCG

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4
Q

Down syndrome quadruple test

A

USS nuchal translucency

Inhibin A

Unconjugated oestradiol

AFP

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5
Q

When to do down syndrome tests

A

Combined test - 11 - 13wks + 6 days

Quadruple test - 15 - 20wks

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6
Q

Down syndrome results

A

Increased nuchal translucency

Increased beta HCG

Decreased PAPP-A

Decreased inhibin A

Decreased unconjugated oestradial

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7
Q

When to test for gestational diabetes

A

24 - 28wks

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8
Q

How to test for gestational diabetes

A

OGTT

Fasting glucose > 5.6

2 hour post-prandial > 7.8

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9
Q

Risks of gestational diabetes

A

Macrosomia
Shoulder dystocia
Preterm
Miscarriage

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10
Q

Risk factors for gestational diabetes

A

Obesity

Previous gestational diabetes

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11
Q

Booking appointment advice

A

Explain how the baby develops during pregnancy

Exercises including pelvic floor exercises

Ideal place of birth + pregnancy care pathway

Breastfeeding and workshops

Participant led antenatal sessions

Screening

Folic acid and vitamins

Food hygiene

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12
Q

Foods to avoid

A

Unpasteurised milk

Ripened soft cheese - Camembert, Brie

Pate

Uncooked ready meals

Raw eggs

Mayonnaise

Smoked salmon

Raw meat

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13
Q

Alcohol advice

A

Stop all alcohol

Refer for alcohol cessation clinic

Risk of fecal alcohol syndrome, preterm birth, small for dates

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14
Q

Booking appointment examination

A

BMI

general clinical exam

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15
Q

Dating scan

A

10 - 13 +6 weeks (first trimester)

CRL

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16
Q

When to screen for gestational diabetes

A 
BMI > 30 
Previous macrosomia 
previous gestational diabetes 
FHx of diabetes 
Family origin with high incidence rate
17
Q

Which conditions are screened for

A 
Gestational diabetes 
Pre eclampsia 
HIV 
Hep B
Syphilis
18
Q

How to screen for pre eclampsia

A

BP

Urinanalysis

19
Q

Risk factors for pre eclampsia

A 
Previous pre eclampsia 
Age 40+ 
Nulliparity 
Pregnancy interval of 10+ years 
FHx 
BMI >30 
HTN and pre-existing vascular disease 
Multiple pregnancy
20
Q

When is CRL not used

A

If > 84 mm

Use head circumference instead

21
Q

What does the combined test screen for

A

Downs syndrome - trisomy 21
Patau - trisomy 13
Edwards - trisomy 18

22
Q

If high risk for Down syndrome

A

Do chorionic villous sampling - 10 weeks

Amniocentesis - 15 weeks

23
Q

Risk of amniocentesis

A

0.5 - 1% chance of stillbirth

24
Q

High risk of Down syndrome

A

1 in 150

25
Q

Non invasive parenteral testing

A

Maternal serum level testing that detects fetal cells

Used as screening tool

26
Q

Number of appointments for nulliparous mother

A

9 - 10

27
Q

Number of appointments parous women

A

7

28
Q

At each visit

A

BP and urine check

24 wks - symphysis - fundal height

36 wks - fetal presentation

29
Q

28 weeks appointment

A

FBC
Rhesus antibodies
OGTT if indicated
Routine anti-D prophylaxis

30
Q

36 weeks appointment

A 
Breastfeeding info 
Birth plan 
How to recognise active labour 
Care for new baby 
Vitamin K prophylaxis 
New born screening 
Postnatal self care 
Baby blues and MH signs 
Risk assessment
31
Q

reasons to scan after 24 weeks

A

Low lying placenta
Small for dates
Malpresentation
42wks and declining induction

32
Q

Breech presentation at 36 wks

A

Offer ECV (external cephalic version) at 36wks

IOL at 38 wks if failed

Year 4 Gynae (35 decks)

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