antenatal care Flashcards
How many appointments in total should a primigravida and a multigravida patient be taking ?
primi - 11
multigravida - 8
when should the booking appointment be for all pregnant women ?
ideally 10 weeks
what is the purpose of the booking appointment ?
for identification of risk factors and refer onwards
after the booking appointment hwne should the other scans be performed ?
first trimester ( 11-13 weeks ) second trimesteric ( 18-22 weeks) third trimesteric ( 34-36 weeks)
what is the purpose of the first trimesteric scan ?
dating
viability
identify if the pregnancy is single/multiple
offer DS screening
what is the purpose of the second trimester scan ?
anomaly scan that is multi dimensional to check for growth anomalies placental site liquor uterine doppler artery
what is the purpose of third trimester scans ?
multiple pregnancies growth presentation placental site anomalies
other than scans when should fetal and maternal assessments be made ?
16 22 25 28 31 34 36 38 39 40 41 weeks
what is important to discuss and manage inn week 28 ?
blood works for HB, antibodies and glucose levels
give Anti-D injection of Rh-ve
when should Hb be repeated ?
week 34
what are the limitations that may be present in the anomaly scan ?
maternal obesity
fetal positioning
what are the limitations for screening ?
false positive results
false negative results
definitive diagnosis is not always possible to reach
what screening tests are offered ?
HIV syphillis Blood group Rhesus haemoglobinopathies Rubella Hep B diabetes Down syndrome
what risk does using antiepileptic drugs impose on the fetus ?
increases the risk of neural tube defects
which anti epileptic drug should be avoided in pregnancy ?
sodium valporate
which alternative safe anti-epileptics can be used in pregnancy ?
Carbamazepine and lamotrigine
what is the gold standard for the screening of Down Syndrome ?
first trimesteric combined screening at 11-13 weeks
including :
1.nuchal translucency
2.Serum markers - BhCG and PAPP-A
3.maternal age
additional markers: nasal bone hypoplasia, ductus venosus , tricuspid regurgitation
what other trisomies can be screened using double markers ?
trisomy 18
trisomy 13
what results in the double marker test would favor DS ?
high Hcg
low PAPP-A
if it is too late for combined testing for DS what is the best next step ?
offer triple marker test at 15-20 weeks but 20 week scan is not a good screen
what other screening can be done for DS ?
NIPT , using free fetal DNA in maternal blood and can detect specific genetic syndromes or mutations
what are the benign conditions that may affect the mother during pregnancy ?
muscoskeletal pain acid reflux physiological dyspnea carpal tunnel syndrome pelvic girdle dysfunction urinary incontinence
what is the triad for hyperemesis gravidarum ?
defined as nausea and vomiting before 20 weeks of pregnancy along with :
dehydration
electrolyte imbalance
ketones in urine
if a pregnant woman complains of piles what is the best management ?
lidocaine
