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WH > antenatal care > Flashcards

antenatal care Flashcards

1
Q

How many appointments in total should a primigravida and a multigravida patient be taking ?

A

primi - 11

multigravida - 8

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2
Q

when should the booking appointment be for all pregnant women ?

A

ideally 10 weeks

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3
Q

what is the purpose of the booking appointment ?

A

for identification of risk factors and refer onwards

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4
Q

after the booking appointment hwne should the other scans be performed ?

A 
first trimester ( 11-13 weeks )
second trimesteric ( 18-22 weeks)
third trimesteric ( 34-36 weeks)
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5
Q

what is the purpose of the first trimesteric scan ?

A

dating
viability
identify if the pregnancy is single/multiple
offer DS screening

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6
Q

what is the purpose of the second trimester scan ?

A 
anomaly scan that is multi dimensional to check for 
growth 
anomalies 
placental site 
liquor
uterine doppler artery
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7
Q

what is the purpose of third trimester scans ?

A 
multiple pregnancies 
growth 
presentation 
placental site 
anomalies
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8
Q

other than scans when should fetal and maternal assessments be made ?

A 
16
22
25
28
31
34
36
38
39 
40 
41 weeks
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9
Q

what is important to discuss and manage inn week 28 ?

A

blood works for HB, antibodies and glucose levels

give Anti-D injection of Rh-ve

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10
Q

when should Hb be repeated ?

A

week 34

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11
Q

what are the limitations that may be present in the anomaly scan ?

A

maternal obesity

fetal positioning

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12
Q

what are the limitations for screening ?

A

false positive results
false negative results
definitive diagnosis is not always possible to reach

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13
Q

what screening tests are offered ?

A 
HIV 
syphillis 
Blood group 
Rhesus 
haemoglobinopathies 
Rubella 
Hep B 
diabetes 
Down syndrome
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14
Q

what risk does using antiepileptic drugs impose on the fetus ?

A

increases the risk of neural tube defects

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15
Q

which anti epileptic drug should be avoided in pregnancy ?

A

sodium valporate

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16
Q

which alternative safe anti-epileptics can be used in pregnancy ?

A

Carbamazepine and lamotrigine

17
Q

what is the gold standard for the screening of Down Syndrome ?

A

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

18
Q

what other trisomies can be screened using double markers ?

A

trisomy 18

trisomy 13

19
Q

what results in the double marker test would favor DS ?

A

high Hcg

low PAPP-A

20
Q

if it is too late for combined testing for DS what is the best next step ?

A

offer triple marker test at 15-20 weeks but 20 week scan is not a good screen

21
Q

what other screening can be done for DS ?

A

NIPT , using free fetal DNA in maternal blood and can detect specific genetic syndromes or mutations

22
Q

what are the benign conditions that may affect the mother during pregnancy ?

A 
muscoskeletal pain 
acid reflux
physiological dyspnea 
carpal tunnel syndrome 
pelvic girdle dysfunction 
urinary incontinence
23
Q

what is the triad for hyperemesis gravidarum ?

A

defined as nausea and vomiting before 20 weeks of pregnancy along with :
dehydration
electrolyte imbalance
ketones in urine

24
Q

if a pregnant woman complains of piles what is the best management ?

A

lidocaine

25
Q

what is the most common cause of leg cramps in pregnant women ?

A

decreased levels of magnesium and calcium or elevated serum phosphorus

26
Q

what is acroparesthesia and what are the causes ?

A

tingling or numb sensation on the fingertips that is usually caused due to oedema around the carpal tunnel or brachial plexus traction syndrome due to shoulder drooping

27
Q

what is the management for acroparesthesia ?

A

vitamin b12

28
Q

what is the recommended dose of folic acid for a low risk pregnant patient ?

A

400 ug/day

29
Q

what instructions should be given on sexual intercourse during pregnancy ?

A

should be avoided in the first trimester then gradually allowed, it is only completely restricted if there is recurrent bleeding, risk of pre-term labour or antepartum hge

30
Q

what risk does smoking during pregnancy impose ?

A

placental insufficiency

31
Q

what advice should be given regarding vaccinations during pregnancy ?

A

flu vaccine should be given
tetanus vaccine
generally all vaccines are safe except live attenuated vaccines

32
Q

what are examples of live attenuated vaccines ?

A 
BCG 
MMR 
Varicella 
Yellow fever 
HPV
33
Q

what are the causes of hyperventilation in pregnant women ?

A

may be physiological due to increased levels of progesterone
could be due to anemia so check HB

34
Q

for leg cramps caused by elevated serum phosphorus what is the best medical management ?

A

aluminium hydroxide to decrease phosphorus absorption

35
Q

what is the caloric intake of a pregnant lady ?

A

2300 kcl a day

WH (68 decks)

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