Antenatal care

Question 1

When does screening for SCD and thalassaemia occur?

Answer 1

At the first booking clinic (<10 weeks)

Question 2

When does the dating scan occur?

Answer 2

Weeks 10-13+6

Question 3

When is the pertussis vaccine offered?

Answer 3

16-week antenatal appointment

Question 4

Anomaly scan occurs at…

Answer 4

20 weeks (18-20+6)

Question 5

When is Anti-D injections given for Rh- women

Answer 5

28-34 weeks

Question 6

The combined test for Downs syndrome is done at…

Answer 6

11-14 weeks

Question 7

The combined test for Downs syndrome is composed of…

Answer 7

Ultrasound for nuchal translucency

Blood tests for

• b-hCG
• Pregnancy associated plasma protein A (PAPP-A)

Question 8

Nuchal translucency greater than ____ is associated with ______

Answer 8

> 6mm, Downs syndrome

Question 9

(Elevated/ low) b-hCG is associated with an (increased/decreased) risk of Downs syndrome

Answer 9

Elevated b-hCG = higher risk

Question 10

(Elevated/ low) PAPP-A is associated with an (increased/decreased) risk of Downs syndrome

Answer 10

Low PAPP-A = greater risk

Question 11

The triple test for Down syndrome can be carried when?

Answer 11

14-20 weeks

Question 12

The triple test for Downs syndrome is composed of…

Answer 12

3 bloods

• b-hCG
• Alpha-fetoprotein
• Serum oestriol

Question 13

(Elevated/ low) alpha-fetoprotein is associated with an (increased/decreased) risk of Downs syndrome

Answer 13

Low alpha-fetoprotein = greater risk

Question 14

(Elevated/ low) serum oestriol is associated with an (increased/decreased) risk of Downs syndrome

Answer 14

Low serum oestriol = greater risk

Question 15

The quadruple test for Down syndrome can be carried when?

Answer 15

After 20 weeks

Question 16

The quadruple test for Downs syndrome is composed of…

Answer 16

4 bloods

• b-hCG
• Alpha-fetoprotein
• Serum oestriol
• Inhibin A

Question 17

(Elevated/ low) inhibin-A is associated with an (increased/decreased) risk of Downs syndrome

Answer 17

Higher inhibin A= greater risk.

Question 18

Amniocentesis/ chorionic villus sampling is indicated when risk of Down syndrome is…

Answer 18

> 1 in 150

Question 19

Amniocentesis/ chorionic villus sampling for Down syndrome can be carried out when?

Answer 19

<15 weeks

Question 20

What is the most recent development for Downs syndrome screening?

Answer 20

Non-invasive prenatal test

- Detects placental DNA in maternal blood

Question 21

What test is carried out to see how much fetal blood has passed into the mother’s blood?

Answer 21

Kleinhauer’s test

• Involves adding acid to maternal blood.
• Fetal Hb is more resistant.
• Greater percentage of Hb left= more fetal blood in maternal circulation.

Question 22

What infections are routinely screened for in the booking clinic?

Answer 22

HIV

Syphillis

Hep B

Question 23

Pregnant women with BMI >30 should be given _______ to prevent neural tube defects

Answer 23

high dose folic acid 5mg

Question 24

What type of high risk women are offered more frequent scans in third trimester

Answer 24

Older women

Obese women

Diabetes/ gestational diabetes

Previous growth restriction

Question 25

Ultrasound measurements for growth [5]

Answer 25

Abdominal circumference

Head circumference

Femur length

Liquor volume

Doppler of placental artery