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STG 2017 > ANTENATAL CARE > Flashcards

ANTENATAL CARE Flashcards

1
Q

What is ANC

A

ANC refers to the comprehensive care given to a pregnant woman so she safely goes through pregnancy, labour and perpeurium with the delivery of a healthy baby

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2
Q

What approach to ANC is admonished by the STG

A

Focused antenatal care with focus on quality rather than quantity

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3
Q

Least number of visits recommended by STG

A

4 comprehensive visits

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4
Q

Schedule for respective visits

A

Booking visits: Before the 14th to 16th week
1st Visit: 16-20 weeks
2nd Visit: 24-28weks
3rd Visit: 28-32 weeks
4th visit: About 36 weeks

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5
Q

The pregnant woman is advised to report to the hospital if she doesn’t deliver after —————— of her due date

A

2 weeks

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6
Q

Assessments done at booking visit

A

History
Maternal examination
Obstetric examinations
LMP and Gestational age
Investigations

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7
Q

Histories that are taken during the booking visit

A

Past medical history
Surgical history
Obstetric history
Family history
Social history

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8
Q

Maternal examinations conducted at booking visit

A

Examine all systems.

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9
Q

Obstetric examinations conducted at the booking visit.

A

Obstetric examination to confirm pregnancy
Measure SFH
Measure FHR

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10
Q

Purpose of checking FHR

A

To assess foetal wellbeing

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11
Q

Normal FHR

A

120 or 110 or 100 -160bpm

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12
Q

Assessment done at follow-up visits

A

Asess health of mother
Blood pressure (limit of 140/90mmHg)
Maternal examinations
Test urine albumin and proteins
Obstetric examinations
Check foetal activity

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13
Q

When is foetal activity checked

A

After 20 weeks ideally during second ANC visit

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14
Q

Investigations done during ANC visits

A

Full blood count
Fasting blood sugar
Urine and stool analysis
Ultrasound scans
Genetic tests
Infectious disease tests

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15
Q

Obstetric examinations done during follow-up visits

A

Fetal heart rate
Foetal heart sounds
Uterine size (SFH)
Lie, presentation and descent of presenting part in the 3rd trimester

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15
Q

Maternal examinations done at followup visits

A

Check for anemia, weight gain, preeclampsia and complications

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16
Q

When is stool analysis done

A

At the booking visit

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17
Q

When is urine analysis done

A

At each visit

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17
Q

Purpose of urine analysis

A

Test for proteinuria and glucosuria

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17
Q

Schedule for full blood count

A

0, 28 and 36 weeks

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17
Q

Tests used for Syphilis screening in pregnancy

A

VDRL: Venereal Disease Research Laboratory
TPHA: Treponema pallidum hemagglutination
RPR: Rapid plasma reagin test

17
Q

Genetic tests that are done in pregnancy

A

G6PD activity
Sickling
Blood group and antibody screen

17
Q

Ultrasound scans in pregnancy

A

Early ultrasound scan
Fetal anomaly scan between 18-24 weeks
Late screening at 36 weeks

18
Q

Infectious diseases tested for in pregnancy

A

Malaria using Blood film
Syphilis
HIV
Hepatitis B

18
Q

Schedule for fasting blood glucose

A

0, 28 and 32 weeks

18
Q

Purpose of early ultrasound scan

A

To rule our ectopic pregnancy
To estimate foetal age and expected delivery date

19
Q

Purpose of late screening scan

A

Placenta position
Foetal wellbeing

19
Q

Objectives for ANC care

A

Ensure good health throughout pregnancy, labour and perpeurium
Detect and treat any condition
Prevent malaria and anemia
Deliver a healthy baby

20
Q

Diabetes screening tests in pregnancy

A

FBG at 0,28 and 32 weeks
Urine glucose

20
Q

What urine glucose level warrants an OGTT test

A

1+/2+ on two occasions

3+/4+ on one occasion

20
Q

Things to avoid in pregnancy

A

Alcohol
Smoking
Herbs and non-prescribed drugs

20
Q

Non-pharmacologic management in ANC (malaria)

A

Encourage use of ITN
Malaria prevention

20
Q

Counselling in ANC

A

Danger signs and symptoms in pregnancy
Pregnancy discomforts and management
Healthy diet
Breastfeeding and newborn care
Family planning

21
Q

When is exercise avoided in pregnancy

A

PROM
Preterm labour in women with incompetent cervix in 2nd/3rd trim.
Pregnancy induced hypertension

22
Q

Routine ANC drugs

A

Anemia prevention
Malaria prophylaxis
Tetanus prophylaxis
Deworming

23
Q

Four categories of PMTCT

A
  1. Primary prevention HIV among women of childbearing age
  2. Preventing unintended pregnancies among women living with HIV
  3. Preventing HIV transmission from pregnant woman to foetus
  4. Treatment care and support for women living with HIV, their children and family.
24
Q

When is mebendazole given in pregnancy

A

24-28 weeks

25
Q

Malaria prophylaxis in pregnancy

A

SP (Sulmethoxazole-Pyrimethamine/
or Sulfadoxine-Pyrimethamine)

5 doses, 1 month apart

Start at 16 weeks or first quickening, do not exceed 36 weeks

26
Q

Anemia prophylaxis in pregnancy

A

Ferrous sulphate 200mg daily, 65mg elemental iron
or
Ferrous fumarate 200mg daily, 65mg elemental iron
or
Iron III hydroxide polymaltose, 100mg elemental iron
+
Folic acid 5mg daily

27
Q

Passive tetanus prophylaxis in pregnancy

A

Passive
IM Tetanol 0.5ml
1st dose from 20th week
2nd dose one month later

27
Q

When is passive tetanus prophylaxis done

A

If patient hasn’t received any anti-tetanus immunisation

28
Q

Types of tetanus prophylaxis in pegnancy

A

Passive
Active

29
Q

Schedule for active tetanus prophylaxis

A

TT1 0.5ml SC or IM at any contact with pregnant woman
TT2: Given one month later
TT3: Given 6 months later
TT4 and TT5: given in subsequent pregnancies

30
Q

Medical conditions that make a pregnancy high risk pregnancy

A

Diabetes
Hypertension
Asthma
Chronic cough eg. pulmonary TB
Heart disease
Thyrotoxicosis
HIV Positivity
Severe anaemia
SCD

31
Q

High risk pregnancies

A

Bleeding at any time before labour
and after labour
Some medical conditions
Multigravidae
Grand multiparity (>=5 children)
Breach presentation
Prolonged pregnancy
Contracted pelvis
Previous instrument delivery
Previous uterine surgery eg. CS, myomectomy.
Preterm labour
Rhesus negative mother with a rhesus positive husband or antibodies

32
Q

High risk pregnancy factors (foetus factors)

A

Uterine size smaller than gestational ag
Uterine size larger than gestational age
Foetal growth restriction
Big baby at term
Pat history of stillbirths or death within 1 week of birth
Past history of miscarriages around same gestational age

33
Q

What is meant by big baby at term

A

SFH is more than 39-40 cm at term

EFW is 4 kg or higher

34
Q

Prolonged pregnancy

A

when the pregnancy lasts longer than 42 weeks

35
Q

What is contracted pelvis

A

pelvis too small for the baby to be delivered safely per
vaginam

36
Q

How can contracted pelvis be easily detected

A

when the mother is short (< 154 cm)

has small feet (shoe size < 4½ UK)

STG 2017 (88 decks)

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