Antenatal Care

Question 1

Give 6 maternal causes of high risk pregnancy?

Answer 1

extremes of age
Chronic illness
Infections
Drugs
Poor past obstetric history
Obstetric complications

Question 2

What is the age at which pregnant women are regarded as ‘older mothers’?

Answer 2

35 y/o

Question 3

Why may an epileptic woman have a high risk pregnancy?

Answer 3

The woman may be on phenytoin which affects vitamin K metabolism which can have detrimental affects on the baby.

Question 4

Guve 6 examples of fetal causes of a high risk pregnancy

Answer 4

Multiple pregnancy
Twin to twin transfusion syndrome
Congenital Abnormality 
Chromosomal abnormalities
Intrauterine growth resection
Hydrops fetalis

Question 5

What is twin to twin transfusion syndrome?

Answer 5

Where you have twins one of which is the donor and one of which is the recipient. One twin is giving blood to the other twin. The recipient becomes swollen and polycythemic, the donor becomes small and anaemic

Question 6

What is Gastroschisia?

Answer 6

A congenital abnormality in the anterior abdominal wall where the abdominal contents freely protrude.

Question 7

What is hydrops fetalis?

Answer 7

Where there is excess body water causing oedema of the fetus.

Question 8

Give three causes of hydrops fetalis

Answer 8

Anaemia
Cardiac disease
Noonans Syndrome

Question 9

What is Noonan’s Syndrome?

Answer 9

An autosomal dominant abnormality which leads to pulmonary stenosis, short stature, pectus excavatum, webbed neck and flat nose

Question 10

What blood typing is performed on pregnant woman?

Answer 10

Blood group and antibodies for Rhesus.

Question 11

If a woman is found to be Rh -ve in pregnancy then what will be done?

Answer 11

She will be given anti D at 28 and 34 wks to prevent an antibody attack if the baby is Rh+ve

Question 12

What infections are tested for in pregancy?

Answer 12

Hep B
Hep C
Rubella
Syphilis
HIV

Question 13

What blood test is carried out in pregnancy to screen for neural tube defects?

Answer 13

AFP which is high

Reduced risk with folic acid

Question 14

What is the triple test for Trisomy 21?

Answer 14

AFP
B-HCG
Estriol
to test for down’s

Question 15

In the UK what pregnancy screening will be offered to ethnic groups?

Answer 15

Hb for Thalassaemia or sickle cell

Question 16

What is the test which is performed at 10-14 weeks gestation to screen for down’s? What does the test involve?

Answer 16

Nuchal Translucency

US of nuchal fold at back of neck, thickening is indicative of down’s.

Question 17

How will the triple test look if the foetus has down’s?

Answer 17

Low AFP
Low Estriol
High B-HCG

Question 18

At what risk of down’s will the woman be offered amniocentesis?

Answer 18

1:250

Question 19

Why may AFP be high in pregnancy when there is not a problem?

Answer 19

Wrong dates
Multiple pregnancy
Bleeding in early pregnancy

Question 20

If the AFP is high in pregnancy then what problems may this suggest?

Answer 20

Neural Tube Defects
Cardiac abnormalities
Gastroschisis

Question 21

What may a low AFP in pregnancy suggest?

Answer 21

Down’s Syndrome

Question 22

Name 4 Diagnostic tests which can be performed antenatally

Answer 22

20 wk USS
Chorionic Villus Sampling
Amniocentesis
Fetal Blood Sampling

Question 23

What is the main issue that is of concern in preterm babies?

Answer 23

Respiratory Distress Syndrome

Question 24

Why do preterm develop Respiratory Distress Syndrome? and how is this corrected?

Answer 24

Their lungs are underdeveloped and so do not produce surfactant. Steroids, either at birth or when preterm labour starts.

Question 25

What are Tocolytic Drugs? Give an example of a Tocolytic drug and why it is used?

Answer 25

Drugs which delay birth.
Salbutamol is an example and they are given so they steroids can be administered which may decrease respiratory distress syndrome.

Question 26

What conditions is diabetes during pregnancy associated with which affect the mother ?

Answer 26

Polyhydramnios,
Pre-eclampsia,
Increased miscarriage

Question 27

What is Polyhydramnios and what disease in pregnancy is it commonly associated with?

Answer 27

Polyhydramnios is too much amniotic fluid surrounding the feotus. It is associated with diabetes.

Question 28

What problems are associated with Diabetes which affect the fetus/neonate?

Answer 28

Intrauterine Growth restriction 
Macosomia
Hypoglycaemia
Respiratory Distress Syndrome
Hypertrophic cardiomyopathy
polycythaemia rubra vera

Question 29

What is the differnce in risk between a mother with insulin dependant diabetes and a mother with gestational diabetes?

Answer 29

Gestational diabetes usually resolves after the birth of the infant. There is also a smaller chance of there being congenital abnormalities of the fetus

Question 30

How can Diabetes in pregnancy cause both macrosomia and intrauterine growth restriction?

Answer 30

IUGR is associated with microvascular disease in the mother and macrosomia is increasd in all pregnant diabetics.

Question 31

Why do neonates get hypoglycaemia if their mothers are diabetic?

Answer 31

Because they are getting a high supply of sugar in the womb and so to maintain homeostasis produce higher amounts of insulin. When this glucose rish blood is no longer there, the insulin levels can remain high and so the neonate can be hypoglycaemic

Question 32

How does hyperthyroidism affect the fetus in pregnant women?

Answer 32

The fetal thyroid can become overstimulated and so the newborn will have symptoms of hyper thyroid including trembling, diarrhoea and tachycardia

Question 33

What condition in preganncy are woman with SLE more likely to develop?

Answer 33

Antiphospholipid syndrome

Question 34

What are the risks associated with antiphospholipid syndrome?

Answer 34

IUGR, miscarriage, preterm delivery and placental abruption

Question 35

What antibodies will be present in antiphispholipid syndrome when there is a heart block in the neonate?

Answer 35

anti-Ro

anti-la