Antenatal care

Question 1

When does the booking scan occur?

Answer 1

Around 12 weeks

Question 2

What is done at the booking scan?

Answer 2

FBC
Antibodies - RhD & ABO
Glucose
Syphilis, rubella, HIV, Hep B&C, 
Urinalysis & culture
Ultrasound scan

Question 3

At how many weeks gestation is the uterus felt at the umbilicus?

Answer 3

20 weeks

Question 4

What is the purpose of the ultrasound at the booking scan?

Answer 4

Confirm viability
Number of fetuses
Confirm gestation

Question 5

What is assessed at follow up visits?

Answer 5

BP and urinalysis
Symphysis- fundal height
Lie and presentation
Engagement of presenting part
Fetal heart auscultation

Question 6

Where is information regarding antenatal care recorded?

Answer 6

Scottish Maternity record

Question 7

How can the risk of Down’s syndrome be assessed in the first trimester?

Answer 7

Measure of skin thickness behind fetal neck using ultrasound (Nuchal thickness; NT)
PAPP-A and bHCG

Question 8

When is the first trimester screening for Down’s syndrome done?

Answer 8

Measured at 11-13+6 weeks

Question 9

What screening is done in the second trimester of pregnancy for Down’s syndrome?

Answer 9

Blood sample at 15-20 weeks

Assay of HCG and AFP

Question 10

Once screening results for Down’s syndrome have been correlated with maternal age and gestation, what risk would warrant further investigation?

Answer 10

> 1:250

Question 11

When can an amniocentesis be performed?

Answer 11

After 15 weeks

Question 12

When can chorionic villus sampling be performed?

Answer 12

After 12 weeks

Question 13

What is the risk with amniocentesis?

Answer 13

1% risk of miscarriage

Question 14

What is the risk with chorionic villus sampling?

Answer 14

2% risk of miscarriage

Question 15

How many extra calories a day should a mother be eating?

Answer 15

250-300 extra

Question 16

How much extra protein should be consumed during pregnancy?

Answer 16

30g/day

Question 17

Why is folic acid given antenatally?

Answer 17

Reduces risk of neural tube defects

Question 18

What extra precautions are taken with multiple pregnancy?

Answer 18

More frequent antenatal visits
Detailed anomaly scan at 18 weeks
Regular scans from 28 weeks for growth
Routine iron supplementation
Warning to mother re risk and signs of pre term labour

Question 19

Why is good diabetic control important in pregnancy?

Answer 19

Complications can be avoided with good control

Question 20

How often should gestational diabetes be monitored?

Answer 20

2-4 weekly check ups from 28 weeks or diagnosis

Question 21

When should delivery be offered in gestational diabetes?

Answer 21

38 weeks

Question 22

What is twin to twin transfusion syndrome?

Answer 22

One baby becomes donor and one is recipient, receiving blood from the donor
Donor baby becomes small and anaemic
Recipient becomes swollen and polycythaemic
Babies are very different sizes

Question 23

What are the causes of hydrops fetalis?

Answer 23

Anaemia

Cardiac disease

Question 24

What forms the ‘triple test’?

Answer 24

For Down’s syndrome screening:

AFP, bHCG, estriol

Question 25

What marker is high in neural tube defects?

Answer 25

AFP

Question 26

When is anti-D given in Rh-ve mothers?

Answer 26

28 and 34 weeks

Question 27

What would the triple test show in downs syndrome?

Answer 27

Estriol low
AFP low
HCG high

Question 28

Why might AFP be raised with no abnormality?

Answer 28

Wrong dates
Multiple pregnancy
Bleeding in early pregnancy

Question 29

What problems does diabetes cause for neonates?

Answer 29

Hypoglycaemia
Hypertrophic cardiomyopathy
Polycythaemia
Respiratory distress syndrome