Antenatal care Flashcards
When does the booking scan occur?
Around 12 weeks
What is done at the booking scan?
FBC Antibodies - RhD & ABO Glucose Syphilis, rubella, HIV, Hep B&C, Urinalysis & culture Ultrasound scan
At how many weeks gestation is the uterus felt at the umbilicus?
20 weeks
What is the purpose of the ultrasound at the booking scan?
Confirm viability
Number of fetuses
Confirm gestation
What is assessed at follow up visits?
BP and urinalysis Symphysis- fundal height Lie and presentation Engagement of presenting part Fetal heart auscultation
Where is information regarding antenatal care recorded?
Scottish Maternity record
How can the risk of Down’s syndrome be assessed in the first trimester?
Measure of skin thickness behind fetal neck using ultrasound (Nuchal thickness; NT)
PAPP-A and bHCG
When is the first trimester screening for Down’s syndrome done?
Measured at 11-13+6 weeks
What screening is done in the second trimester of pregnancy for Down’s syndrome?
Blood sample at 15-20 weeks
Assay of HCG and AFP
Once screening results for Down’s syndrome have been correlated with maternal age and gestation, what risk would warrant further investigation?
> 1:250
When can an amniocentesis be performed?
After 15 weeks
When can chorionic villus sampling be performed?
After 12 weeks
What is the risk with amniocentesis?
1% risk of miscarriage
What is the risk with chorionic villus sampling?
2% risk of miscarriage
How many extra calories a day should a mother be eating?
250-300 extra
How much extra protein should be consumed during pregnancy?
30g/day
Why is folic acid given antenatally?
Reduces risk of neural tube defects
What extra precautions are taken with multiple pregnancy?
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
Why is good diabetic control important in pregnancy?
Complications can be avoided with good control
How often should gestational diabetes be monitored?
2-4 weekly check ups from 28 weeks or diagnosis
When should delivery be offered in gestational diabetes?
38 weeks
What is twin to twin transfusion syndrome?
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
What are the causes of hydrops fetalis?
Anaemia
Cardiac disease
What forms the ‘triple test’?
For Down’s syndrome screening:
AFP, bHCG, estriol
