Antenatal Care Flashcards
What vitamin should all women have in pregnancy and breastfeeding and at what dose
Vitamin D 10mcg
Ideally when should screening for sickle and thalassaemia be done by
10 weeks
What screening for downs screening is offered and when
Combined screening at 11-13+6
Triple or quad screening at 15-20 weeks if:
Combined missed
Unable to measure NT on USS
When should booking occur by
Ideally 10 weeks
How many anc appointments should low risk women get
Nulliparous 10
Multiparous 7
When and how should gestational age be assessed
USS CRL at 10-13+6
HC if CRL >84mm
How is listeriosis avoided
Pasteurised or UHT milk
No ripe/soft cheese
No pate inc vegetable pate
No uncooked/undercooked ready meals
How is salmonella avoided
Raw/partially cooked eggs
Raw/partially cooked meat
What is 1 unit of alcohol
How much can you have in pregnancy
1/2 pint, 1 shot
Small wine = 1.5 units
No more than 1-2 weekly
How should seatbelts be applied
Above and below the bump not over it
When should N&V resolve
16-20 weekdays
What is considered normal Hb
Booking 110
28 week 105
When should sickle and thalassaemia screening be done as routine
Feral prevalence >1.5 cases per 10,000 pregnancies
Otherwise family origin questionnaire can be used
Or if MCV <27 picograms
What at the anomaly scan should print referral for an FMU scan
NT >6mm
>2 soft markers
When should a placental localisation scan be done
At 32 weeks only if the placenta covered the int os at the anomaly
If women decline induction when and what monitoring should be offered
2x weekly CTG and weekly deepest pool
At 11-13+6 what does an A wave and tricuspid regurge indicate an increased risk of
Aneuploidy
What % of PET can be predicted from the booking Hx
47%
With a false + rate of 10%
What % of women take the correct pre conception folic acid
20-50%
What is the incidence of RBC Ab
1:80
What is the incidence of a cute appendicitis in pregnancy
1:800 - 1:1500
Most common in 2nd trimester
If US imaging for appendicitis in pregnancy is inconclusive, what imaging is second line
MRI
sensitivity 90% specificity 98%
What is the 1st line malaria prophylaxis in areas of chloroquine resiStance
Mefloquine
What investigation should be done for a 1st presentation of reduced FM
Auscultation with Doppler, CTG not indicated
What % of twins are monochorionic
33%
What is the perinatal mortality in the whole uk and what is it in monochorionic twins
UK 7 per 1000
MC twins 300-700 per 1000
A 30-70% increase
What risks are reduced by antenatal steroids and by how much
Death 31%
RDS 44%
Intraventricular haemorrhage 46%
Doxorubicin & epirubicin
What type of drugs are they
A Hx of use should prompt what investigation antenatally
Anthracyline chemotherapy agents used in breast Ca
Cause dose dependant LV dysfunction so an echo is required
By how much does domestic violence increase maternal mortality
3x
What level of anti-D should trigger referral to FMU
How often should levels be measured
> 4
Levels 4-15 correlate with a moderate risk of HDFN
Once detected they should be checked every 4 weeks till 28 weeks, then 2 weekly till delivery
Regarding anti-D, what is the window for optimal timing to prevent sensitisation
72hr
If placenta praevia is suspected at the anomaly scan, what follow up imaging should be done and when
Colour flow Doppler at 32 weeks
MRI is used if scan is not diagnostic
I’m sepsis, what fluids should be given if lactate is >4
Crystalloid 20ml/kg
When should caution be used with acyclovir
<20 weeks
What is the risk of HSV infection if primary infection occurs within 6 weeks of delivery
30-60%
How long is the incubation period for HSV
7 days
What % of pregnancies are complicated by PPROM
2%
Regarding PPROM at what gestation should delivery be considered
34 weeks
What is the risk of prom at the time of Cx stitch insertion
<1%
