Antenatal care

Question 1

Describe Antenatal Care

Answer 1

At presentation
- FBC
- Blood group + antibody. 
- GTT
- TFT
Infections
- Rubella
 - Varicella
- Hep B SAg
- Hep C
- HIV
- Syphillus serology
- Chlamydia if <25 years
- Papsmear if due. 

1st Trimester screen - 11-13 weeks.

• NT scan
• HCG
• PAPPA blood test

Mid 2nd Trimester Scan - 18-20 week scan.

• morphological abnormalities
• placental lie
• amniotic fluid levels

2nd trimester screen - 28 weeks
- GTT
- Rh-D antibodies administered if Rh- negative
- Immunisations
dTPa (boostrix)
diptheria, tetanus, acellular pertussis.
- fluvax.

34 week US

• placental lie
• baby’s position
• amniotic fluid

36 weeks
- GBS swab + antibiotics if necessary.

General checkups:
Every 4 weeks up to weeks 28. 
Every 2 weeks after week 28. 
- urinalysis
- fundal height
- doppler - fetal heart beat
- blood pressure
- check BSL if required.

Question 2

What are the effects on the baby if it has Downs syndrome?

Answer 2

Brain + CNS

• microcephaly
• developmental delays
• low IQ
• Alzheimers disease in 40s

Eyes

• cataracts
• nystagmus
• myopia

Ears
- hearing defects

Heart

• congential defects
• usually AVSD

GU

• hypospadias
• infertility

GI

• dudoenal atresia
• hirschprungs disease

General

• small stature
• small limbs