Antenatal Care Flashcards
Dates for invasive/ non invasive prenatal testing
Non invasive: free foetal DNA Week 10. $500 out of pocket. Most accurate test for trisomy 21.
Invasive:
- amniocentesis : Week 15. Risk of miscarriage 1/1000
- chorionic villous sampling- Week 12. Risk of miscarriage 1:500
What is the Triple test and when is it done?
Trimester 1 US
PAPPA
B-hCG
Week 9-13
What is the Quadruple test and when is it done?
Bhcg
AFP
Oestriol
Inhibin A
Week 14-20 - trimester 2
When is trimester 2 ultrasound performed?
W19-21
What are four components of a CTG?
Foetal HR
Variability
Acceleration/ deceleration
Contractions
An early uniform deceleration on ctg indicates
Early normal parasympathetic response of foetal head compression
A complicated variability and deceleration on ctg indicates:
Cord compression
Folate normal dose
0.4mg
Start 3 months prior preg
5 mg for at risk patients
Folate dose for ‘at risk ‘ pregnancies
At risk meaning?
4mg
At risk:
Past cleft palette
Past spins bifida
Maternal epilepsy - taking valproate
T1 screening components
T1US, PAPPA, beta-hCG
T2 screening components
beta-hCG, AFP, inhibin, oestridol
Amniocentesis dates
W15+
CVS dates
W11+
NIPT
W10_
T2US dates
W19-21 (W20)
IOL recommended dates
W42 +0
IOL Bishop’s 5 or less
Dinoprostone (PGE2)
IOL Bishop’s >5
ARM + Oxytocin
IUGR screening
SF height+ U/S
Options for further investigating hypoxia
Continuous CTG monitoring, scalp electrode, foetal LDH
Antenal Questions to ask:
Swam, - care - ssed
S eatbelts
W eight gain (10-14kg)
A ir travel
M aternity leave
C ats
A lcohol
R ecreational drugs
E ducation
S moking
S ex
E xercise (avoid supine exercise after first trimester)
D iet (folate, iron, vit D) + stop fish oil before 39 weeks
