Antenatal care

Question 1

When to give anti-D

Answer 1

• After threatened miscarriage for Rh- women
• After complete miscarriage for Rh- women
• After termination of pregnancy for Rh- women
• After birth for Rh- women with a confirmed Rh+ baby (send cord blood)
• After abdominal trauma (direct, MVA, etc) for Rh- women
• After ECV for Rh- women
• After antepartum haemorrhage for Rh- women
• After severe unexplained abdominal pain for Rh-women (possible concealed abruption)
• After invasive testing (CVS/amniocentesis) for Rh- women

Question 2

Risk factors for GBS

Answer 2

• preterm (<37 weeks)
• prolonged membrane rupture (>18 hours)
• previous GBS-affected baby
• known GBS carriage (not just carrier status from a previous pregnancy)
• GBS UTI this pregnancy
• fever in labour (treat with broad spectrum antibiotics, not just benzylpenicillin)