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Reproduction > Antenatal Care > Flashcards

Antenatal Care Flashcards

1
Q

What is sensitivity?

A

true positive/ (positive + false negative)

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2
Q

What is specificity?

A

true negative/ (negative + false positive)

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3
Q

What is done at the booking visit?

A

full history; exam- BMI; CVS; abdomen; Ix

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4
Q

What is Naegele’s Rule?

A

estimated due date based on LMP

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5
Q

When is the booking visit?

A

around 12 weeks

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6
Q

What investigations are done at the booking visit?

A

Hb; ABO; Rhesus; syphilis; HIV; hep B and C; UA; US

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7
Q

What is looked at on US at the booking visit?

A

confirm viability; singleton/mulitple pregnancy; estimate gestational age; major structural abnormalities; offer Down’s screening

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8
Q

What is the purpose of UA?

A

look for asymptomatic bacteruria; gestational DM; pre-eclampsia

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9
Q

How many pregnancies at the booking viist US won’t be viable?

A

1 in 5

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10
Q

What is the function of the yolk sac?

A

supports pregnnacy until placenta

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11
Q

What is done at follow up visits?

A

history- physical and mental health; fetal movements; BP and UA; symphysis-fundal height; lie and presentation; fetal heart auscultation

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12
Q

When is a transverse lie a problem in pregnnacy?

A

36/37 weeks

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13
Q

What are the problems with transverse lie?

A

cord prolapse; malposition eg breech

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14
Q

What is the still birth rate in pregnnacy?

A

1 in 200

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15
Q

What is done in an anomaly risk assessment in the first trimester?

A

increased nuchal thickenss

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16
Q

What blood test is done for fetal anomlaies in the 2nd trimester?

A

hCG and AFP

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17
Q

What is considered high risk for Down’s?

A

more than 1 in 250

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18
Q

What is placental praevia?

A

placenta is low lying in the womb and covers all or part of hte cervix

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19
Q

What is done is placental praevia is seen at a scan between 18-20+6 weeks?

A

offered abdo scan at 32 weeks

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20
Q

When is nuchal thickness measured on USS?

A

11-13+6 weeks

21
Q

What is nuchal thickness?

A

<3.5mm

22
Q

What tests is nuchal thickness combined with in the first trimester for Downs screening?

A

HCG and PAPP-A

23
Q

What is used to estimate gestation before 13 weeks?

A

crown-rump length

24
Q

What should be used to estimate gestation after 13 weeks?

A

head circumference

25
Q

What is second trimester screening for Down’s?

A

maternal age+ biochemical markers- AFP; hCG; uncojugated oestradiol and inhibin A

26
Q

When is the second trimester screening for Down’s?

A

between 14-20 weeks

27
Q

Who gets the second trimester screening for Down’s?

A

those who missed the first trimester offer

28
Q

What is the miscarriage rate with amniocentesis?

A

1%

29
Q

When is amniocentesis performed?

A

after 15 weeks

30
Q

When is chorionic villous sampling carried out?

A

after 12 weeks

31
Q

What is them iscarriage rate with chorionic villous sampling?

A

2%`

32
Q

When is maternal anaemia screened for?

A

booking and 28 weeks

33
Q

What questions are used to screen mental health in pregnnacy?

A

new feelings or thoughts which make you disturbed or anxious?
thoughts of suicide or self-harm?
feeling incompetent as a mother, feeling distnaced or estranged; feel getting worse?

34
Q

What are the risk factors for gestational DM?

A

BMI >30; previous macrosomic baby (>4.5kg); Fhx; minority ethnic family origin

35
Q

Who should be offered testing for gestational DM?

A

woman with any one risk factor for GDM

36
Q

What is the fasting plasma glucose for GDM?

A

> 5.6mmol

37
Q

What is the 2hour plasma glucpse level for GDM?

A

> 7.8mmol

38
Q

Who should be sent for ultrasound measuremtn of fetal size?

A

women with single SFH below 10th centile or slowing or static growth

39
Q

What could make SFH inaccurate?

A

BMI >35; large fibroids; hydramnios

40
Q

What is the treatment for women at high risk of pre-eclampsia?

A

75mg of aspiring from 12 weeks to birth

41
Q

What are the high risk factors for pre-eclampsia?

A

HT disease in prev pregnnacy; CKD; AI disease eg SLE or EPS; T1 or T2DM; chronic HT

42
Q

What are the moderate risk factors for pre-eclampsia?

A

first pregnancy; age 40 or more; pregnnacy interval of >10 years; BMI >35; Fhx; multiple pregnnacy

43
Q

When should a booking appt in pregnnacy be carried out?

A

ideally by 10 weeks

44
Q

What should be done at 16 weeks?

A

review screening tests etc; BP and UA

45
Q

What should be carried out at 18-20 weeks?

A

USS anomaly scan

46
Q

Who should get an appt at 25 weeks?

A

nulliparous women

47
Q

When is the second appt for all pregnant women?

A

28 weeks

48
Q

What is done at the 28 week appt?

A

second screening for anaemia and blood group abs; offer anti-D; BP and UA; SFH;

49
Q

Who should get an appt at 31 weeks?

A

nulliparous women

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