Antenatal care

Question 1

What should be discussed in pre-pregnancy counselling?

Answer 1

• Ensure rubella immunity
• Stop smoking and drugs, limit alcohol
• Weight loss and exercise
• Folic acid and Vit D supplements
• Pre-existing conditions
• Teratogenetic medications
  Genetic councelling
• spontaneous miscarriage

Question 2

Which drugs are teratogenic?

Answer 2

Anti-epileptic drugs
ACEi
Immune-modulators
St John’s wort

Question 3

What is the purpose of folic acid supplementation?

Answer 3

Prevent neuro tube defects

Question 4

What is the advise about alcohol during pregnancy?

Answer 4

Avoid during T1 and when trying

T2-3: 1-2 units, once or twice a week

Question 5

How much folic acid should be taken and when?

Answer 5

0.4mg daily

1 month pre-conception until 13 weeks

Question 6

What foods should be avoided in pregnancy?

Answer 6

Caffeine (limit to 200mg/day)
Cook meat & eggs thoroughly
Pate
Soft cheese
Shellfish
Raw fish

Question 7

When are antenatal appointments?

Answer 7

10-13+6 weeks: booking USS, screening
16 weeks: iron supplement, BP & urine
18-20 weeks: USS
28 weeks: anti-D, screening, measure abdo, BP & urin,
34 weeks: anti-D, measure abdo, BP & urine
36 weeks: measure abdo, BP & urine, position
38 weeks: measure abdo, BP & urine
41 weeks: induction

Question 8

What tests can be done to screen for Down’s syndrome?

Answer 8

Combined test: 11-13+6

Triple/quadruple: 15-20

Question 9

What blood tests should you do during pregnancy and when?

Answer 9

<10 weeks
Blood group, Rh D status
Haemoglobinopathies
Anaemia
Red cells allo-antibodies
Hep B
HIV
Rubella susceptibility
Syphilis

Question 10

What is the combined test?

Answer 10

Down's syndrome screening
11-13+6 weeks
Nuchal translucency
bHCG
PAPPA

Question 11

What is the triple/quadruple test?

Answer 11

Down's syndrome screening 15-20 weeks
bHCG
AFP
Estriol
\+/- inhibin A