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GOSH > Antenatal Care > Flashcards

Antenatal Care Flashcards

1
Q

What general topics must you discuss at the booking visit?

A
  • Smoking
  • Diet
  • Alcohol
  • Folic acid
  • Vitamin D
  • Antenatal classes
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2
Q

What investigations are important at the booking visit?

A
  • BMI
  • Blood pressure
  • Urine dipstick
  • FBC - blood group
  • Infection screen
  • Urine culture
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3
Q

What infections do you test for at the booking visit?

A
  • HIV
  • Hep B
  • Syphilis
  • Rubella
  • Asymptomatic bacteriruria
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4
Q

When is the dating scan?

A

10 - 13 +6 weeks

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5
Q

What is the purpose of the dating scan?

A
  • Exclude multiple pregnancy

- Crown-rump measurements

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6
Q

When is the CRL less accurate for dating?

A

> 20wks

If CRL >84mm

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7
Q

When is the 1st T21 screening?

A

11-13+6weeks + nucal scan

  • combined test
  • Detect cardo-abnormalities
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8
Q

When is the anomaly scan?

A
  • 18-20+6 weeks
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9
Q

At the anomaly scan, If a woman’s placenta is found to extend across the os, when should another scan be offered?

A

32 weeks

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10
Q

At 25 weeks what appointment is made for primips?

A
  • General check-up
  • BP, urine, symphysis-fundal height
  • More information
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11
Q

When is the first dose of Anti-D offered to Rhesus negative women?

A

28 weeks

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12
Q

What Hb level may lead you to consider prescribing iron tablets?

A

<10.5

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13
Q

When is the second dose of Anti-D given?

A

34 weeks

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14
Q

What is discussed at 34 weeks?

A

Birth plan
Labour information
Pain relief

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15
Q

When is presentation checked with the offer of an ECV?

A

36 weeks

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16
Q

How do you calculate the date for expected delivery from the LMP?

A
  • 1st day of LMP + 7 days

- + 9 months

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17
Q

If a woman has a routine cervical smear appointment during pregnancy, when should it be rearranged for?

A

12 weeks post partum

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18
Q

What may severe itching in pregnancy be indicative of?

A

Obstetric Cholestasis

19
Q

When is the quadruple test offered?

A

14-20weeks

20
Q

When is the OGTT offered if indicated?

A

24-28wks

21
Q

How is the risk of T21 calculated?

A

Maternal age x risk ratio from combined screening

22
Q

What risk level determines if the quadruple test is offered or not?

A

> 1 in 150

23
Q

What is the likelihood of T21 if there is a positive combined screening test?

A

1 in 9

24
Q

Which 3 chromosomal abnormalities are detected during pregnancy?

A
  • T13 - Patau’s
  • T18 - Edward’s
  • T21
25
Q

What is the detection rate of the combined screening test?

A

85%

26
Q

What size nuchal translucency is indicative of disease?

A

3.5mm

27
Q

What forms the combined screening test?

A
  • Nuchal Translucency USS

- Maternal blood test for B-hCG and PAPP-A

28
Q

What levels of b-hCG indicate disease?

A

Raised - T21

Low - T13, T18

29
Q

What is PAPP-A?

A
  • Pregnancy associated plasma protein A
  • Produced by placenta during pregnancy
  • Low levels indicate T13,18,21
30
Q

What is the quadruple test for?

A

T21

31
Q

Who is the quadruple test offered to?

A
  • If missed combined screening after 1st trimester

- Blood test

32
Q

What is a positive quadruple test?

A
  • Alphafetoprotein - LOW
  • Unconjugated oestriol (uE3) - LOW
  • hCG - HIGH
  • Inhibin A - HIGGH
33
Q

What is the minimum detection rate of the quadruple test?

A

80%

34
Q

What is the false positive rate of the quadruple test?

A

4.1%

35
Q

What is the risk of miscarriage with chorionic Villous sampling?

A

1%

36
Q

When are the results for CVS given?

A

48hrs

37
Q

When are the results for Amniocentesis given

A

3 weeks

38
Q

When are CVS and amniocentesis performed?

A

CVS - >11wks

Amniocentesis >15wks

39
Q

What is the risk of miscarriage in amniocentesis?

A

1 in 120/0.8%

40
Q

When can structural abnormalities be detected?

A

18-20+6 wks

41
Q

What structural abnormalities can be detected?

A
  • Ancephaly
  • Gastroschisis
  • Heart defects
  • T13/T18
42
Q

Which haemoglobinopathies can you detect during the booking bloods?

A
  • Sickle Cell

- Thalassaemia

43
Q

If the umbilical artery waveform demonstrates reverse-end diastolic flow or absent end diastolic flow, what does this indicate?

A
  • Placental resistance

- Consider early delivery +30wks

GOSH (4 decks)

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