Antenatal Care Flashcards

1
Q

Listeria infection is a problem if contracted, with fetal

mortality being _______

A

30–50%.

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2
Q
Folic acid (0.5 mg tablets) is now generally
recommended to commence about\_\_\_\_\_\_\_\_ preconception and \_\_\_\_\_\_\_post concepcion
A

3 months prior to conception, continuing to 12 weeks postconception

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3
Q

Rubella serology should be estimated and, if
required, immunisation_______ prior to conception
should be initiated

A

4 weeks

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4
Q

When to test for seroconversion for rubella

A

Test for seroconversion 6–8

weeks late

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5
Q

Rubella Vaccination should be avoided in early
pregnancy, and pregnancy avoided for ________after
rubella vaccination.

A

28 days

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6
Q

if vaginal bleeding: if Rh negative, send blood
sample for Rh antibodies—if absent, give one
ampoule ______ within
72 hours of first bleed

A

anti-D gammaglobulin

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7
Q

Perform the four classic techniques of palpation

(applies to later visits):

A

1 Fundal palpation
2 Lateral abdominal palpation
3 Pawlik palpation
4 Deep pelvic palpation

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8
Q

When to do Maternal serum screening (MSST)

A

(9–13 weeks, 11 is ideal):

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9
Q

MSST tests

A

— Free β -hCG

— PAPP-A

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10
Q

If MSST performed at 11 weeks and combined
with NT one week later, it enables the risk of
_____ and _________ to be defined and
compared with age-related risk

A

trisomy-21 and trisomy-18

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11
Q
Nuchal translucency (NT) ultrasound (usually
\_\_\_\_\_\_\_\_
A

12–13 weeks)

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12
Q

Second trimester MSST

• performed at ________ (if desired)

A

15–16 weeks

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13
Q

Second trimester MSST

Genetic testing for recessive disorders
such as ________ and ________ can be
discussed at this time.

A

cystic fibrosis

thalassaemia

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14
Q

Recently, free fetal DNA testing has been available
in Australia and overseas. It is performed on a
maternal blood sample taken at about_______

A

10–12 weeks

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15
Q

If positive free fetal DNA testing, _______ or __________would usually be required for
confirmation

A

amniocentesis or

chorionic villus biopsy

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16
Q

A common routine schedule (if all appears normal)

  • Initial in first trimester: _______
  • Up to 28 weeks: every _______
  • Up to 36 weeks: every _____
  • 36 weeks–delivery:_____
A

8–10 weeks

4–6 weeks

2 weeks

weekly

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17
Q

Guidelines for OGTT

A

• First visit—if previous gestational diabetes or
strong family history
• About 20 weeks—as above + normal initial test
• About 26 weeks—for all other patients

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18
Q

The average number of visits is 12 but the need
for this number is being questioned, with some
authorities recommending as few as______

A

six visits

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19
Q

urinalysis (protein and sugar)—many clinics
repeat at each visit only if there is _______at
the first visit or if signs of hypertension, kidney
disease or pre-eclampsia develop.

A

proteinuria

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20
Q

Record day of first fetal movements (i.e.
‘quickening’) (ask patient to write down the dates):
• primigravida: ______
• multigravida:______

A

17–20 weeks

16–18 weeks

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21
Q

Causes of proteinuria in pregnancy

A

Urinary tract infection
Contamination from vaginal discharge
Pre-eclampsia toxaemia
Underlying chronic kidney disease

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22
Q

The uterus is a pelvic organ until the ______ of pregnancy

A

twelfth week

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23
Q

At about _______weeks it
has reached the level of the umbilicus and reaches
the xiphisternum between ________ weeks

A

20–22

36 and 40

24
Q

If the symphysis fundal height is more than ____ different
from that expected for the gestation, the cause of
this should be evaluated by ultrasound examination

A

2 cm

25
Q

______ and ________ helps prevent constipation of

pregnancy

A

Bran with cereal

26
Q

It is usual to gain about ______ during pregnancy

A

12 kg

27
Q

Smoking, alcohol and other drugs

1 standard drink of ______
• 1 cup of _____ or 2 cups of tea

A

alcohol

coffee

28
Q

There is convincing evidence that promotion
of smoking cessation programs during pregnancy
is effective, with improved outcomes, including
reduction in_______ and _______

A

preterm birth rates and low birthweight rate

29
Q

Mothers taking illicit drugs, especially opioids and
amphetamines, require identification, counselling,
treatment and surveillance for the __________

A

neonatal abstinence syndrome in the newborn child

30
Q

Coitus should be encouraged during pregnancy but

with appropriate care, especially in the _______

A

4 weeks before

delivery

31
Q

They should avoid international air travel after
______ weeks and travel after 34 weeks is usually not
permitted.

A

28

32
Q

Normal weight gain is minimal in the first
20 weeks, resulting in a _____weight gain in the first
half of pregnancy

A

3 kg

33
Q

From 20 weeks onwards there is
an average weight gain of _____ kg per week. From 36
weeks the weight gain usually levels off.

A

0.5

34
Q

if the movements
drop to fewer than ______ per day, the patient should be
referred to hospital for fetal monitoring

A

10

35
Q

Possible exposure to rubella

If her immune status is unknown, perform a _______ and repeat titres in 2–3 weeks

A

rubella IgG titre and IgM and repeat the IgG and IgM

36
Q

Vaginal bleeding

<6 weeks: Do _________ (ultrasound
usually unhelpful).

A

serial quantitative HCG levels,

which should double every 2 days

37
Q

Vaginal bleeding

6–8 weeks:________

A

Ultrasound will define an intrauterine

pregnancy and exclude an ectopic.

38
Q

Vaginal bleeding

> 8 weeks: Normal ultrasound is reassuring since
miscarriage rate is only ________ unless the amount of
intrauterine blood is large

A

3%

39
Q

T or F
Rest is not necessary for threatened
miscarriage

A

T

40
Q

A small bleed between 18–24 weeks indicates
possible ________ and warrants a speculum
or vaginal examination plus fetal assessment

A

cervical ‘weakness’

41
Q

Be aware that an incomplete abortion can cause

___________

A

cervical shock (pelvic pain and fainting).

42
Q

If a threatened miscarriage occurs, check the blood

group and test for________

A

rhesus antibodies in maternal

serum.

43
Q
If the mother is Rh-negative and no
antibodies are detected, give one ampoule of \_\_\_\_\_\_\_\_\_\_ intramuscularly if the woman
actually miscarries (not for threatened abortion).
A

anti-D

gammaglobulin

44
Q

Medication for Nausea and vomiting during pregnancy

A

— pyridoxine 25–50 mg bd or tds

— if still ineffective add metoclopramide 10 mg tds

45
Q

This is severe vomiting in pregnancy, which may
result in severe fluid and electrolyte depletion. It
occurs in about 1 in 100 pregnancies

A

Hyperemesis gravidarum

46
Q

Hyperemesis gravidarum association

A
  • Normal complication
  • Hydatidiform mole
  • Multiple pregnancy
  • Urinary infection
47
Q

________ is the basis of the cramps

A

Prolonged plantar

flexion

48
Q

There is no evidence
that __________ help cramps during
pregnancy

A

calcium supplements

49
Q

Painful haemorrhoids may be eased by the application of __________or perhaps haemorrhoidal ointments containing local anaesthetic

A

packs soaked in warm saline

50
Q

Exercise guidelines during pregnancy

A

• avoid overheating and dehydration
• allow for a long warm-up before exercise and a
long cool-down
• choose low-impact or water exercise

51
Q

If desperate for CTS, what to do?

A

an injection of corticosteroid into the carpal tunnel can be very effective (check drug category for risk relative to dates

52
Q

Cause of hypotension during pregnancy

A

This is due to increased peripheral circulation and

venous pooling

53
Q

Generalised itching (pruritus gravidarum) is usually
associated with ________ due to oestrogen
sensitivity in the third trimester

A

cholestasis

54
Q

Obesity is associated with increased obstetric

morbidity, including_____ and ______

A

difficult labour and potential

anaesthetic risks

55
Q

T or F

Iron is not routinely recommended for pregnant
women who are healthy, following an optimal diet and
have a normal blood test

A

T

56
Q

_________ is essential for the developing fetus and
if deficiency is known or suspected (e.g. vegetarian/
vegan diet)

A

Vitamin B12

57
Q

It is recommended, for pregnant and lactating
women and those planning a pregnancy, to take _______of supplementary iodine as soon as possible by
using iodised salt for cooking and a multivitamin that
includes iodine

A

150

mcg