Antenatal Care Flashcards
What are the aims of antenatal care?
Detect disease in the mother
Monitor and promote fetal well-being
Prepare mothers for birth and make a plan of care
Monitor trends to prevent or detect any early complications of pregnancy
BP is the most important variable
IS thromboprophylaxis or aspirin needed?
What happens in the the booking visit (1st antenatal visit)
Full obstetric history Any concurrent illness VTE risk? Gestation diabetes risk? Past mental illness Risk of BBV, haemoglobinopathy Unsupported?
What examination and investigation at booking visit?
Heart, lungs BP Weight Abdomen Genitally cut?
Bloods: FBC Blood group and Rhesus Antibody screen Syphyllis Rubella serology HbsAg HIV Sickle test Hb electrophoresis Vitamin D
MSU for bacteria or protein
Check for TB if at risk
What advise at booking visit
Smoking
Alcohol
Diet
Correct use of seat belts - above/below bump
Folic acid
Vitamin D
Offer antenatal classes
Information of maternity benefits including free dental care
Usual exercise and travel OK up to 36 weeks
Fit to fly letter may be required
Intercourse OK if no vaginal bleeding
When do visits occur?
<12 weeks
10 - early scan to confirm dates
11 - Down’s syndrome screening
16 weeks - information on animaly and blood results - treat anaemia or UTI
18 weeks - anomalyy scan
28 weeks - routing BP, urine dip, SFH, anaemia screen,
First dose of anti-D prophylaxis
34 weeks - discuss labour and birth plant, second dose of anti-D to Rh negative women
36 weeks - discuss breastfeeding, neonatal vitamin K, postnatal care, postnatal depression
Check presentation - offer external cephalic version
38 weeks - routine care
40 weeks - discuss post-dates pregnancy and management
41 weeks - discuss labour plans and induction
What nutritional supplements are given in pregnancy?
Folic acid from before conception until 12 weeks after to reduce risk of NTD
Vitamin D supplement
When is folic acid given?
Before conception until 12 weeks
What advice on alcohol in pregnancy?
Pregnancy women should not drink
What advice of food in pregnancy?
Avoid unpasteurised milk, ripened soft cheeses, pate, undercooked meat
Avoid raw or partially cooked eggs and meat
What advice on work in pregnancy?
Maternity rights and benefits
Assess occupational hazards
What advice on air travel in pregnancy?
Women > 37 weeks with singleton and no additional risk factors should avoid air travel
Women with multiple pregnancy should avoid air travel once > 32 weeks
Increased risk of VTE
What advice on nausea and vomiting in pregnancy?
Natural remedies - ginger and acupuncture
Antihistamines first line - promethazine
What advice on vitamin D in pregnancy?
Importance of maintaining vitamin D
Women at risk - Asian, obese, poor diet
When is anti-D given in pregnancy with Rh -ve mother?
28 and 34 weeks
When should a mother be given anti-D postnatally
Rh -ve women where baby’s blood group cannot be determined or if baby’s group is unknown 72h post-delivery
