Antenatal care Flashcards
What conditions are screened for in all pregnant women?
Anaemia Bacteriuria Blood group, Rhesus status and anti-red cell antibodies Down's syndrome Fetal anomalies Hepatitis B HIV Neural tube defects Risk factors for pre-eclampsia Rubella immunity Syphilis
What conditions are screened for depending on the history?
Placenta praevia Psychiatric illness Sickle cell disease Tay-Sachs disease Thalassaemia
What conditions are screening not routinely offered for?
Bacterial vaginosis Chlamydia Cytomegalovirus Fragile X Hepatitis C Group B Streptococcus Toxoplasmosis
How many antenatal visits are recommended in first pregnancy if uncomplicated?
10§
How many antenatal visits are recommended in subsequent pregnancies if uncomplicated?
7
When and what is involved in a booking visit?
8-12 weeks
General information e.g. diet, alcohol, smoking, folic acid, vit D
BP, urine dipstick, BMI
Booking bloods/urine
What is tested for in booking bloods/urine, when is this done?
8-12 weeks Bloods: FBC, blood group, rhesus status, red cell alloantibodies, haemoglobinopathies hep B syphilis rubella HIV test to all women urine culture - asymptomatic bacteriuria
When are dates confirmed and multiple pregnancy excluded?
10-13+6 weeks
When is downs syndrome screening?
11-13+6 weeks
What is done at 16 weeks?
Information on the anomaly and the blood results. If Hb < 11 g/dl consider iron
Routine care: BP and urine dipstick
When is the anomaly scan?
18-20+6
What is done at 25 weeks, what are the conditions for this?
routine care
primip
What is part of routine care?
BP
urine dipstick
Symphysis fundal height
What is done at 28 weeks?
Routine care
second screen for anaemia and atypical red cell alloantibodies
First dose of anti-D prophylaxis to rhesus -ve women
what should Hb levels be to consider iron supplements?
<11g/dl at 16 weeks
<10.5g/dl at 28 weeks
When are appointments for routine care?
25 28 31 34 36 38 40 41
When is second dose of anti-D prophylaxis given to rhesus negative women?
34 weeks
What are done at 36 weeks?
Check presentation - offer external cephalic version if indicated
Information on breast feeding, vitamin K, ‘baby-blues’
When is external cephalic version indicated?
36 weeks
when is induction discussed if past 40 weeks?
41 weeks
when are doses of anti-D prophylaxis given to rhesus negative women?
28 and 36 weeks
What are natural remedies or n & V in pregnancy?
ginger
acupuncture - p6 point by the wrist
What is first line pharmacological treatment of N&V in pregnancy?
antihistamines - promethazine
what is recommended with regards to vit D in pregnant women?
daily supplement of 10micrograms of vit D
who is at particular risk of bad vit d levels
asian
obese
poor diet
what are the recommendations regarding alcohol in pregnancy?
shouldn’t drink at all
