Antenatal care

Question 1

What are WHO recommendations for the number of contacts during pregnancy? How should the contacts be divided between the trimesters?

Answer 1

WHO recommend a total of 8 contacts. One contact during the first trimester, two contacts in the second trimester and five contacts in the third trimester.

Question 2

What are the main maternal physiologic adaptions that occur during pregnancy?

Answer 2

Increased plasma volume.
Changes to the respiratory system.
Weight gain.

Question 3

Increased plasma volume is essential for a normal pregnancy. No increase in plasma volume is associated with a heightened risk of certain poor pregnancy outcomes, which ones?

Answer 3

Fetal growth restriction and intrauterine fetal death.

Question 4

What are the maternal outcomes of increased plasma volume during pregnancy?

Answer 4

Increased venous pressure in lower extremities and a subsequent higher risk of deep vein thrombosis.

Increased hearth volume by 10 % and a 30 % increase in wall thickness of the left ventricle at term.

Increased blood flow to the kidney. Slight risk of hydronephrosis and increased risk of UTI.

Question 5

What physiological respiratory changes occur during pregnancy?

Answer 5

Increased tidal volume and ventilation.
Reduced residual volume.
(The respiration rate is unchanged.)

Question 6

What are the causes of weight gain during pregnancy?

Answer 6

Growth of conception products, uterus and mammae.
Fluid retention.
Increased fat deposits.

Question 7

What is the total weight gain during pregnancy on average?

Answer 7

10-12 kg.

Question 8

By which health care workers are antenatal check-ups given?

Answer 8

General practitioner, midwife or both.

Question 9

When is the first ultrasound scan during pregnancy usually performed?

Answer 9

During week 17-20 in the second trimester.

Obs: endret fra 2022 - alle skal få tilbud om tidlig UL i uke 11-14!

Question 10

Hvilke uker er del av hvilke trimester i svangerskapet?

Answer 10

1. trimester: Fra siste menstruasjon og ut uke 13.
2. trimester: Fra begynnelsen av uke 14 og ut uke 26.
3. trimester: Fra begynnelsen av uke 27. og ut svangerskapet.

Question 11

When is the first antenatal check-up carried out? What should be addressed during the consultation?

Answer 11

In week 6-12 during the first trimester.

Talk about the development of the fetus, nutrition, tobacco, snuff, alcohol and other lifestyle habits, antenatal screening tests, antenatal care practice, maternity and paternity benefits and book a place at hospital or midwifery unit. (All women should be asked about previous history of psychiatric disorders as well as current mental health.)

Question 12

What are indications for measuring HbA1c during the first trimester?

Answer 12

Previously had gestational diabetes.
Parents have diabetes.
Ethnic background from a country outside Europe.
BMI > 30 (obesity).

Question 13

How common is it for women to experience nausea and/or vomiting during pregnancy? When is this usually resolved?

Answer 13

90 % of women experience nausea and/or vomiting during pregnancy. It is usually resolved between week 16-20 in pregnancy.

Question 14

When in pregnancy is usually a Rhesus D test offered?

Answer 14

In week 24 during the third antenatal check up.

Question 15

What can be consequences of UTI during pregnancy?

Answer 15

Serious maternal infection and premature labor.

Question 16

When is the fourth antenatal check-up carried out? What is it especially important to remember during this consultation?

Answer 16

In week 28. It is especially important to check hemoglobin and to give Rh-prophylaxis if needed.

Question 17

Oral glucose tolerance test (OGTT) is somethimes indicated during pregnancy. When is it performed and what are the indications for performing it?

Answer 17

OGTT is performed in week 24-28.
Indications include prior gestational diabetes, parents with diabetes, BMI > 25, ethnic background from countries outside Europe and age > 25 years (or > 40 years if given birth before without gestational diabetes.)

Question 18

When in pregnancy is the assessment of fetal position done?

Answer 18

In week 36 during the sixth follow-up.

Question 19

What are some ways of easing back aches or pelvic pain during pregnancy?

Answer 19

Exercising in water, massage therapy and back care classes.

Question 20

When in pregnancy is the eight check-up? What is it important to do during this consultation?

Answer 20

In week 40.

It is important to inform about overdue and refer the patient to hospital care.