Antenatal Care

Question 1

Trimesters:

Week of expected metal movements?

Answer 1

20 weeks

Question 2

Key milestones:

Before 10 wks
Between 10-14 wks
16 weeks - Antenatal appointment
Between 18-21 weeks - Anomaly scan

Range of antenatal appointments follow depending on needs

Answer 2

Booking clinic - Baseline assessment - plan the pregnancy

Dating scan - Gestational age

Question 3

Additional milestones:

Test for gestational DM?
Rhesus status?
When is a scan performed to identify placenta praevia?

IGR - What type of scans are needed?

List a few things covered during appointments?

2 vaccines offered?

Answer 3

Oral glucose tolerance test

Anti-D injections if Rhesus negative
32 wks - anomaly scan

Serial growth scans

SFH
Fetal presentation
Urine dip - PE
BP - PE

Whooping cough
Influenza

Question 4

Booking Clinic:

Booking bloods taken - list why?

Assess risk and screen for complications:

Blood borne viruses? - 4

Additional
Blood pressure - BP and proteinuria for PE
BMI

Answer 4

Blood group - ABO and rhesus
Antibodies - Rhesus D antibodies
Complete blood count - FBC - anaemia
Sickle cell and thalassemia testing

HIV
Hep B
Syphilis
Rubella

Question 5

Risk Assessment:

Provide prophylaxis used in conditions below:
- Rhesus negative
- Gestational DM
- IGR
- VTE
- PE

D
- Initial tests used? - 3
- Chorionic villous sampling (CVS) - what is it?
- Amniocentesis - what is it?

Answer 5

Rhesus - Anti-D
G DM - OGTT
Fetal growth restriction - serial growth scans
VTE - LMWH
Pre-eclampsia - Aspirin

Nuchal thickness
Maternal age
Maternal bloods

Used to detect birth defects, genetic diseases, and other problems during pregnancy. During the test, a small sample of cells (called chorionic villi) is taken from the placenta where it attaches to the wall of the uterus.

It involves removing and testing a small sample of cells from amniotic fluid, the fluid that surrounds the unborn baby in the womb (uterus), to check if your baby has a genetic or chromosomal condition.

Question 6

Down Syndrome Testing:

Combined Test - USS + Bloods:
- USS looking for?
- 2 maternal blood tests

Triple test - Bloods only - 14-20 wks:
3 tests in total - 1 is Beta-HCG
Other 2?

Karyotyping (only if identified as high risk):
2 tests?

Answer 6

USS - Nuchal translency - > 6mm (possible downs)

Beta-HCG - higher indicates greater risk
Pregnancy associated plasma protein A (PAPPA) - lower indicates greater risk

AFP - lower indicates greater risk
Serum estriol - lower indicates greater risk

Amniocentesis - USS guided aspiration of amniotic fluid
Chorionic villus sampling (CVS) - USS guided biopsy of the placental tissue (before 15 wks)