Antenatal care

Question 1

What infections are screened for in antenatal care?

Answer 1

Asymptomatic bacteriuria - midstream urine culture Hep B HIV Syphillis

Question 2

What are the components of the combined test (screening) for Down’s Syndrome and what are the findings? When would you do these?

Answer 2

B-hCG (increased) PAPP-A (decreased) Nuchal translucency (increased) Mnemonic: BAN

Mnemonic: BUN (b-hCG and nuchal translucency increase) while PAPP-A decreases

Between 10 - 14 weeks

Question 3

What are examples of confirmatory tests for Down’s syndrome and when are they done?

Answer 3

Chorionic Villus sampling (10 - 14 weeks) Amniocentesis (15 weeks)

Question 4

What are the components of the quadruple test for Down’s syndrome and when are they done?

Answer 4

B-hCG (increased) [HI] Inhibin A (increased) AFP (decreased) Unconjugated oestriol (decreased) Done between 14 - 20 weeks Always 2 increased, 2 decreased 1 in 150 at term cut-off –> amniocentesis Mnemonic: hi (h in B-hCG and I in inhibin A)

Question 5

How to determine gestational age in 1st trimester?

Answer 5

Crown-rump length

Question 6

Which groups of high risk pregnant women should take high dose folic acid - 5mg?

Answer 6

Women on anticonvulsants

Women with baby with previous history of neural tube defects

Women with BMI > 35

Women with history of diabetes

Women with history of sickle cell disease

Women with folic acid deficiency

Question 7

How to determine gestational age in 2nd trimester?

Answer 7

head circumference

Question 8

How to determine gestational age in 3rd trimester

Answer 8

Symphysial fundal height