Antenatal care Flashcards
When does gestational thrombocytopaenia present
2nd trimester
What are the indications for anti D before 12 weeks
Ectopic
molar pregnancy
therapeutic TOP
When do you do 1st trimester US
11+3 - 13+6 - use CRL
When does head circumference get measured
14-20 weeks
What factors go into down’s syndrome algorithm (2 tests)
Nuchal translucency
PAPP-A (low)
b-hCG (high)
maternal age
Can also use maternal biochemical markers from 14-20 weeks aFP unconjugated oestradiol inhibin A hCG
What do you give for P-E prevention
75 mg aspirin from 12 weeks
Who do you give P-E prophylaxis to
Women at high risk: HTN during previous disease CKD antiphospjolipid syndrome Chronic HTN DM
Woman with 2 or more moderate risk factors primiparity maternal age >40 BMI >35 at booking FHx P-E multiple pregnancy
How do we screen for FGR?
SFH at every appointment past 24 weeks
if concerns over FGR then do US
When do you do anomaly scan
20-22 weeks
What do you look for on anomaly scan
Anatomy and some anomalies
spina bifida
renal agenesis
diaphragmatic hernia
What are the diagnostic features of GDM
random glucose >5.6
2 hour fasted glucose >7.8
What are the risk factors for GDM
past GDM past macrosomia 1st degree relative w/ DM high BMI ethnicity
What do you do when mum first presents to healthcare professional?
Specific info about folic acid
vit d supplementation
food hygiene
lifestyle advice (smoking and drinking)
when is the booking appointment
<10 weeks
What obs and bloods are checked at booking scan
Baseline BP BMI risk factors for GDM pre-eclampsia FGM mental health conditions
bloods:
red cell autoantibodies
rhesus status
anaemia
What do you give info about at booking scan
how baby develops nutrition and diet exercise (pelvic floor) antenatal screening flu and whooping cough
What are the screening tests for down’s syndrom
combined test (11+0 - 13+6) serum screening test (14+0 - 20+0)
What is the combined down’s syndrome test?
PAPP-A (low) b-HCG (raised) Nuchal tranlucency (raised)
What is the serum screening test for down’s syndrome
AFP
b-HCG
unconjugated oestriol
inhibin a
when is the dating scan
10-13+6
What happens in the dating scan?
viability gestational age multiple pregnancy NUCHAL TRANSLUCENCY chorionicity
When is the first midwife review
16 weeks
What do you look at at midwife review
Look at results of screening tests (give iron if anaemic)
BP and urinary protein
OGTT if hx of previous GDM
when is the anomaly scan?
18-20+6 weeks
What do you look for in anomaly scan
structural abnormalities
placental location (low or high) - if low offer another scan at 32 weeks
amniotic liquor volume
gender+growth of foetus
