Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obstetrics > Antenatal Care > Flashcards

Antenatal Care Flashcards

1
Q

Deifne gravida

A

Number of pregnancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define parity

A

Number of deliveries post-24wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is the estimated delivery date calculated?

A

LMP date + 7/7 + 9/12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How many visits will a nulliparous woman have?

A

10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How many visits will a multiparous woman have?

A

8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When should the booking visit occur?

A

Between 8 and 10wks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What happens at the booking visit?

A

Risk assessment: midwife or consultant led care
Booking bloods
Estimate dates
Screening consent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the blood tests at the booking visit?

A 
FBC
Blood grouping
Antibody screen 
Rhesus status
HIV screen
Haemoglobinopathies
Hepatitis B 
Syphilis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the clinical signs and symptoms of early pregancy?

A

Spotting, breast soreness and enlargement, amenorrhoea, N+V, abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What would be visible on an USS in a pregnant woman at 4, 5, 6, 7, 8wks gestation respectively?

A 
4 weeks: gestation sac
5 weeks: yolk sac
6 week: foetal pole
7 weeks: foetal heart activity
8 weeks: limb buds and movements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When is gender evident on USS?

A

From 16wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the two key pregnancy hormones?

A

Beta hCG and progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When is hCG produced and what produces it?

A

Following implantation, produced by the blastocyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe how hCG levels change over pregnancy?

A

Levels rapidly rise up to 10wks gestation, then begin to plateau. Some will drop.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is hCG detectable?

A

4wks after LMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is progesterone produced and what stimulates its production?

A

Produced from the corpus luteum, and stimulated by hCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the role of progesterone in pregnancy?

A

To change maternal physiology to accomodate pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What changes to maternal CV system occur as a result of progesterone and why do these occur?

A

CV: increased HR, increased stroke volume, increased cardiac output, reduced BP. This maximises placental perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What changes to maternal respiratory, uterine, immune and smooth muscle physiology occur as a result of progesterone?

A

Respiratory: reduced lung capacity
Uterine: quiescence
Immune: immunodeficiency to protect foetus
Smooth muscle: relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What invasive and non-invasive screening tests are available to pregnant women? Which are available on the NHS?

A

Non-invasive:

  • Combined test: in dating scan
  • Quadruple test
  • Private sector cffDNA

Invasive:

  • Chorionic villus sampling
  • Amniocentesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the combined screening test made up of?

A

USS scan for nuchal translucency + beta HCG + PAPP-A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does the combined screening test look for and how accurate is it?

A

85% accuracy
Down’s
Edward’s
Pateau’s

23
Q

When is the combined test performed?

A

Between 11+0 and 13+6

24
Q

What does a low PAPP-A suggest?

A

Increased risk of trisomy 21, IUGR, pre-eclampsia

25
Q

How are the results of the combined test presented?

A

Risk percentage: 1/150 indicates a higher risk

26
Q

What are the next steps if combined screening is less than 1/150?

A

Prenatal diagnostic testing: CVS or amniocentesis.

27
Q

When is the quadruple test appropriate?

A

When the booking visit occurs after 10wks gestation?

28
Q

When is the quadruple test conducted?

A

Between 15 and 20 wks in women with a late booking visit.

29
Q

What is the quadruple test?

A 
Four blood tests only for:
AFP
Unconjugated oestriol
Total hCG
Inhibin-A
30
Q

What does the quadruple test look for?

A

Down’s and open neural tube defects

31
Q

Why is there no USS component of the quadruple test?

A

Nuchal measurement cannot be measured

32
Q

What result of the quadrupl e woudl be suspicious for Down’s?

A

Low AFP and oestriol

High hCG and inhibin-A

33
Q

How are the results of the quadruple screening presented?

A

Risk percentage: 1/150 or less indicates high risk

34
Q

What are the next steps if quadruple screening is less than 1/150?

A

Prenatal diagnostic testing offered: CVS or amniocentesis

35
Q

Describe chorionic villus sampling

A

US guided needle inserted into the placenta and the cells are samples

36
Q

Describe amniocentesis

A

US guided needle into amniotic sac and fluid sampled

37
Q

What is cffDNA screening?

A

Extracting placental DNA from maternal blood sample

38
Q

What does cffDNA screen for and how accurate is it?

A

99% accurate detection of Down’s, Edward’s or Pateau’s

39
Q

What are some examples of cffDNA testing?

A

IONA, Harmony, Serenity, NIFTY

40
Q

When is the dating scan performed?

A

12 wks (11+2 to 11+1)

41
Q

What information is gained from the dating scan?

A

Nuchal translucency and estimated date of delivery

42
Q

What is the cut off value for normal nuchal translucency?

A

3.5mm+ = potentially abnormal

43
Q

How is EDD estimated on the dating scan?

A

Crown-rump length

44
Q

When does the anatomy scan (foetal anomaly scan) take place?

A

20 wks (18+0 to 20+6)

45
Q

What key abnormalities are checked for on an anomaly scan?

A

Anencephaly
Gastroschisis
Exomphalos

46
Q

When would a uterine artery dopper be performed at the anatomy scan?

A

If there are 1 major RF or 3 minor risk factors (from prescribed list)

47
Q

What conditions does the uterine artery doppler assess risk for, and how does it do this?

A

Identifies risk of pre-eclampsia, placental insufficiency and IUGR by measuring the pressure in the uterine vessels to assess placental perfusion

48
Q

Describe foetal development up to 12wks

A
  1. Fertilisation occurs in the Fallopian tubes
  2. The fertilised ovum becomes a zygote, then morula, then blastocyst
  3. The blastocyst enters the uterine cavity and implants at day 23 in the decidua (endometrium)
  4. Implantation triggers hCG release which stimulates the corpus luteum to produce progesterone
  5. The uterine blood vessels form maternal blood lakes (lacunae) which oxygenate the blastocyst. This is a precursor to the placenta
  6. The foetus doubles in size every week until 12wks
49
Q

Why is the LMP used to date a pregancy?

A

Most women are unlikely to know when they are ovulation, so LMP is used instead

50
Q

What four methods are there for assessing foetal growth?

A

Fundal height
Serial growth USS
Biophysical profiling
Placental function (uterine artery dopplers)

51
Q

How is fundal height measured and what is the rough assessment of growth?

A

Pubic symphysis to fundus of stomach

Height = number of weeks pregnant

52
Q

What measurements are taken on serial growth scans?

A

Head circumference
Abdominal circumference
Femur length
(+/- biparietal diameter)

53
Q

What are the criteria used in a biophysical profile?

A

Foetal breathing movements
Foetal movements
Foetal tone
Amniotic fluid volume

54
Q

What would a high pulsatility index and high resistance index indicate on uterine artery doppler?

A

Placental insufficiency

Obstetrics (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions