Antenatal Care Flashcards
what bloods are done at the booking visit?
Hb rhesus status (antibodies) syphilis HIV Hep B and C urinalysis
what is assessed at the USS at the booking visit
confirm viability single or multiple pregnancies estimate gestational age structural abnormalities offer trisomy screening
what is Naegele’s rule?
due date based on woman’s LMP + 280 days
what is measured to estimate gestational age?
CRL
what blood disorders are screened for?
HbS
thalassaemia
anaemia throughout
when are anti-D injections given?
28 weeks
after any sensitising events
trisomy screening disorders
- Down’s syndrome: trisomy 21. RF include maternal age. Screening does not rule out.
- Edward’s syndrome: trisomy 18. High risk of stillbirth with survival days-weeks
- Patau’s syndrome: trisomy 13. High risk of stillbirth with survival days-weeks
trisomy screening components if missed 1st trimester
maternal age
markers (AFP, hCG, UE3, inhibin A)
what is next line of high risk on trisomy screening?
NIPT at around 10 weeks
diagnostic tests for trisomy
amniocentesis
chorionic villus sampling
when is amniocentesis performed?
performed after 15 weeks
when is CVS performed?
after 12 weeks
how is foetal growth measured?
serial measurement of SFH from 24 weeks
overall what is done at booking?
haemoglobinopathies Hep B&C HIV Syphilis red cell antibodies anaemia number fetuses viability PMH PSH Obstetric hx meds, allergies, SH, FH past mental health history FGM BMI (& trisomy screening offered) domestic abuse
overall what is done at the 20 week scan
anomaly scan- cleft, heart, NTD, limb defects, placental site, diaphragmic hernia, abdominal wall defects, lungs abnormalities, brain abnormalities, urinary tract abnormalities
what is done at 28 weeks?
anti-D/ red cell antibodies
anaemia
OGTT 24-28 weeks if high risk
what should women at high risk of pre-eclampsia take?
150mg of aspirin from week 12-36
what is done at all screenings?
BP urine (UTI, PET, diabetes) macrosomnia/IUGR mental health abuse and support
when is anti-D given?
if the woman is Rh -ve:
- bleeding after 20 weeks
- sensitising events (TOP, trauma, ectopic, ECV, C/S, amniocentesis, CVS, labour)
what is the Kleinhauer test done for?
measures amount of foetal blood in maternal circulation and allows dosing for anti-D
