Antenatal Care

Question 1

what bloods are done at the booking visit?

Answer 1

Hb
rhesus status (antibodies)
syphilis
HIV
Hep B and C
urinalysis

Question 2

what is assessed at the USS at the booking visit

Answer 2

confirm viability
single or multiple pregnancies
estimate gestational age
structural abnormalities
offer trisomy screening

Question 3

what is Naegele’s rule?

Answer 3

due date based on woman’s LMP + 280 days

Question 4

what is measured to estimate gestational age?

Answer 4

CRL

Question 5

what blood disorders are screened for?

Answer 5

HbS
thalassaemia
anaemia throughout

Question 6

when are anti-D injections given?

Answer 6

28 weeks

after any sensitising events

Question 7

trisomy screening disorders

Answer 7

1. Down’s syndrome: trisomy 21. RF include maternal age. Screening does not rule out.
2. Edward’s syndrome: trisomy 18. High risk of stillbirth with survival days-weeks
3. Patau’s syndrome: trisomy 13. High risk of stillbirth with survival days-weeks

Question 8

trisomy screening components if missed 1st trimester

Answer 8

maternal age

markers (AFP, hCG, UE3, inhibin A)

Question 9

what is next line of high risk on trisomy screening?

Answer 9

NIPT at around 10 weeks

Question 10

diagnostic tests for trisomy

Answer 10

amniocentesis

chorionic villus sampling

Question 11

when is amniocentesis performed?

Answer 11

performed after 15 weeks

Question 12

when is CVS performed?

Answer 12

after 12 weeks

Question 13

how is foetal growth measured?

Answer 13

serial measurement of SFH from 24 weeks

Question 14

overall what is done at booking?

Answer 14

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

Question 15

overall what is done at the 20 week scan

Answer 15

anomaly scan- cleft, heart, NTD, limb defects, placental site, diaphragmic hernia, abdominal wall defects, lungs abnormalities, brain abnormalities, urinary tract abnormalities

Question 16

what is done at 28 weeks?

Answer 16

anti-D/ red cell antibodies
anaemia
OGTT 24-28 weeks if high risk

Question 17

what should women at high risk of pre-eclampsia take?

Answer 17

150mg of aspirin from week 12-36

Question 18

what is done at all screenings?

Answer 18

BP
urine (UTI, PET, diabetes)
macrosomnia/IUGR
mental health
abuse and support

Question 19

when is anti-D given?

Answer 19

if the woman is Rh -ve:

• bleeding after 20 weeks
• sensitising events (TOP, trauma, ectopic, ECV, C/S, amniocentesis, CVS, labour)

Question 20

what is the Kleinhauer test done for?

Answer 20

measures amount of foetal blood in maternal circulation and allows dosing for anti-D