Antenatal Care Flashcards
when should folic acid supplements be taken in pregnancy
before conception until 12 weeks gestation
what does folic acid supplementation prevent
neural tube defects
what is the recommended dose of folic acid
400 micrograms
what groups of people are suggested to take a higher dose (5mg) of folic acid
diabetes epilepsy and taking AEDs BMI >30 previous pregnancy with neural tube defect family history of neural tube defect
what are some of the features of a child with foetal alcohol syndrome
learning and behavioural needs
poor growth
facial abnormalities
consuming alcohol in pregnancy also increases risk of what adverse outcome
IUGR stillbirth SIDS microcephaly neonatal abstinence
nicotine consumption in pregnancy increases the risk of what adverse outcomes
miscarriage
IUGR
SIDS
what is the recommended limit of alcohol in pregnancy
0 - no amount is safe
when should the booking visit during pregnancy be carried out
ideally before 10 weeks but no later than 12
what is the aim of the booking visit
to identify high risk pregnancies
to identify if the pregnancy is viable
outline some of the main areas that are assessed in the booking visit
blood group and rhesus D antibodies
screen for haemoglobinopathies, anaemia, HIV, syphilis, Hep B
offer trisomy screening
blood pressure and urine for proteinuria
check viability of pregnancy/gestational age
how is the gestation of a pregnancy assessed at the booking visit
crown rump length can be measured between 10 and 14 weeks
head circumference is for CRL >84mm
when is head circumference used to measure gestational age
from 11-16 weeks
when should the screening test for trisomy be completed
between 11 and 13+6 weeks
what conditions are screened for in the trisomy screening test
Trisomy 13 - Patau’s
Trisomy 18 - Edward’s
Trisomy 21 - Down’s
what is involved in the trisomy screening test
blood test and US
what bloods tests are carried out in trisomy screening
AFP
PAPPA
HCG
AFP typically low with trisomy and other 2 are raised
what is assessed on the US in trisomy screening
nuchal thickness, the amount of fluid collecting at the nape of foetus’ neck
the larger the NT, the more likely a trisomy is
if a woman is detected as high risk for trisomy, what are her next options
no further testing
NIPT
diagnostic testing
what 2 tests are involved in diagnostic testing for trisomy
chorionic villous sampling
amniocentesis
how does chorionic villous sampling take place and when can it take place
takes place between 11-4 weeks
sample of placental tissue either transcervically or transabdominally
how does amniocentesis take place and when can it take place
can be carried out after 15 weeks to enable the amniotic sac to adequately fill with fluid
sample of the amniotic fluid obtained for genetic testing
out of CVS and amniocentesis which has greater risk of miscarriage
CVS, also risk of amniotic fluid embolism
what is NIPT
non-invasive prenatal testing is a second screening test
analyses cell free DNA in the mothers blood from the foetus
when is the foetal anomaly scan carried out
between 18 and 21 weeks
what foetal anomalies are screening for in the anomaly scan
spina bifida acencephaly gastroschisis exomphalos cardiac abnormalities cleft lip bilateral renal agesis diaphragmatic hernia
when is the whooping cough vaccine offered to pregnant women
28-32 weeks
what is exomphalos
GI defect with bowel covered by sac of amnion
gastroschisis
matted loops of bowel outside body with no covering
