Antenatal Care And Screening

Question 1

What are the stages of a normal pregnancy

Answer 1

Three trimesters which include 1-12 weeks, 13-27 weeks and 28-term
Singleton pregnancy
Length is estimated between 37-42 weeks

Estimated date of delivery based on naegeles rule (add 7 days on to LMP and subtract 3 months)

Question 2

What are the aims of antenatal care

Answer 2

Monitor the pregnancy
Develop a relationship between HCP and families
Deliver information which promotes choice
Recognise deviations from the norm
Raise awareness of public health issues - health promotion eg smoking cessation
Prepare parents for birth and beyond
Number of appointments depends on parity - fewer appointments for greater parity

Question 3

What is the booking appointment

Answer 3

Completed by 10+0 weeks
First contact with the maternity services in which a detailed history of medical and social circumstances is taken
Baseline observations are taken
Blood tests
Opportunity for change
Public health messages
Discussion of screening
Referral to an obstetrician if necessary

Question 4

After the booking appointment when are the subsequent antenatal visits

Answer 4

12 week ultrasound
16 weeks
20 week Ultrasound
25 weeks if 1st pregnancy
28 weeks
31 weeks if 1st
34 weeks
36 weeks
38 weeks
Term
Term + 1 week if not delivered

Question 5

What screening occurs in the antenatal period

Answer 5

Infectious diseases
Sickle cell and thalessemia
Foetal anomaly screening programme FASP

Question 6

What happens at a standard antenatal visit

Answer 6

BP
Urinalysis
Abdominal exam ( locate fundus and foetus, then symphysis-fundal height)
Auscultation of FH (fundal height)
Oedema
Discussion of test results
Well-being discussion

Question 7

Risk factors for adverse outcomes to pregnancy

Answer 7

Chronic or acute disease including mental health
Social factors such as BMI, smoking, safeguarding
Findings from observations in antenatal care such as BP, proteinuria or SFH (symphysis-fundal height)
Bleeding
Infection

• also more likely to if from an ethnic minority background or live in a deprived area

Question 8

Pregnancy loss - miscarriage

Answer 8

Early miscarriage = prior to 14 weeks

Late miscarriage = foetal demise between 14 weeks and 23+6

Spontaneous miscarriage = body itself has discontinued the pregnancy

Missed miscarriage = pregnancy may have not been identified either through test or symptoms

Recurrent miscarriage = three or more miscarriages that have occurred consecutively

Inevitable miscarriage = bound to occur usually due to cervical opening

Question 9

Other types of pregnancy loss except miscarriage

Answer 9

• abortion
• termination = discontinuation of a pregnancy through medical means either pharmacological or surgical
• ectopic pregnancy = fertilised ovum implants outside of the uterine cavity
• molar pregnancy = abnormal placental development, no foetus is formed

-stillbirth = foetus born after 24 weeks with no signs of life

• neonatal death = born after 20 weeks and dies within 1st month of life (characterised into early neonatal death which is in first 7 days and late NND 7-28 days