Antenatal Care and Screening

Question 1

List the advice which makes up pre-pregnancy counselling.

Answer 1

General health measures: improve diet, optimise BMI, reduce alcohol consumption

Smoking cessation- not just mother but anyone in the house

Folic acid

Vitamin D

Question 2

What are some previous pregnancy problems in the mother which should be noted when planning for another pregnancy?

Answer 2

Pre-eclampsia
DVT/PE
Previous delivery- perineal tear

Question 3

What are some previous pregnancy problems in the baby which should be noted when planning for another pregnancy?

Answer 3

Foetal abnormality
Intrauterine growth restriction
Preterm birth

Question 4

Is antenatal screening compulsory?

Answer 4

No

->important to stress that mother may find out news about the baby which could be distressing or cause anxiety for the rest of the pregnancy.
However, does allow detection of conditions early so they can be treated

Question 5

Screening of babies for anomalies is done under which technqiue?

Answer 5

Ultrasound

Question 6

How many scans get carried out in a non-complicated pregnancy?

Answer 6

2

-first visit scan and detailed anomaly scan

Question 7

What is the purpose of the first visit scan?

Answer 7

Ensures the pregnancy is viable
Checks for multiple pregnancy
Identifies abnormalities incompatible life

In this visit, screening for Down syndrome can be offered

Question 8

What is the purpose of the detailed anomaly scan?

Answer 8

Systematic structural review of baby
Can identify problems that need intrauterine or postnatal treatment

->Not possible to identify all problems

Question 9

Screening for which three trisomy’s are offered?

Answer 9

Trisomy 13, 18 & 21

13= Patau syndrome
18= Edwards syndrome
21= Down syndrome

Question 10

Of the three conditions, which are compatible with life?

Down, Patau, Edward

Answer 10

Down syndrome

Question 11

What is one of the disadvantages of trisomy screening?

Answer 11

May result in parents needing to make a difficult decision regarding termination of pregnancy if baby has a syndrome which in incompatible with life e.g. Edward’s or Patau syndrome

Question 12

What do screening tests involve?

Answer 12

NT measurement
CRL (crown0rump length)
Blood test for PAPP-A, hCG
Maternal age

Question 13

What does increased maternal age increase risks of?

Answer 13

Down syndrome

Question 14

If screening result comes back with a high risk result, which further tests are offered?

Answer 14

CVS
Amniocentesis- testing the amniotic fluid
Non-invasive prenatal testing

Question 15

What is one of the most common GI symptoms in pregnancy?

Answer 15

Heartburn

->due to relaxation of the oesophageal sphincter

Question 16

Which two things need to be done in every appointment with a pregnant person?

Answer 16

Blood pressure
Urinalysis