Antenatal Care and Screening

Question 1

What aspects of the patients history are very important?

Answer 1

Menstruation
Medical
Obstetric
Family 
Social

Question 2

What investigations are important?

Answer 2

Hb
ABO; Rhesus
Syphilis, Rubella, HIV, Hep B/C
Urinalysis: MSSU, C&S
USS

Question 3

What is an ultrasound scan performed for?

Answer 3

Confirm viability
Number of fetuses
Confirm gestation

Question 4

What Down’s Syndrome risk assessments are carried out in the First Trimester?

Answer 4

Measure of skin thickness behind fetal neck using USS
Measured at 11-13+6 weeks
Combined with HCG and PAPPA

Question 5

What Down’s Syndrome risk assessments are carried out in the Second Trimester?

Answer 5

Blood sample at 15-20 weeks

Assay of HCG and AFP

Question 6

What Down’s Syndrome risk assessments are carried out in the First AND Second Trimester?

Answer 6

Incorporation of these measurements / results with maternal age and gestation to give a personal risk
1:250 high risk and requires further investigation (e.g. amniocentesis)

Question 7

What are 2 specific diagnostic tests for Down’s?

Answer 7

Amniocentesis

Chorionic villus sampling

Question 8

Describe Amniocentesis

Answer 8

Usually performed after 15 weeks

Carries miscarriage rate of 1%

Question 9

Describe Chorionic villus sampling?

Answer 9

Usually performed after 12 weeks

Carries a miscarriage rate of 2%