Antenatal Care and Screening

Question 1

What are the objectives of antenatal care?

Answer 1

Detect and manage pre existing maternal disorders that may affect pregnancy outcome
Prevent or detect and manage maternal and fetal complications of pregnancy
Detect congenital fetal problems if requested
Plan birth circumstances
Provide lifestyle advice

Question 2

What is investigated at the booking appointment?

Answer 2

FBC
Antibodies
ABO, Rhesus
Glucose
Syphyllis
Rubella
HIV
Hep B&C
Urinalysis, MSSU C&S
US- viability, number, gestation

Question 3

What investigations are carried out at the follow up visits?

Answer 3

aFP or Triple test
US
Anti D if Rh-ve
FBC abs, Anti D if Rh-ve
BPS if no induction

Question 4

What is examined at the booking appointment?

Answer 4

Ht
Wt
BP
CVS
Abdomen

Question 5

What is examined at the follow up visits?

Answer 5

BP
Urinalysis
Symphysis-fundal height
Lie and presentation
Engagement
FH auscultation

Question 6

What are objectives of US for fetal anomaly?

Answer 6

Reduction in perinatal mortality and morbidity
Potential for in utero treatment
Identification of conditions amenable to neonatal surgey

Question 7

What is involved in the Down’s RA at the first trimester?

Answer 7

Measure of skin thickness behind fetal neck using US (nuchal thickness)
Measured at 11-13+6 weeks
Combined with HCG and PAPP-A

Question 8

What is involved in the Down’s RA at the second trimester?

Answer 8

Blood sample at 15-20 weeks

Assay of HCG and AFP

Question 9

What is involved in the Down’s RA for both the first and second trimester?

Answer 9

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

Question 10

When is amniocentesis carried out, and what is the miscarriage risk?

Answer 10

After 15 weeks, 1%

Question 11

When is chorionic villus sampling carried out, and what is the miscarriage risk?

Answer 11

After 12 weeks, 2%