Antenatal care and screening

Question 1

in pregnancy counselling what should be assessed in all women?

Answer 1

> occupation (stress)
> general health measures (age, BMI, diet)
> folic acid 400mcg
> parity
> substance misuse

Question 2

what measures would you advise in a pregnant lady with PKU?

Answer 2

restart the low phenylalanine diet

Question 3

what measures might you take in a pregnant lady with hypothyroidism?

Answer 3

medication to increase thyroxine

Question 4

what measures might you take in a pregnant lady with diabetes?

Answer 4

need to optimise control and switch to insulin if type 2

Question 5

what measures might you take in a pregnant lady with epilepsy?

Answer 5

review their drugs as many are toxic

Question 6

what measures might you take in a lady with aortic stenosis?

Answer 6

advise against pregnancy

Question 7

what measures might you take in a pregnant lady with graves disease?

Answer 7

treatment to decrease thyroxine

Question 8

what would you assess in an antenatal examination?

Answer 8

> routine how they are feeling
foetal movement (after 20 wks) change, pattern
urinalysis
abdominal palpation (symphysial fundal height, estimate baby size, determine foetal presentation)
BLOOD PRESSURE
listen to foetal heart

Question 9

what haematological problems should you screen for?

Answer 9

> anaemia
immunisations
rhesus disease (AB against blood groups)

Question 10

what neural tube defects can ultrasound detect in the 1st trimester?

Answer 10

> spina bifida

> ancephalopathy

Question 11

what is carried out if you cannot get a NT measurement at the 20wk ultrasound?

Answer 11

maternal serum is tested for alpha foetal protein

Question 12

what is the second trimester ultrasound scan used to detect?

Answer 12

> major structural abnormalities
soft markers for chromosomal abnormalities
foetal abnormality

Question 13

what infections are screened for?

Answer 13

> hep b
syphilis
HIV
rubella

Question 14

what does first trimester screening for downs syndrome look at?

Answer 14

> maternal risk factors
serum beta-human chronic gonadotrophin
pregnancy associated plasma protein
foetal nuchal translucency

Question 15

what is foetal nuchal translucency?

Answer 15

measurement from the crown rump length that increases with gestational age

Question 16

what tests can be carried out to screen for downs syndrome if the pregnancy is high risk?

Answer 16

> chorionic villus sampling (10-14wks, 1-2% risk)

> amniocentesis (15 wks, 1% risk)

Question 17

what non-invasive tests for down’s syndrome are there?

Answer 17

maternal blood testing for foetal cell free DNA looking for chromosome trisomies