Antenatal care and screening Flashcards
outline the key features of morning sickness
- occurs in 80-85% of women
-
worse in conditions where levels of HCG are higher
- molar pregnancy
- twin pregnancy
- can lead to a more severe form called hyperemesis gravidarum
outline the different types of pre-pregnancy counselling and their aims
- all women - done in primary care
- general health- BMI, diet, reduce alcohol
- confirm immunity to rubella
- folic acid supplements
- smoking cessation advice
- women with known medical problems
- optimise their health
- may have to stop/ change certain medications
- women with previous pregnancy prblems
- counsel regarding risk of recurrence
- actions to reduce risk of recurrence
outline what is done in the routine antenatal examination
- ask mum
- are you feeling well?
- is baby moving?
- BP & Urinalysis
- abdominal palpation
- determine presentation
- listen to foetal heart
what are the infections screened for in an asymptomatic pregnant woman and what treatment options can you offer if positive?
- Hep B - passive and active immunisation for baby
- Syphilis- treat with penicillin
- HIV- offer treatment to mum to prevent vertical transmission
- MSSU- UTI
what else would you want to screen for in a pregnant woman?
- iron-deficiency anaemia
- rhesus disease / Anti-c
what does the 1st visit scan detect?
- whether pregnancy is viable
- multiple pregnancies
- any abnormalities incompatible with life
- can offer + carry out Down’s Syndrome screening
- what is Down’s Syndrome?
- when is there an increased risk of it?
- trisomy 21
- increased risk with increased maternal age / FH or personal history of it
what is the first test to identify Down’s Syndrome?
- 1st trimester screening
- uses
- maternal risk factors
- B-HCG
- PAPP-A
- nuchal translucency measurement
- uses
what is the detection rate of the 1st trimester USS for down’s syndrome?
90%
- can also detect Anencephaly and Spina bifida
what about nuchal translucency is used more in determining risk?
SIZE rather than PRESENCE of it
what is a disadvantage of the 1st trimester USS screening?
- only detects high or low risk of DS
- need to do more tests to have a definitive answer
what other tests can you do?
- Chorionic Villus Sampling (placenta sampling)
- Amniocentesis (amniotic fluid sampling)
- Non-Invasive Prenatal testing
- Mother blood sampling
- look for foetal cell-free DNA
- look for chromosomal trisomies
if you are a woman with a personal or FH of NTD, what should you do to reduce risk?
5mg of folic acid
what scan detects most NTD’s?
- 2nd trimester USS detects > 90% of NTD’s
- its’ purpose is to detect foetal abnormality
- good at testing for structural defects but not chromosomal
when is 1st trimester scan carried out?
between 10-14 weeks
