Antenatal Care and Screening

Question 1

What effect does pregnancy have on cardiac output and blood pressure?

Answer 1

Cardiac output increases

Blood pressure decreases during the second trimester

Question 2

At what level of Hg should iron deficiency anaemia be treated in pregnancy?

Answer 2

Under 10.5

Question 3

What counselling advice should be given to women pre-pregnancy?

Answer 3

Improve diet
Optimise BMI
Reduce alcohol consumption
Smoking cessation advice
Folic acid-400 mcg (reduces chances of spina bifida)
Confirm Immunity to Rubella

Question 4

What drug is given to reduce the chance of having a smaller baby?

Answer 4

150mg aspirin (gives heartburn)

Question 5

What drug is used for thromboprophylaxis in pregnancy?

Answer 5

Dalteparin is safest (heparin)

Question 6

What three things can be assessed during an antenatal palpation?

Answer 6

Assess symphyseal fundal height (SFH)
Estimate size of baby
Estimate liquor volume

Question 7

What infections are screened for in pregnancy?

Answer 7

Hepatitis B
Syphilis
Rubella
HIV

Question 8

What effect does Rhesus disease have on a foetus?

Answer 8

Women produce Anti D autoantibodies which can cause iron deficiency anaemia in the foetus

Question 9

What are Nuchal Translucencies?

Answer 9

The measurement of fluid behind the foetus’ neck and can be used in combination with the mother’s age and blood tests to determine the chances of the baby having down’s syndrome

Question 10

What methods can be used to detect Trisomy chromosomal mutations in pregnancy?

Answer 10

Chronic Villus Sampling-from placenta
Amniocentesis- from amniotic fluid
Mother’s age
Non-invasive prenatal testing-only private currently

Question 11

What type of hormones are oestrogen, progesterone and testosterone?

Answer 11

Steroid hormones

Question 12

What effect does oestrogen and progesterone have on the pituitary and hypothalamus?

Answer 12

Oestrogen and progesterone have a negative feedback effect on the pituitary and hypothalamus, except from mid cycle when it has a positive feedback where the pituitary releases LH

Question 13

What hormones do the granulosa, corpus luteum and the theca cells release?

Answer 13

Granulosa- Oestrogen
Theca- Inhibin
CL- progesterone

Question 14

How long after an LH surge mid cycle does ovulation occur?

Answer 14

36 hours

Question 15

What hormones does Inhibin suppress?

Answer 15

LH and FSH

Question 16

How is a pregnancy maintained if an egg is fertilised?

Answer 16

Corpus Luteum continues to produce progesterone as it is stimulated by HCG. If no pregnancy occurs then corpus luteum turns to corpus albicans which stops producing progesterone to induce bleeding

Question 17

What male cells produce which hormones in the gonads?

Answer 17

Leydig cells produce testosterone (FSH affected)
Sertoli cells produce inhibin (LH affected)
Germ cells produce sperm

Question 18

In what circumstances does rhesus disease occur?

Answer 18

For it to occur three things need to happen
Mother needs to be rhesus negative
Baby needs to be rhesus positive
Mother needs to have experienced sensitisation (mother has been exposed to rhesus positive blood and developed an immune response to it)