Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

REPRO > Antenatal Care and Screening > Flashcards

Antenatal Care and Screening Flashcards

1
Q

How many scans in pregnancy?

A
  • 2 scans (booking and 28 weeks)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do you screen for antenatally on booking?

A
  • STI (HIV and Syphilis)
  • Molar pregnancy
  • Ectopic preg.
  • how many babies
  • conditional testing for Down $
  • ESTIMATED DD
  • anemia
  • rhesus status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Most accurate way to estimate DD on usg?

A

-crown-rump length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What to look for in USG?

A
  • abdominal wall and heart defects
  • anencephaly
  • spina bifida
  • placenta privia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the importance of consistent screening

A

-post partum hemorrhage leading cause of DEATH worldwide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the risk of UTI?

A
  • pre-term labour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How accurate is Down syndrome ?

A
  • -false positive rate of 5%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does the midwife label the pregnancy as?

A
  • red pathway : obstetric input (miscarriage hx)

- green pathway : low risk pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What suggests an ectopic preg?

A
  • no yolk sac
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is the pregnancy considered to be viable?

A
  • when a heart beat is detected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is examined during the antenatal follow up visits?

A 
BP and urinalysis
Symphysis- fundal height
Lie and presentation
Engagement of presenting part
Fetal heart auscultation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When should the baby be lying longitudinally ?

A

—-by 36 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the objectives of USG for fetal anomaly?

A
  • Reduction in perinatal mortality and morbidity
  • Potential for in utero treatment (to treat spina bifida laproscopically)
  • Identification of conditions amenable to neonatal surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Significance for screening for cleft-lip?

A
  • a.w Trisomy 13 and 18

- so the mom is expecting this from her baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Poor survival rate of baby?

A
  • trisomy 18 and 15

- cardiac abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is placenta praevia?

A
  • low-lying placenta in womb (covers the cervix)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Can you tell the morbidity of a Down $ baby?

A
  • range

- –some need lifelong support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Risk of down $ baby in 40 y.o and older deliveries?

A

1 in 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How to Dx Down $?

A
  • Nuchal thickness
  • measured at 11-13weeks+6days
  • combined with HCG and PAPP-A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When is nuchal thickness considered to be normal?

A

—-if CRL is 45-84mm (value of <3.5mm is normal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Alternative for amniocentesis for those at a high risk of having a baby with certain genetic and chromosomal conditions?

A

cffDNA testing, non-invasive prenatal testing (NIPT) - cell free fetal DNA in maternal blood; detected at 7 wks of pregnancy

22
Q

When is amniocentesis performed? Its miscarriage risk?

A
  • after 15 weeks

- 1%

23
Q

When is chorionic villi sampling performed?

A
  • after 12 weeks

- 2% miscarriage risk

24
Q

Signs of rhesus status?

A
  • middle cerebral artery lucency on USG of the fetus suggests anemia??
  • red cell rise in maternal blood
25
Q

Pts with inaccurate SFH?

A
  • those with BMI>35
  • large fibroids
  • hydramnios
26
Q

What is advised for women with HIGH- risk of pre-eclmapsia?

A
  • take 75mg of aspirin daily from 12 weeks gest. until BIRTH —–those at hig risk: CKD pt/hypertensive disease
27
Q

What is advised for women with HIGH- risk of pre-eclmapsia?

A
  • take 75mg of aspirin daily from 12 weeks gest. until BIRTH —–
28
Q

What is meant by sensitivity?

A
  • how often a test generates a POSITIVE result for the condition being tested on
  • a test with 90% sensitivity will correctly return a POSITIVE result for 90% of people who have the disease —but 10% will return a false negative (people who should have returned as a positive)
29
Q

What is meant by specificity?

A
  • a test’s ability to correctly generate a negative result for people who don’t have the condition

–a high-specificity test will correctly rule out almost everyone who doesn’t have the condition

30
Q

What is Naegele’s Rule?

A
  • predicts the estimated DUE date based on the onset of the woman’s LMP (first day)
  • –add on 9mo & 7days
31
Q

How accurate are the 1st trimester screening of Down Syndrome?

A
  • a sensitivity of 90%
  • false positive rate of 5%
  • —but ONE in 20 women who have a HIGH risk result will have a baby NOT affected by DOWN’s
32
Q

What invx are done during the booking visit?

A
  • Hb
  • ABO; Rhesus
  • Syphilis; HIV; Hep B & C
  • Urinanalysis; MSSU C&S
  • USG
33
Q

What should be looked for on USG?

A
  • confirm Viability (HR)
  • single/multiple pregn
  • estimated gestational age
  • structural abnormalities
34
Q

What fetal abnormalities can be seen on USG?

A
  • anencephaly
  • open spina bifida
  • cleft lip
  • diaphragmatic hernia
  • gastroschisis
  • exomphalos
  • b/l renal agenesis
  • Patau’s $ (trisomy 13)
  • Edwards’ $ (Trisomy 13)
  • lethal skeletal dysplasia
35
Q

What is decided if an earlier USG scan (18wks and 20 wks6days) showed the placenta extends over the cervix ?

A
  • another abdominal scan should be scheduled at 32 weeks

- if unclear : VAGINAL scan

36
Q

How many scans are done during a normal pregnancy?

A
  • To check DD, # of pregnancies, Down $ (IF you want): 10 weeks -13 weeks6days
  • Another anomaly scan at 18 wks- 20wks + 6 days
37
Q

Other causes of increased nuchal translucency ?

A
  • Turner’s $
  • Downs $
  • Cardiac anomalies
  • —-chromosome abnormalities
38
Q

How to find the risk a woman holds to get a Down Syndrome bbY?

A
  • in 1st and 2nd trimester: use USG in conjuncture with AFP and hCG results and incorporate with maternal AGE and gestation to find a PERSONAL risk

–>1:250= means HIGH risk (do amniocentesis)

39
Q

What should be offered to the mother after she is told of her risk (LOW or HIGH)?

A
  • accurate pregnancy dating

- detailed COUNSELLING

40
Q

When is a 2nd trimester screening done?

A

at 15-20+6wks

  • when women MISS their first trimester screening
  • to those in whom CUBS is UNSUCCESSFUL
  • —Maternal age+Biochem. Markers (AFP/hCG/ UE3/Inhibin A)
41
Q

What is CUBS?

A

Combined Ultrasound and Biochemical Screening Test at 11-14 weeks

42
Q

When is the mother tested for maternal anemia?

A
  • screened at Booking and at 28 wks
    (Iron def., Folate def., B12 def.)
    —–blood group and antibody status also determined now.
43
Q

How does Rh Hemolytic disease develop?

A
  • RH(-) mom and a Rh (+) bby
  • at delivery: Rh (+) bby blood cells enter the MOTHER’S bloodstream> prodn of Rh Abs
  • Rh antibodies remain
  • —NEXT pregnancy: Rh Abs ATTACK the baby’s blood cells
44
Q

At the booking appointment, how do you evaluate the risk of the mom having GDM?

A
  • BMI >30kg/m2
  • previous MACROSOMIC baby (4.5kg or above)
  • previous gestational diabetes
  • family hx of diabetes
  • minority ethnic origin with HIGH diabetes prevalence
45
Q

How to dx GDM?

A
  • use 2hr 75g ORAL glucose tolerance test (for those with GDM risk)
  • diagnose it if:
    FASTING plasma glucose is 5.6mmol/L or ABOVE
    OR
    2HR plasma glucose of 7.8mmol/L or above
46
Q

When is serial measurement of the SFH recommended at?

A
  • EACH antenatal appointment (from 24 wks) ——improves prediction of SGA neonate
47
Q

When may the SFH measurement be inaccurate?

A
  • BMI>35
  • Large fibroids
  • hydramnios
48
Q

What medical conditions indicate a HIGH risk of developing PRE-ECLAMPSIA?

A
  • CKD
  • hypertensive in LAST pregnancy
  • Type 1 or 2 Diabetes
  • chronic H/T
  • autoimmune disease: SLE or Anti-phospholipid syndrome
49
Q

Factors indicative of LOW risk of pre-eclampsia?

A
  • 1st pregnancy
  • > 40y.o
  • pregnancy interval of MORE than 10 years
  • BMI of 35kg/m2
  • family hx of Pre-eclampsia
  • Multiple pregnancy
50
Q

Purpose of Urinanalysis?

A
  • UTI
  • PET (proteinuria)
  • Diabetes
  • Asymptomatic bacteriuria
51
Q

What are co-variables to consider for the development of down syndrome?

A
  • Smoking status
  • previously affected pregn.
  • assisted conception
52
Q

What additional risk may thalassemia hold for the mother and baby?

A
  • issue of CARDIOMYOPATHY for the mother d/t iron overload
    -increased risk of fetal growth restriction
  • with 9m.o of little to no chelation= ENDOCRINOPATHIES may develop in the mom
    (DM, hypothyroidism, hypoparathyroidism)

REPRO (55 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions