Antenatal Care and Screening

Question 1

explain morning sickness

Answer 1

affects around 80% of women
worse in conditions where HCGT is higher eg twins
lead to hypermesis gravidarum
usually better after 16 weels

Question 2

how does pregnancy affect cardiac

Answer 2

CO increases by 30-50%
heart rate increases 70-90
palpitations

Question 3

how does pregnancy affect blood pressure

Answer 3

DROPS in the second trimester 
expansion of uterioplacental circulation 
a fall in systemic vascular resistance 
reduction in blood viscosity 
reduction in senssivhty to angiotensin

Question 4

how does pregnancy affect urine output

Answer 4

increases
renal plasma flow increases
GFR increases
creatinine decreases and serum urea

Question 5

does pregnancy increase risk of UTI

Answer 5

yes
more urinary stasis
hydronephoris

Question 6

how does pregnancy affect blood

Answer 6

increased iron requirement 
iron supplements if <110 hb 
drop in hb from 133-121
platelets fall
WBC increases

Question 7

how does pregnancy affect respiratory

Answer 7

increase RR as progesterone reduces CO2
plasma pH increases
SOB

Question 8

how does pregnancy affect Gi

Answer 8

peristalsis reduced-heartburn

gastric emptying- constipation

Question 9

who is pre-preganncy counselling for

Answer 9

all women, previous health or pregnancy issues

Question 10

what are general advice givne

Answer 10

improve diet 
smoking cessation 
folic acid 
optimise mental health 
BMI

Question 11

how are diabetic pregnant women managed

Answer 11

switched to insulin

Question 12

what are renal patients more at risk of

Answer 12

pre-eclampsia

Question 13

what is the risk of peolewith epilspey

Answer 13

sodium valproate is associated with spina bifida

Question 14

what should happen if a woman has had 2 sections

Answer 14

always deliver by a section, if only one due to breech baby should be fine with normal labour

Question 15

what is the point in an antenatal exmaination

Answer 15

reduces feta and maternal mortality
check fetal abnormality
fatal size

Question 16

what are routine things to check

Answer 16

feeling unwell? 
BP
urinalysis 
abdominal palpation-measure bump and size of baby
assess lie

Question 17

what is antenatal screening

Answer 17

testing of a symptomless population in order to detected.a disease at age early stage

Question 18

what infecitons are screened for

Answer 18

hep B
syphilis treated with penicillin
HIV
MSSU-UTI

Question 19

why is the blood screened

Answer 19

for iron deficiency aneamia

rhesus disease

Question 20

screening for anomalies

Answer 20

multiple grenancies
Down syndrome
fatal abnormalities

Question 21

what is a detailed anomaly

Answer 21

systemic structural review of the bay

Question 22

explain screening for down syndrome

Answer 22

chromosomal abnormalities
3 copies of 21
maternal age and family history increases risk
must be aware the test just shows risk

Question 23

when is first trimeter USS carried out

Answer 23

10-14 weeks gestation

fetal nuchal translucency measurement -crown to rump

Question 24

what otpions are there with a high risk result

Answer 24

further testing
CVS -chorionic villus sampling
amioncentesis

Question 25

what are exmaples of non-invasive prenatal testing

Answer 25

maternal blood

free fetal DNA

Question 26

when is screening for a neural tube defect used

Answer 26

family history of NTD

maternal serum-alphafeto protein

Question 27

when is the second trimester USS performed

Answer 27

18-20 weeks

detect fetal abnormality