antenatal care and screening ?

Question 1

when is morning sickness worse ?

Answer 1

when HCG is higher - twin pregnancy, molar pregnancy

usually settles by 16 weeks
can progress to hyperemesis gravidarum

Question 2

when and why does blood pressure drop in pregnancy ?

Answer 2

second trimester
expansion of uteroplacental circulation
fall in SVR

Question 3

what happens to the urinary system in pregnancy ?

Answer 3

increased urinary stasis, hydryonephrosis is physiological in third trimester

pyelonephritis more common, associated with preterm labour

Question 4

what hormone acts on the respiratory system ?

Answer 4

progesterone

Question 5

what happens to O2 and CO2 in pregnancy ?

Answer 5

O2 stays the same

CO2 reduced

Question 6

what is covered in pre-pregnancy counselling ?

Answer 6

general health measures - improved diet, optimise BMI, reduce alcohol
smoking cessation
folic acid 400mcg

address known medical problems
discuss previous pregnancy problems

Question 7

what infections are screened for antenatally ?

Answer 7

rubella
hep B
syphillis
HIV

Question 8

what blood conditions are screened for antenatally ?

Answer 8

iron deficiency anaemia
rhesus factor
anti-c
anti-Kell

Question 9

what is checked at a first visit scan ?

Answer 9

ensure pregnancy is viable
multiple pregnancy
identify abnormalities incompatible with life
offer and carry out Down syndrome screening

Question 10

what tests are done at first trimester screening for Down syndrome ?

Answer 10

maternal risk factor
BHCG
pregnancy associated plasma protein A (PAPP-A)
nuchal translucency

Question 11

what further tests are offered for a high risk result for Down syndrome ?

Answer 11

chorionic villous sampling - 10-14 weeks, 1-2% miscarriage

amniocentesis - 15+ weeks, 1% miscarriage

Question 12

what blood test can be done to assess risk of a neural tube defect ?

Answer 12

serum alpha fetoprotein