Antenatal Care and Screening

Question 1

what is the incidence of morning sickness?

Answer 1

80-85%

Question 2

what can cause morning sickness to be worse?

Answer 2

conditions where bhcg is higher, e.g. twin, molar

Question 3

which condition can morning sickness progress to?

Answer 3

hyperemesis gravidarum

Question 4

how much does cardiac output increase by?

Answer 4

30-50%

Question 5

how much does heart rate increase by?

Answer 5

from 70 to 90bpm

Question 6

what is the blood flow requirement of the uterus at term?

Answer 6

must exceed 1L/min

Question 7

when does blood pressure drop?

Answer 7

second trimester

Question 8

what causes the blood pressure to drop in the second trimester?

Answer 8

expansion of the uteroplacental circulation
fall in systemic vascular resistance
reduction in blood viscosity
reduction in sensitivity to angiotensin

Question 9

what causes increased urine output?

Answer 9

renal plasma flow increases by 25-50%
GFR increases by 50%
serum urea and creatinine decrease

Question 10

what causes the decrease in serum urea and creatinine?

Answer 10

partly due to increased GFR

partly due to dilution effect of increased plasma volume

Question 11

why is it important to treat uti in pregnancy?

Answer 11

associated with preterm labour

Question 12

in pre-pregnancy counselling, which previous pregnancy maternal problems should you counsel regarding risk of recurrence?

Answer 12

caesarean section
dvt
pre-eclampsia

Question 13

in pre-pregnancy counselling, which previous pregnancy foetal problems should you counsel regarding risk of recurrence?

Answer 13

pre-term delivery
intrauterine growth restriction
foetal abnormality

Question 14

what kind of maternal problems can be identified during antenatal examination?

Answer 14

problems such as pre-existing or developing illness

‘minor’ problems of pregnancy such as anaemia

Question 15

what kind of foetal problems can be identified during antenatal examination?

Answer 15

small for gestational age

foetal abnormality

Question 16

what kind of social problems can be identified during antenatal examination?

Answer 16

support needed
domestic violence
psychiatric illness

Question 17

which conditions is antenatal urinalysis screening for?

Answer 17

pre-eclampsia
diabetes
uti

Question 18

what are the aims of abdominal palpation?

Answer 18

assess symphyseal fundal height (SFH)
estimate size of baby
estimate liquor volume
determine foetal presentation
listen to the foetal heart

Question 19

if the baby remains in a breech presentation after 36 weeks what is normally offered?

Answer 19

ECV

if declined or failed, elective caesarean

Question 20

which infections are all women screened for?

Answer 20

hepatitis B
syphilis
HIV
rubella
uti

Question 21

which population of pregnant women are offered anti-D?

Answer 21

all rhesus negative women

Question 22

when is first trimester screening carried out?

Answer 22

10-14 weeks