Antenatal Care and Screening in Pregnancy Flashcards

1
Q

how do you work out the sensitivity of a test?

A

true positive / (positive + false negative)

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2
Q

how do you work out the specificity of ates?

A

true negative / (negative + false positive)

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3
Q

what examinations are done at the patient’s 1st presentation to the antenatal clinic?

A
height
weight
BP
CVS
abdomen
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4
Q

how do you work out the due date of a mother?

A

add 9 months and 7 days to the date of the last mentrual period ie 280 days

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5
Q

what Ix is done at the patient’s first presentation to an antenatal clinic?

A
Hb
ABO; rhesus
syphilis/HIV/hep b+c
urinalysis (MSSU)
protein c and protein s
USS
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6
Q

what is examined on follow up appointments?

A
BP
urinalysis
symphyseal-fundal height
lie and presentation of foetus
engagement of presenting part
foetal heart auscultation
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7
Q

at what gestation do women get a fetal anomaly scan?

A

18-21 wks

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8
Q

what is placenta praevia?

A

placenta is low lying in the womb AND

covers all or part of the cervix entrance

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9
Q

Ix for placenta praevia

A
  1. initial USS scan (18-20wks)
  2. if detected get another abdo USS at 32 weeks
  3. transvaginal USS if unclear
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10
Q

what is nuchal thickness and what conditions is it present in?

A

neck thickness

chromosomal abnormalities eg DS

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11
Q

what is CRL? what does it measure

A

crown rump length
length from the top of the head to the bottom of the buttocks
gestational age

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12
Q

when is nuchal thickness measured in downs screening?

A

11-14 weeks

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13
Q

outline the downs risk assessment procedures and when they are done

A
"CUBS" - combined USS biochemical screening:
nuchal thickness between 11-14 weeks
blood sample at 15-20 weeks
assay of hCG and AFP in 2nd trimester
do amniocentesis if high risk
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14
Q

amniocentesis is performed at what gestation?

A

15 weeks

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15
Q

chrionic villus sampling is performed at what gestation?

A

12 weeks

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16
Q

when are mothers screened for anaemia?

A

booking

28 weeks

17
Q

what is taken in the history of mothers on a follow up antenatal visit?

A

physical and mental health

fetal movements

18
Q

when would you do a second trimester screening for aneuploidy?

A

women who miss 1st trimester screening

if CUBS is unsuccessful

19
Q

what questions can help to screen for depression in mothers?

A

new thoughts that werent there before?suicide/self harm thoughts?
feeling incompetent as a mother?
do you feel distanced estranged from baby?
is it getting worse? persistent?

20
Q

risk factors for gestational diabetes?

A
BMI >30
previous macrosomic baby >4.5kg
previous gestational diabetes
FH of diabetes (1st degree)
minority ethnic family with T1DM
21
Q

Ix of small for gestational age foetus

A
  1. uterine artery doppler

2. umbilical artery doppler (do this first if high risk)

22
Q

risk factors for SGA foetus?

A
low/high BMI
smoking
maternal age
drugs
previous small baby
previous stillbirth
chronic hypertension/vascular disease/diabetes
anti-phospholipid syndrome
heavy bleeding
renal impairment
23
Q

when should symphyseal fundal height first be measured?

A

24 weeks

24
Q

what women will have an inaccurate SFH?

A

BMI >35
hydramnios
large fibroids

25
Q

when should a mother be referred for USS of fetal size because of her SFH measurement?

A

if its under the 10th centile OR

slow/static growth

26
Q

prophylactic Tx of preeclampsia? when should it be given and for how long?

A

75mg aspirin OD

from 12 weeks - birth

27
Q

who is high risk for preeclampsia?

A
hypertensive disease during previous pregnancy
CKD
autoimmune disease eg lupus/APLS
T1/T2DM
chronic hypertension
28
Q

name moderate risk factors for preeclampsia

A
first pregnancy
age 40+
pregnancy interval >10yrs
BMI >35
FH
multiple pregnancies
29
Q

why is urinalysis routinely done in pregnant mothers?

A
checks for:
UTI
asymptomatic bacteriuria
preeclampsia
diabetes