Antenatal Care & Maternal Medicine Flashcards
(57 cards)
When is the “dating scan”?
8-14 weeks
ideally 10-14 weeks to T21 screening can be offered
When is the usual window for the booking appointment?
8-12 weeks
When is the best time for pregnant people to have the whooping cough vaccine?
after the anomaly scan and before 32 weeks gestation
When is the “anomaly scan”?
18-20 weeks
often called the 20 week scan
People who are pregnant for the first time will be offered extra midwife appointments, when are these?
25 weeks
31 weeks
40 weeks
When is the first anti-D treatment offered for Rhesus negative pregnant people?
28 weeks
At what weeks will people usually have routine antenatal check ups with a midwife or doctor?
8-12 weeks - booking 16 weeks 28 weeks 34 weeks 36 weeks 38 weeks 41 weeks 42 weeks
Which three infectious diseases are recommended to be screened for in pregnancy?
HepB
HIV
Syphilis
What does the “20 week scan” look for?
looks in detail at baby’s bones, heart, brain, spinal cord, face, kidneys and abdomen to assess for 11 rare conditions:
- anencephaly
- open spina bifida
- cleft lip
- diaphragmatic hernia
- gastroschisis
- exomphalos
- serious cardiac abnormalities
- bilateral renal agenesis
- lethal skeletal dysplasia
- Edwards (T18)
- Patau (T13)
What is the combined screening test in pregnancy?
- screening for T13, 18, 21
- a combination of blood test and USS to determine nuchal translucency
- can happen between 10 weeks and 14 weeks
- not diagnostic, just estimates risk: results are lower chance or higher chance
If someone gets a “higher chance” result from the combined screening test, what are their options for further testing?
diagnostic tests:
- amniocentesis (15+ weeks)
- chorionic villus sampling (11-14 weeks)
further risk assessment:
- non-invasive prenatal testing (NIPT) blood test to determine risk more accurately
When should screening for sickle cell and thalassaemia take place in pregnancy?
- ideally before 10 weeks
If screening shows there is a chance a pregnancy could have sickle cell or thalassaemia, what are the options for further tests?
diagnostic tests:
- amniocentesis (15+ weeks)
- chorionic villus sampling (11-14 weeks)
What is the purpose of the dating scan?
- check how many weeks pregnant the individual is and work out the EDD
- determine if this is a multiple pregnancy
- check the pregnancy is in the uterus
- check the pregnancy’s development
What are the recommendations about using supplements in pregnancy?
- anyone who is pregnant or thinks there’s a chance they could be pregnant should take 400micrograms of folic acid every day from before conception to 12 weeks gestation to reduce the chance of neural tube defects
- pregnant people should also take a daily vitamin D supplement
- they should avoid supplements containing cod liver oil or vitamin A (retinol)
Who should take higher-dose folic acid?
Anyone who’s pregnancy has a higher chance of being affected by neural tube defects, e.g.
- mum or dad have a neural tube defect
- mum or dad have a family history of neural tube defects
- mum had a previous pregnancy affected by a neural tube defect
- mum has diabetes
- mum takes anti-epilepsy medicine
- mum takes anti-retroviral medicine for HIV
What are the two doses of folic acid recommended in pregnancy?
- 400micrograms if low risk for neural tube defects
- 5mg if higher risk
What is the Healthy Start scheme?
If you’re pregnant or have children under the age of 4 you can get free vouchers or payments every 4 weeks to spend on:
- cow’s milk
- fresh, frozen or tinned fruit and vegetables
- infant formula milk
- fresh, dried, and tinned pulses
You can also get free Healthy Start vitamins
When do foetal movements start?
around 20 weeks and continue until birth
What lifestyle advice should be given to pregnant people?
Avoid:
- alcohol (risk of miscarriage, small for dates, preterm delivery, foetal alcohol syndrome)
- smoking (many risks)
- unpasteurised dairy (risk of listeriosis)
- undercooked or raw poultry (risk of salmonella)
- contact sports
- live vaccines
Safe:
- sex
- moderate exercise
Be aware:
- flying increases risk of VTE, most airlines need note from a medical professional after 28 weeks
- seatbelts should go above or below bump, not across
What are the risks associated with smoking in pregnancy?
- FGR
- miscarriage
- stillbirth
- preterm labour and delivery
- placental abruption
- pre-eclampsia
- cleft lip or palate
- SIDS
What are the features of foetal alcohol syndrome?
- microcephaly
- thin upper lip
- smooth flat philtrum
- short palpebral fissure
- learning disability
- behavioural difficulties
- hearing and vision problems
- cerebral palsy
What risks are associated with underrated hypothyroidism in pregnancy?
- miscarriage
- anaemia
- small for gestational age
- pre-eclampsia
How should hypothyroidism be treated in pregnancy?
- titrate levothyroxine to achieve a low-normal TSH
- dose usually needs to be increased 25-50mcg compared to pre-pregnancy requirement
- levothyroxine does cross the placenta
