Antenatal Care NICE

Question 1

When should booking visit be?

Answer 1

Before 10 weeks gestation

Question 2

What to discuss at booking (9)

Answer 2

Foetal development
Nutrition (inc folic acid)
Exercise (pelvic floor)
Place of birth
Pregnancy care pathway
Breastfeeding
Antenatal classes
Screening
Mental health issues

Question 3

Folic acid
How much to take
Why

Answer 3

400mcg per day for women who are pregnant/ planning pregnancy
Reduced risk of NTDs

Question 4

Food-acquired infections: what to warn about

Answer 4

Avoid:

unpasturised milk, ripened soft cheese, pate, raw/ partially cooked eggs and meat

Question 5

Timing of ultrasound scans in pregnancy

Answer 5

Early scan: 11 - 13+6 weeks

Anomaly scan: 18 - 20+6 weeks

Question 6

Early scan - why is this important?

Answer 6

CRL - dating
Detects multiple pregnancies
Nuchal translucency: chromosome abnormalities (downs, edwards, pataus)

Question 7

Routine booking investigations

Answer 7

Urine culture
FBC
Antibody screen
serology for syphilis
Rubella
Offer HIV + Hep B
USS
Screen for schromosomal abnormalities
Hb electrophoresis

Question 8

Anomaly scan
When?
Looking for what?
Examples

Answer 8

18 - 20+6 weeks

Structural foetal abnormalities
E.g. anencephaly, other NTDs, hydrops

Question 9

What vitamin supplement should be avoided?

What food (same vitamin)

Answer 9

Avoid vitamin A (teratogenic)

Liver + liver products

Question 10

When should symphisis-fundal height be measured

How is it worked out

Answer 10

Each antenatal appointment from 20 weeks

After 20 weeks: should match no of weeks

Question 11

When should foetal presentation be assessed?

How?

Answer 11

At 36 weeks

By abdominal palpation

Question 12

How should gestational age be estimated if CRL is >84mm?

Answer 12

Head circumference