Antenatal care of uncomplicated pregnancy Flashcards
By what GA should a booking appointment take place ?
By 10 Weeks
How many routine antenatal appointments for
- nulliparous?
-multiparous?
Nulli - 10
Multi - 7
What do you do at the booking appointment ?
Detailed history
Assess risk for pre-eclampsia, IUGR, GDM, VTE, FGM
If face to face appointment - BMI,BP & urine dipstick
Blood investigation - CBC, BG, Rh
Offer screening for
Infections - HIV, HbsAg, VDRL
Sickle Cell and Thalassemia
Fetal anomaly
Should the woman’s partner be involved ?
as per her wishes
Risk of maternal mortality compared with white women
For black ?
For mixed ethnicity ?
For Asian ?
4 times in black
3 times higher in mixed
2 times higher in asia
Risk of stillbirth compared with white babies
For black ?
For Asian ?
More than twice
50% higher
Risk of maternal mortality in most deprived areas compared with least deprived ?
> 2.5 times
Risk of stillbirth in most deprived areas compared with least deprived ?
Twice - 2 times
At which GA are the scan appointments?
11.2 - 14.1 wks
For GA and to detect multiple pregnancy
If opted for, screen for T21,13,18
18 - 20.6 wks
Anomaly scan
Placental localization
My partner and I - both of us used to smoke but we have stopped smoking a week back when we found out we were pregnant.
What do you do for this woman ?
Refer to NHS Stop Smoking Services
If currently smoking or stopped within the past 2 weeks
Which blood investigations are repeated at the 28 wk appointment?
CBC
BG
Antibodies
Apart from the booking appointment, when is risk reassessed for
VTE
Pre eclampsia
IUGR
VTE - after any significant health event or hospital admission
Pre eclampsia and IUGR - 2nd trimester - 16 wk appointment
What GA do you perform an OGTT ?
24-28
28 weeks with BP 150/90
after OGTT, How urgent do you refer to secondary care ?
Within 24 hrs
If >=160/110 - same day
What GA onwards do you ask for fetal movements ?
24 wks
What GA do you examine for possible breech presentation?
36 w
How do you treat pelvic girdle pain ?
Physiotherapy
Non rigid lumbopelvic belt
Done with the Antenatal Care guideline
When to stat conceiving after course of Tamoxifen
3 months
because of tertogenicity, it taked from 2 to 3 months to wash out.
what u/s measure we use to date pregnancy
Crown rump lenght
which measurement we use to date pregnancy in case of CRL > 88mm
Head circumference
With regard to the routine anomaly scan in pregnancy, what threshold of nuchal-fold measurement should trigger a referral to a fetal medicine specialist?
> 6 mm
In an uncomplicated pregnancy, how often should auscultation of the fetal heart be performed by the midwifery team?
only when requesteed by the mother
women after 42 weeks who decline IOL
close monitoring:
- CTG twice weekly
- AFV assessment
in Non stress test, beat to beat variability indicates ?
intact fetal brain stem and heart
