antenatal care schedule management Flashcards
What early pregnancy guidance should be provided to women referred to the antenatal care pathway?
Provide guidance on smoking and alcohol cessation, pregnancy supplements, and a healthy diet before the booking visit.
How many antenatal visits are recommended for first pregnancies and subsequent pregnancies if uncomplicated?
10 antenatal visits for the first pregnancy and 7 antenatal visits for subsequent pregnancies if uncomplicated.
What is included in the booking appointment by 10+0 weeks gestation?
The booking appointment includes a full history (medical, obstetric, mental health, family, medications, allergies, social), assessment of risk factors for venous thromboembolism, gestational diabetes, and pre-eclampsia, and guidance on supplements and lifestyle.
What are the key supplements and lifestyle advice given during the booking appointment?
Folic acid 400μg OD (or 5mg OD if high-risk) until 12 weeks, Vitamin D 10μg OD, and advice on diet, smoking cessation, and alcohol cessation.
What vaccinations are recommended during the booking appointment and at 16 weeks?
Flu vaccine should be given straightaway, and the pertussis vaccine should be booked for at 16 weeks.
What blood tests and screenings are performed at the booking appointment?
Blood tests for FBC, blood group, rhesus D status, haemoglobinopathies, red cell alloantibodies, hepatitis B, HIV, syphilis, and foetal anomalies. Urine dipstick and MC&S for proteinuria and asymptomatic bacteriuria.
What is the purpose of the dating scan conducted between 11+2 to 14+1 weeks?
The dating scan accurately dates gestation using Crown-Rump Length (CRL), detects multiple pregnancies, and assesses nuchal translucency for Down’s syndrome, Edward’s syndrome, and Patau’s syndrome if opted in.
What screenings are offered between 11+0 to 13+6 weeks or 15+0 to 20+0 weeks?
Down’s syndrome screening using either the combined test between 11+0 – 13+6 weeks or the serum screening test (triple or quadruple test) between 15+0 – 20+0 weeks. Also screens for Edward’s and Patau’s syndromes.
What steps should be taken at the 16 weeks (14-18 weeks) appointment?
Check Hb levels and give oral iron tablets if Hb < 11 g/dL. Reassess risk factors for foetal growth restriction, VTE, and pre-eclampsia. Administer the pertussis vaccine.
What is assessed during the anomaly scan conducted at 18+0 to 20+6 weeks?
The anomaly scan detects structural anomalies, placenta location, amniotic liquor volume, gender, and foetal growth. Screens for 11 conditions including anencephaly, spina bifida, cleft lip, and congenital heart disease.
When is the oral glucose tolerance test (OGTT) performed and who should receive it?
The OGTT is performed between 24-28 weeks for women with risk factors for gestational diabetes.
What is checked during the 25 weeks appointment for nulliparous women?
At 25 weeks, check BP, BMI, and urine dip, measure symphysis-fundal height (SFH), discuss baby’s movements, and safety-net for reduced fetal movements (RFM).
What is done at the 28 weeks midwife review?
At 28 weeks, perform a second screening for anaemia and red cell alloantibodies. Give oral iron tablets if Hb < 10.5 g/dL.
What additional assessments are made during the 31 weeks GP review for nulliparous women?
During the 31 weeks GP review, check BP, BMI, urine dip, and SFH.
What key points are covered during the 34 weeks midwife review?
At 34 weeks, check BP, BMI, urine dip, and SFH. Administer the second dose of anti-D prophylaxis to rhesus-negative women and provide information about labour, birth plan, and pain control.
