Antenatal Care, Screening and Public Health

Question 1

when ideally is the booking scan/visit

Answer 1

8-12 weeks gestation

Question 2

what are mothers given at the booking visit and why

Answer 2

folic avid

prevent neural tube defects

Question 3

when are mothers offered anti-D if they are Rh -ve

Answer 3

at 28 weeks

Question 4

at what levels if the uterus at at 12 weeks gestation

Answer 4

pubic symphysis

Question 5

what tests are done at the booking visit

Answer 5

Hb
ABO/Rhesus
Syphilis; Rubella; HIV; Hep B&C;
Urinalysis; MSSU C&S

USS = confirm viability, no. of foetuses

Question 6

how can a foetus be Ix for Down’s Syndrome in the first trimester

Answer 6

Measure of skin thickness behind fetal neck using ultrasound (Nuchal thickness; NT)

Measured at 11-13+6 weeks

Combined with HCG and PAPP-A

Question 7

how can a foetus be Ix for Down’s Syndrome in the second trimester

Answer 7

Blood sample at 15-20 weeks

Assay of HCG and AFP

Question 8

what are the 2 specific diagnostic tests for Down Syndrome

Answer 8

Amniocentesis:

• performed > 15 weeks
• carries a miscarriage rate of 1%

Chorionic villus sampling:

• performed after 12 weeks
• carries a miscarriage rate of 2%

Question 9

what is the current cervical screening program in Scotland

Answer 9

every 3 years from age 25-49

every 5 years from age 50-64

Question 10

what is involved in cervical screening

Answer 10

Speculum examination
- Visual examination of the cervix
- Brush sample of the cells from the transformation zone of the cervix
> liquid based cytology

Question 11

what vaccine is being offered to girls to try decreased cervical cancer numbers

Answer 11

HPV vaccine offered to girls aged 11-13

Question 12

what HPV virus’ are linked with cervical cancer

Answer 12

HPV 16 and 18

Question 13

what the biggest risk factors for breast cancer

Answer 13

1st - alcohol
2nd - obesity
3rd - lack of physical activity

Question 14

how does weight gain related to risk of breast cancer

Answer 14

5% increase risk of breast cancer with every

2 kg/m2

Question 15

who gets IVF [criteria]

Answer 15

BMI of female partner must be above 18.5 and below 30

Non smokers for >3 months

No illegal and abusive substances

Both partners must
bemethadone free for at least one year prior to treatment

Neither partner should drink alcohol

Neither partner to have undergone voluntary sterilisation, even if sterilisation reversal has been self-funded