Antenatal care timetable Flashcards
How many antenatal visits for the first pregnancy vs later pregnancies (if uncomplicated)?
- 10 antenatal visits in the first pregnancy if uncomplicated
- 7 antenatal visits in subsequent pregnancies if uncomplicated
When does the booking visit ideally occur?
8 - 12 weeks (ideally < 10 weeks)
What is done during the booking visit?
- General information gathered e.g. diet, alcohol, smoking, folic acid, vitamin D, antenatal classes
- BP, urine dipstick, check BMI
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Booking bloods/urine:
- FBC, blood group, Rh status + red cell alloantibodies, haemoglobinopathies
- HBV, syphilis
- HIV test is offered to all women
- urine culture for asymptomatic bacteriuria
When does the dating scan occur? What else does it look for?
Early scan to confirm dates + exclude multiple pregnancy happens at:
10 - 13+6 weeks
When does trisomy 21 screening and nuchal scanning occur?
11 - 13+6 weeks
When do anomaly and blood results usually come back? What is also done at this stage?
Information on the anomaly and the blood results at 16 weeks
- If Hb <11 g/dl consider iron
- Routine care: BP and urine dipstick
When is the anomaly scan done?
18 - 20+6 weeks
When is the symphysis-fundal height (SFH) first measured?
On the antenetal care timetable it is measured at 25 weeks
…alongside routine BP and urine dipstick
Visits at which weeks are only done if primipara?
- 25 weeks
- 31 weeks
- 40 weeks *(incl discussion about options for prolonged pregnancy)
Routine care at all above which includes: BP, urine dipstick, symphysis-fundal height (SFH)
When is the first dose of anti-D prophylaxis given to Rh-ve women?
28 weeks:
- Routine care: BP, urine dipstick, SFH
- Second screen for anaemia and atypical red cell alloantibodies. If Hb < 10.5 g/dl consider iron
- First dose of anti-D prophylaxis to rhesus negative women
When should you consider giving iron to a pregnant patient? When is Hb measured antenatally?
- Measured first at 10-12 weeks but results at 16 weeks - if Hb is <11g/dL then consider iron
- Later measured at 28 weeks - if <10.5 g/dl then consider iron here
When does the second screening for atypical red cell alloantibodies and anaemia occur?
28 weeks
When is the second dose of anti-D prophylaxis given to rhesus negative women? Is this necessary?
34 weeks
Evidence base suggests that there is little difference in the efficacy of single-dose (at 28 weeks) and double-dose regimes (at 28 & 34 weeks). For this reason the RCOG in 2011 advised that either regime could be used ‘depending on local factors’
What happens at the 34 week visit?
- Routine care (BP, urine dip, SFH)
- Check presentation - offer external cephalic version if indicated
- Information on breast feeding, vitamin K, ‘baby-blues’
What happens at the 38 week visit?
Routine care
