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COM MED > Antenatal clinics > Flashcards

Antenatal clinics Flashcards

1
Q

ANC

Maternal care package is given by

A

the family health bureau

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2
Q

ANC

Pre - PG screening service package given for newly married couples

A
  • Marriage registrar invitation card
  • Pre- PG/ Preconception screening tool
  • BMI
  • “Our best wishes for your blissfull home” booklet
  • Booklet for healthcare workers
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3
Q

ANC

Marriage registar invitation card

A

card to register in eligible family register. Even if the registrar doesn’t give, PHM should register newly married couples within 3/12 of marriage

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4
Q

ANC

Sessions for newly married couples Hx is done by

A

MOH, PHNS, PHM

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5
Q

ANC

How many antenatal care sessions are held for newly married couples

A

Two sessions

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6
Q

ANC

Pre- conception screening tool/ Hx includes

A
  • Medical Hx
  • Drug Hx
  • Family Hx
  • Sexual and reproductive health
  • Nutritional problems
  • Env risk factors
  • Psychosocial Hx- Depression, violence
  • Age
  • Education
  • Occupation- exposure to chemicals, heavy metals, sounds
  • Consanguinity
  • Gyn/ Obs Hx
  • Smoking, alcohol, betel chewing, substance usage
  • Exercise, hobbies
  • Sanitary facilities at home
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7
Q

ANC

Pre- conception screening tool is filled by

A

both wife and husband

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8
Q

ANC

Examination is also done on

A

both wife and husband

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9
Q

ANC

Examination includes

A
  • Weight
  • Height
  • BMI
  • BP
  • CVS
  • Respi
  • Abd
  • CNS gross
  • Breast
  • General examination
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10
Q

ANC

Ix done

A
  • blood sugar
  • Hb
  • +/- VDRL, Group & Rh (not routinely done)
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11
Q

ANC

Mx of Antenatal care

A
  • Go through pre- PG screening tool
  • Family planning advice
  • Happy married life advice
  • If not had recieved Rubella MMR by PHM
  • Health education
  • PCST is handed back to the couple.
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12
Q

ANC

Registration in ANC happens on

A
  • Walk- in to the ANC ( same day will be the booking visit)
  • Home visit by the PHM - Provide a date for the booking visit
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13
Q

ANC

Pregnancy record varies from mother and PHM (T/F?)

A

True. It’s two different types of records

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14
Q

ANC

Pregnany record for the mother is known as the

A

H512

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15
Q

ANC

Pregnany record is available in what languages

A

all three languages

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16
Q

ANC

Primi mothers are marked in what colour in H512

A

Blue

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17
Q

ANC

PG at risk is marked in what colour in H512

A

Red and documented in the space given in the H512

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18
Q

ANC

Rubella should be given ideally

A

at least 1 month prior the conception

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19
Q

ANC

Why is rubella vaccine important

A

to prevent congenital rubella syndrome

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20
Q

ANC

What types of diseases should be normalized before conception

A
  • DM
  • HTN
  • Epilepsy
  • Anemia
  • Hypothyroidism
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21
Q

ANC

What steps should be taken before conception

A
  • family planning
  • give folic acid
  • Rubella vaccine if not given
  • Nutritional advice
  • Normalize any non- communicable disease if any
  • Meds might have to be altered
  • Smoking/ alcohol cessation
  • unity/ bond advice
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22
Q

ANC

Besides rubella vaccine what other vaccine is given pre- PG in private sector

A

Chicken Pox usually given 3/ 12 prior PG

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23
Q

ANC

STD screening

A

not routinely done in SL

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24
Q

ANC

Genetic screening

A

not routinely done. But thalassemia screening done if its a high- risk condition

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25
Q

ANC

What areas are high risk for thalassemia

A
  • Kurunegala
  • Anuradhapura
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26
Q

ANC

Folic Acid Dose

A

1mg daily till the end of T1 ( first 12/52)

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27
Q

ANC

Daily required dose of Folic Acid but the prescribed dose

A

daily requirement is 0.4mg but 1mg is prescribed daily because there are no 0.4mg pills in SL

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28
Q

ANC

Last used contraceptive used

A
  • Contraceptive failure
  • Expected/ unexpected PG
  • Cu- IUCD - ectopic PG?
  • If no methods used - precious child
29
Q

ANC

Hx taken during the booking visit includes

A
  • PMHx
  • Present Obs Hx
  • Past Obs and Gyne Hx
  • Detailed medical and surgical Hx
  • FHx
  • Social Hx
  • Ask for any complaints- Nausea, Heartburn, urinary Sx,abd pain, PV bleeding
  • LMP to calculate the EDD
  • Folica acid taken or not
  • If this was a planned PG
  • Rubella Taken, Immunization Hx
30
Q

ANC

If the mother has PV bleeding in the early stages. Whats the concern

A

miscarriage. Needs immediate admission

31
Q

ANC

If the mother has abd pain during the booking visit?

A

Suspect ectopic PG. needs immediate admission

32
Q

ANC

When is the booking visit usually done

A

usually 6-8 weeks of POA

33
Q

ANC

Examination done in the booking visit includes

A
  • Height
  • Weight
  • Eyes- pallor
  • ankle and facial edema
  • BP
  • auscultate for murmurs
  • Respi exam, abd exam
  • breast exam
  • mental health exam
  • icterus
  • dental hygiene
  • cyanosis
  • clubbing
  • thyroid disease
34
Q

ANC

what’s used to calculate the height

A

stadiometer

35
Q

ANC

Height is calculated closest to the

A

0.5cm

36
Q

ANC

weight is calculated

A

to the closest 0.1kg

37
Q

ANC

Why is ankle and facial edema checked in the booking visit

A

to screen for PG induced HTN, pre- eclampsia

38
Q

ANC

Ix done in the booking visit

A
  • FBC
  • UFR- to check for protein, sugar
  • VDRL
  • HIV
  • Grouping and Rh factor
  • FBS/ PPBS
39
Q

ANC

Anemia cut- off in T1 and T2, T3

A
  • T1- <11g/ dL
  • T2, T3- <10.5 g/dL
40
Q

ANC

MCV and MCH values to refer to curative hospitals

A
  • MCV- <80
  • MCH- <27
41
Q

ANC

Mx after the booking visit

A
  • Give supplements
  • refer all mothers to hospitals for shared care
42
Q

ANC

If VDRL becomes positive what needs to be done

A

do a TPPA or TPHA

43
Q

ANC

TPPA

A

Treponema pallidum particle agglutination test

44
Q

ANC

TPHA

A

Treponema pallidum heme agglutination test

45
Q

ANC

why is another test done after a positive VDRL

A

PG can cause false positives in VDRL

46
Q

ANC

Supplements given in booking visit

A
  • Folic acid 1mg/d
  • Thriposha - 2 packets/ month
47
Q

ANC

Routine visit Hx

A
  • Any complaints
  • Any Sx
48
Q

ANC

Examinations done only in the booking visit

A
  • Height
  • BMI
  • Respi exam
  • Breast exam
49
Q

ANC

Why is height checked in the booking visit

A

if the mother is < 145cm its an absolute indication for LSCS

50
Q

ANC

Examinations done in every visit ( routine visit)

A
  • Weight
  • pallor
  • BP
  • Abd exam
51
Q

ANC

Examinations done once in every trimester

A
  • CVS ( murmurs)
  • Mental health
52
Q

ANC

Ix done in routine visit

A
  • urine for sugar and protein in every visit
  • Hb/ FBC- done in 28 weeks
  • OGTT done in 28 weeks
53
Q

ANC

If OGTT raise suspicion for GDM. Next step

A

repeat OGTT again at 34 weeks

54
Q

ANC

Whats recorded as weight in the H 512

A

weight gain in relation to POA in a graph

55
Q

ANC

based on what is the expected weight made

A

BMI

56
Q

ANC

BMI ranges

A
  • < 18.5 - underweight
  • 18.5- 24.9 - normal
  • 25- 29.9 overweight
  • > = 30 - obese
57
Q

ANC

Expected weight gain for the normal BMI range

A

11.5 - 16 kg

58
Q

ANC

higher the BMI….. the weight gain in PG

A

lower the weight gain

59
Q

ANC

Besides weight gain what else is graphed during ANC

A

SFH w a measuring tape. graphed according to the POA

60
Q

ANC

Diabetic tests done during PG

A
  • FBS
  • OGTT
  • PPBS
61
Q

ANC

If FBS, PPBS is high how is Diabetes Dx

A

Dx by OGTT

62
Q

ANC

OGTT

A

Mother will come fasting. Take a blood sample for FBS
Dissolve 75g of monohydrated glucose sachet in water ask to drink it. Take a blood sample 2 hours after.

63
Q

ANC

Monohydrated satchets come in…. flavors

A
  • orange
  • lemon
64
Q

ANC

Is thalassemia screening done in SL

A

usually no. done if there’s a high risk and also in high risk areas- kurunegala, anuradhapura

65
Q

ANC

Dipstick test

A

dipstick dipped in urine sample and the colour the dipstick changes into is matched with the colour of the Dx colours to see if its high in sugar

66
Q

ANC

If dipsticks are not available, what other options are available

A
  • for sugar- benedicts test can be done
  • for protein- heat precipitation, coagulation test can be done
67
Q

ANC

micronutrients given during PG

A
  • folic acid- 3 months prior to PG
  • Iron - to prevent anemia
  • Vit c- to increase iron absorption
  • Ca- for fetal skeletal development
  • Thriposha
68
Q
A

COM MED (2 decks)

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