antenatal screening Flashcards
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what is pre-pregnancy counselling
general health measures: diet, BMI, alcohol consumption
smoking cessation advice
folic acid (400mcg)
vitamin D (10mcg)
what is pre-pregnancy counselling for known medical problems
- optimise maternal health
- psychiatric health
- stop/change unsuitable drugs
- advice regarding complications/against pregnancy
what are some previous pregnancy problems
maternal
- caesarean section
- DVT
- pre eclampsia
foetal
- preterm delivery
- intrauterine growth restriction
- foetal abnormality
what actions can reduce previous pregnancy complications?
maternal
- thromboprophylaxis
- low dose aspirin
foetal
- treatment of infection
- high dose folic acid
- low dose aspirin
what is antenatal examination?
- routine enquiry
- blood pressure
- urinalysis
- abdominal palpation: assess symphyseal fundal height, estimate size of baby, estimate liquor volume
- determine foetal presentation
- listen to foetal heartbeat
What infections are screened for in pregnancy?
- syphilis
- hepatitis B
- HIV
- UTI
- rubella
What haematological screening is carried out?
- iron deficiency anaemia
- isoimmunisation including Rhesus disease, anti-C and anti-kell
What is the purpose of the first ultrasound scan?
- ensure pregnancy viable
- multiple pregnancy
- identify abnormalities incompatible with life
- offer and carry out Down’s syndrome screening
what is a detailed anomaly scan?
systematic structural review of baby
what first trimester screening for Down syndrome is there?
10 -14 weeks gestation, uses:
- maternal risk factors
- serum beta-hCG
- pregnancy associated plasma protein A (PAPP-A)
- fetal nuchal translucency (NT) measurement
where are nuchal translucency measurements taken from?
between crown and rump lengths of 45-84mm
it increases with gestational age
incidence of chromosomal and other abnormality is related to size of NT
what happens with a high risk NT result for Down syndrome?
further testing is offered:
- CVS (10 - 14 weeks)
- amniocentesis (15 weeks onward)
- non-invasive prenatal testing
what is non-invasive prenatal testing carried out?
maternal blood taken and can detect fetal cell free DNA released from placenta
What should those at high risk of neural tube defects be advised?
5mg of folic acid to reduce risk
