Antenatal screening

Question 1

What points are covered in pre-pregnancy counselling?

Answer 1

Improvement of diet
Optimise BMI
Reduce alcohol consumption
smoking cessation
Vitamin D supplement
Folic acid supplement (ideally for 3 months before pregnancy)
Stop/change any teratrogenic drugs
Good control of diabetes or epilepsy
Optimise mental health
Discuss previous pregnancy problem if any

Question 2

What standard antenatal screening’s are done and when?

Answer 2

First visit scan usually 10-14 weeks

Second trimerst/ detailed anaomly scan ~ 18-22 weeks

Question 3

What is screened for in the First trimester visit?

Answer 3

Ultrasound scan done. This checks:
Pregnancy is viable
Multiple pregnancy
Identify abnormalities incompatible with life
Offer to carry out Down’s syndrome screening (and for other trisomies)

Question 4

How is Down’s syndrome screened for?

Answer 4

Nuchal translucency measurement- measurement taken using ultrasound of Crown Rump’s length. This increases with gestation. The larger a NT is for gestation the higher the risk of trisomy.

Question 5

What happens if the inital trisomy screening comes back as high risk?

Answer 5

Choronic-villi sample (10-14 weeks gestation)
Amniocentisis (15 weeks)
Non-invasive prenatal testing (this is not diagnostic and uses free fetal DNA from placenta)

Question 6

What is checked at a second trimester ultrasound?

Answer 6

Done 18-22 weeks.
Screening for major structural abnormalities:
neural tube defect
Exomphalos
Cleft lip

Question 7

Up until which point can abortions be carried out in the UK?

Answer 7

Before 24 weeks

In very limited circumstances they can be carried out after this.