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Reproduction > Antenatal Screening > Flashcards

Antenatal Screening Flashcards

1
Q

What % of women deliver on their due date?

A

4%

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2
Q

What % of women will deliver within one week either side of their due date?

A

60%

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3
Q

What basic investigations are carried out at the booking visit?

A 
Hb
ABO - Rhesus
STD screening (HIV, Hep, Syphillis) 
Urinalysis
USS
Confirm viability of pregnancy 
Estimate gestational age
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4
Q

An empty sac is an ________ until proven otherwise

A

Ectopic pregnancy

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5
Q

What % of foetal heart defects are picked up in screening/

A

60%

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6
Q

Major structural abnormalities occur in __% of pregnancies?

A

2-3%

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7
Q

What genetic abnormality is found in Patau’s syndrome

A

Trisomy of c13

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8
Q

What is placenta previa

A

This is when the placenta lies low in the womb, covering most, if not all of the cervix.

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9
Q

What should be done if 18+0 r 20+6 scans show placenta previa?

A

Rescan at 32 weeks

If abdo exam unclear, offer vaginal scan

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10
Q

What do you test in the first trimmest to assess Down’s Risk and how do you do it?

A

Skin thickness of fetal neck

USS - nuchal thickness

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11
Q

When is nuchal thickness screened for?

A

11-13 weeks

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12
Q

What is considered a normal skin thickness

A

<3.5mm when crown rump length is between 45-84 mm

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13
Q

What screening tests are done in second trimester for Downs?

A

Blood sample for assay of HCG and AFP

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14
Q

What gestational age is blood test sampling for Down’s carried out

A

15-20 weeks

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15
Q

When would amniocentesis be offered?

A

If a woman’s risk is greater than 1:250

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16
Q

What screening options are available if a woman misses first trimester screening?

A

Mid trimester screening from w15-20+6

17
Q

If a woman attends the first trimester screening, is it necessary to offer the mid trimester screen?

A

No

18
Q

What tests are done at the id trimester screening?

A

Maternal age + biochemical markers = risk assessment

Biochemical markers:
AFP
hCG
unconjugated oestradiol
inhibin A
19
Q

How are the biochemical markers measured?

A

Specific immunoassay methods

20
Q

What non invasive prenatal test can identify women with an increased risk of certain genetic and chromosomal conditions?

A

Cell free foetal DNA testing

aka non invasive prenatal testing

21
Q

When is amniocentesis carried out?

A

After 15 weeks

22
Q

What is the risk of miscarriage following amniocentesis testing/

A

1%

23
Q

When is chorionic villous sapling carried out?

A

After 12 weeks GA

24
Q

What is the miscarriage rate in chorionic villous sampling?

A

2%

25
Q

What risk factors would mean you should offer a test for gestational diabetes?

A
  • BMI >30
  • Previous macrosomic baby
  • Previous GD
  • FHx of diabetes
  • Minority ethnic family origin with high prevalence of DM
26
Q

What test is done for at risk women, for gestational diabetes?

A

2 hour 75g oral glucose tolerance test

27
Q

What results would be diagnostic of gestational diabetes?

A

Fasting plasma glucose of 5.6mmol/litre or above
OR
2 hour plasma glucose level of 7.8 mmol/litre or above

28
Q

What measurement is recommended from week 24, to predict potential SGA?

A

Symphysis - fundal height

29
Q

When would women be referred for foetal sizing by USS?

A

BMI >35
Large fibroids
Hydramnios
(basically anything that makes it hard to measure SFH)

30
Q

What medication should be given to women at high risk for pre-eclampsia?

A

75mg aspirin daily from 12w until birth

31
Q

What risk factors would make a woman ‘high risk’ for pre-eclampsia?

A 
Chronic kidney disease
Hypertension in previous pregnancy
Diabetes T1 or 2
Chronic hypertension
Autoimmune diseases e.g. SLE or antiphospholipid syndrome
32
Q

What risk factors would be considered moderate risk for pre-eclampsia?

A 
>40y/o 
First pregnancy
BMI >35
FHx of preeclampsia 
Multiple pregnancy
Pregnancy interval >10years
33
Q

When should you offer an OGTT for a woman with mild risk factors for gestational diabetes?

A

Weeks 24-28

34
Q

If a woman has had gestational diabetes in past pregnancies, what is the appropriate screening procedure?

A

OGTT as soon as they book their first visit
If that’s normal
Recheck at 24-28 weeks

35
Q

What is the combined test?

A

This is when the mother goes for screening weeks 11-13 and it involves a blood test and an ultrasound scan

36
Q

When would a triple/quadruple test be performed?

A

If the woman misses the 11-13 week screening

Can be performed from weeks 15-20

37
Q

What does the triple test incorporate?

A

Serum alpha fetaprotein, bHCG and oestriol.

38
Q

What is included in the quadruple test?

A 
Usually weeks 15-16
AFP
hCG
unconjugated oestradiol
inhibin A

Reproduction (19 decks)

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