Antenatal screening Flashcards
What is morning sickness?
A condition that affects around 80-85% of women. It is worse in conditions where human chorionic gonadotrophin is higher e.g. twins, molar pregnancy
What is hypermevis gravidarum
Severe morning sickness- prolonged and severe nausea and vomiting
This leads to dehydration, weight loss and hypotension
What pre- pregnancy counselling can be done for woman in primary care? (5)
Improve diet Optimise BMI Reduce alcohol consumption Smoking cessation advice Folic acid (400mcg) stop/change any unsuitable drugs
What risks may the mother experience during pregnancy?
What can be done to reduce these risks?
Cesarean section
DVT
Pre-eclampsia
Thromboprophylaxis
Low dose aspirin
What fetal risks may occur to the baby during pregnancy?
How can these be reduced?
Pre-term delivery
Intrauterine growth restriction
Fetal abnormality
Treat infection
High dose folic acid
Low dose aspirin
What is involved at the antenatal examination? (5)
Fetal movements (after 20 weeks) B.P Urinalysis abdominal palpation, fundal height, estimate size of baby Fetal presentation and heart rate
Blood tests are typically carried out to screen for certain maternal issues that may cause harm to the pregnancy. What are they? (6)
Hep B Syphilis HIV UTI Iron deficiency anaemia Isoimmunisation (rhesus, anti-c, anti-kell)
What is involved at the first visit ultrasound scan? (5)
Carried out around 10-14 weeks to:
Ensure viable pregnancy
Determine if multiple pregnancy
Identify abnormalities incompatible with life
Offer and carry out screening for serious defects such as Down’s syndrome screening
How are major conditions such as down syndrome screened for at first trimester ultrasound scan
They look at serum chorionic gonadotrophin,
pregnancy associated plasma protein A (PAPP-A)
fetal nuchal translucency (NT) measurement
Parents are told it is only an estimation of risk.
What is Nuchal translucency?
What is done if NT testing is positive?
Distance between crown and rump, depending o the size this can provide a risk of Down’s syndrome. Options for further testing include
CVS
Amniocentesis
Non-invasive prenatal testing
What is CVS?
What is amniocentesis?
When are they completed?
Completed between 10 and 14 weeks a sample of the chorionic villus is obtained.1-2% chance of miscarriage
Amniocentesis involves sampling of the amniotic fluid from 15 weeks onwards. >1% chance of miscarriage
What is meant by non-invasive prenatal testing?
Maternal blood is taken
Can detect fetal cell free DNA
Looks for chromosomal trisomies
Non invasive
What occurs during a second trimester ultrasound?
Screening test for major structural abnormalities
What major structural abnormalities are screened for in a second trimester ultrasound?
Hypoplastic left heart
exomphalos
cleft lip
