Antenatal_Care_Timetable_Flashcards

Question 1

How many antenatal visits are recommended for the first pregnancy if uncomplicated?

Answer 1

10 antenatal visits.

Question 2

How many antenatal visits are recommended for subsequent pregnancies if uncomplicated?

Answer 2

7 antenatal visits.

Question 3

Do women need to be seen by a consultant if the pregnancy is uncomplicated?

Answer 3

No, women do not need to be seen by a consultant if the pregnancy is uncomplicated.

Question 4

What is the purpose of the 8-12 weeks (ideally < 10 weeks) booking visit?

Answer 4

General information (e.g., diet, alcohol, smoking, folic acid, vitamin D, antenatal classes), BP, urine dipstick, check BMI, booking bloods/urine (FBC, blood group, rhesus status, red cell alloantibodies, haemoglobinopathies, hepatitis B, syphilis, HIV test offered to all women, urine culture to detect asymptomatic bacteriuria).

Question 5

What is the purpose of the 10-13+6 weeks visit?

Answer 5

Early scan to confirm dates, exclude multiple pregnancy.

Question 6

What is the purpose of the 11-13+6 weeks visit?

Answer 6

Down’s syndrome screening including nuchal scan.

Question 7

What is the purpose of the 16 weeks visit?

Answer 7

Information on the anomaly and the blood results. If Hb < 11 g/dl consider iron. Routine care: BP and urine dipstick.

Question 8

What is the purpose of the 18-20+6 weeks visit?

Answer 8

Anomaly scan.

Question 9

What is the purpose of the 25 weeks visit (only if primip)?

Answer 9

Routine care: BP, urine dipstick, symphysis-fundal height (SFH).

BMI

Question 10

What is the purpose of the 28 weeks visit?

Answer 10

Routine care: BP, urine dipstick, SFH. Second screen for anaemia and atypical red cell alloantibodies. If Hb < 10.5 g/dl consider iron. First dose of anti-D prophylaxis to rhesus negative women.

Question 11

What is the purpose of the 31 weeks visit (only if primip)?

Answer 11

Routine care as above.

Question 12

What is the purpose of the 34 weeks visit?

Answer 12

Routine care as above. Second dose of anti-D prophylaxis to rhesus negative women. Information on labour and birth plan.

Question 13

What is the purpose of the 36 weeks visit?

Answer 13

Routine care as above. Check presentation - offer external cephalic version if indicated. Information on breast feeding, vitamin K, ‘baby-blues’.

Question 14

What is the purpose of the 38 weeks visit?

Answer 14

Routine care as above.

Question 15

What is the purpose of the 40 weeks visit (only if primip)?

Answer 15

Routine care as above. Discussion about options for prolonged pregnancy.

Question 16

What is the purpose of the 41 weeks visit?

Answer 16

Routine care as above. Discuss labour plans and possibility of induction.

Question 17

summarise

Answer 17

Antenatal care: timetable

NICE issued guidelines on routine care for the healthy pregnant woman in March 2008. They recommend:
10 antenatal visits in the first pregnancy if uncomplicated
7 antenatal visits in subsequent pregnancies if uncomplicated
women do not need to be seen by a consultant if the pregnancy is uncomplicated

*the evidence base suggests that there is little difference in the efficacy of single-dose (at 28 weeks) and double-dose regimes (at 28 & 34 weeks). For this reason the RCOG in 2011 advised that either regime could be used ‘depending on local factors’

Question 18

Theme: Routine antenatal care

A. 7 - 8 weeks
B. 8 - 12 weeks
C. 11 - 13+6 weeks
D. 14 -15 weeks
E. 16 weeks
F. 18 - 20+6 weeks
G. 25 weeks
H. 28 weeks
I. 34 weeks
J. 38 weeks

For each of the following components of routine antenatal care select the gestation when it should occur

16. Second screen for anaemia and atypical red cell alloantibodies
17. Nuchal scan
18. Urine culture to detect asymptomatic bacteriuria

Answer 18

16. Second screen for anaemia and atypical red cell alloantibodies

The correct answer is: 28 weeks

17. Nuchal scan

The correct answer is: 11 - 13+6 weeks

18. Urine culture to detect asymptomatic bacteriuria

The correct answer is: 8 - 12 weeks

Question 19

A 23-year-old woman attends her antenatal booking appointment. She thinks that she is 10 weeks pregnant. This is her first pregnancy. Which one of the following is not routinely performed?

Assess body mass index
Pelvic examination
Urine culture if dipstick urine normal
Check for red cell alloantibodies
Hepatitis B testing

Answer 19

Pelvic examination

The correct answer is Pelvic examination. In the UK, pelvic examinations are not routinely performed at antenatal booking appointments. This is because a pelvic examination does not provide additional useful information in asymptomatic women and can be uncomfortable. It is only conducted if indicated by specific symptoms or concerns such as pain or bleeding.

The option Assess body mass index is incorrect as this is routinely done during the initial antenatal appointment. Body mass index (BMI) provides important information about the mother’s nutrition status and potential risks during pregnancy, like gestational diabetes or pre-eclampsia.

Urine culture if dipstick urine normal is also a routine procedure. Urine tests are used to detect urinary tract infections (UTIs), proteinuria, and glycosuria which could indicate gestational diabetes or preeclampsia. Even if the dipstick test appears normal, it may still be sent for culture to rule out asymptomatic bacteriuria which can lead to UTIs later in pregnancy.

The option Check for red cell alloantibodies refers to a blood test that checks for antibodies that could potentially attack the baby’s red blood cells. This test is particularly important for Rh-negative women who might develop antibodies against Rh-positive fetal cells. Therefore, it is routinely performed at the booking visit.

Lastly, Hepatitis B testing is also part of routine antenatal screening in the UK. If a pregnant woman has hepatitis B, there’s a risk of passing the infection on to her baby at birth. By identifying infected mothers-to-be before they give birth, steps can be taken to reduce the risk of mother-to-child transmission.

Question 20

Theme: Routine antenatal care

A. 5 - 7 weeks
B. 8 - 12 weeks
C. 10 - 13+6 weeks
D. 14 -15 weeks
E. 16 weeks
F. 18 - 20+6 weeks
G. 25 weeks
H. 28 weeks
I. 34 weeks
J. 38 weeks

For each of the following components of routine antenatal care select the gestation when it should occur

87. Anomaly scan
88. First dose of anti-D prophylaxis to rhesus negative women
89. Early scan to confirm dates

Answer 20

For each of the following components of routine antenatal care select the gestation when it should occur

87. Anomaly scan
    18 - 20+6 weeks
88. First dose of anti-D prophylaxis to rhesus negative women
    28 weeks
89. Early scan to confirm dates
    10 - 13+6 weeks

Question 21

Theme: Routine antenatal care

A. 7 - 8 weeks
B. 8 - 12 weeks
C. 10 - 13+6 weeks
D. 14 -15 weeks
E. 16 weeks
F. 18 - 20+6 weeks
G. 25 weeks
H. 28 weeks
I. 34 weeks
J. 38 weeks

For each of the following components of routine antenatal care select the gestation when it should occur

61. Early scan to confirm dates
62. First screen for anaemia and atypical red cell alloantibodies
63. First dose of anti-D prophylaxis to rhesus negative women

Answer 21

Theme: Routine antenatal care

A. 7 - 8 weeks
B. 8 - 12 weeks
C. 10 - 13+6 weeks
D. 14 -15 weeks
E. 16 weeks
F. 18 - 20+6 weeks
G. 25 weeks
H. 28 weeks
I. 34 weeks
J. 38 weeks

For each of the following components of routine antenatal care select the gestation when it should occur

61. Early scan to confirm dates
    10 - 13+6 weeks
62. First screen for anaemia and atypical red cell alloantibodies
    8 - 12 weeks
63. First dose of anti-D prophylaxis to rhesus negative women
    28 weeks