Anti-natal care Flashcards
What happens at the booking visit
History - menstrual, medical, obstetric, family, social
Examination - ht, wt, bp, CVS, abdo
Investigations
Ultrasound
When is the gestation calculated from
1st day of last period
What investigations are done at the booking visit
Hb ABO;rhesus STI HIV Hep C and B Urinalysis ultradsound
At what gestation does the fundus reach the level of the umbilicus
20 wks
When is alpha fetal protein checked
16weeks
When is the fetal anomaly scan
18 weeks
When is anti d given if rhesus negative
28wks - Antibodies checked at 34wks
How often are midwife led follow up visits in a normal pregnncy
every 4 weeks from booking
every two weeks from 30 weeks
every week after 36wks
How is the risk for Downs assessed in 1st trimester
Nuchal thickness at 11-14wks
HCG and PAPP-A
How is down’s risk assessed in second trimester
15-20 weeks get an assay of HCG and AFP
When would investigation of amniocentesis be required
with a risk greater than 1:250
When is amniocentesis performed
after 15 weeks
What is the miscarriage rate if amniocentesis
1 percent
When is chorionic villus sampling done
after 12 weeks
What is the miscarriage rate of chorionic villus sampling
2 percent
What is now the standard down;s screening
Combined test = Nuchal transclucency +HCG + PAPP-A
When is the combined test done
11-14 weeks
What happens if women requests downs screening after 14 weeks
triple or quadruple test between 15-20wks
define triple test
alpha-fetoprotein, unconjugated oestriol, human chorionic gonadotrophin
define quadruple test
alpha-fetoprotein, unconjugated oestriol, human chorionic gonadotrophin and inhibin-A
What is first line treatment for nausea in pregnancy
Anti histamines - Promethazine NICE recommended
How much vitamin D should pregnancy women supplement
10mg daily - in healthy start vitamins
What women are at risk of vit D deficiency
Asian
obese
poor diet
What vitamin is tetatrogenic in high doses
Vitamin A- liver should be avoided.
How much folic acid should be supplemented and when
400mcg from before conception until 12 weeks to reduce risk of neural tube defects
What food should be avoided in pregnancy
Liver - vit A
Ripened soft cheeses eg brie, pate or undercooked meat = LISTERIA
Raw or part cooked eggs and meat = SALMONELLA
