Anti-natal care

Question 1

What happens at the booking visit

Answer 1

History - menstrual, medical, obstetric, family, social
Examination - ht, wt, bp, CVS, abdo
Investigations
Ultrasound

Question 2

When is the gestation calculated from

Answer 2

1st day of last period

Question 3

What investigations are done at the booking visit

Answer 3

Hb
ABO;rhesus
STI
HIV
Hep C and B
Urinalysis
ultradsound

Question 4

At what gestation does the fundus reach the level of the umbilicus

Answer 4

20 wks

Question 5

When is alpha fetal protein checked

Answer 5

16weeks

Question 6

When is the fetal anomaly scan

Answer 6

18 weeks

Question 7

When is anti d given if rhesus negative

Answer 7

28wks - Antibodies checked at 34wks

Question 8

How often are midwife led follow up visits in a normal pregnncy

Answer 8

every 4 weeks from booking
every two weeks from 30 weeks
every week after 36wks

Question 9

How is the risk for Downs assessed in 1st trimester

Answer 9

Nuchal thickness at 11-14wks

HCG and PAPP-A

Question 10

How is down’s risk assessed in second trimester

Answer 10

15-20 weeks get an assay of HCG and AFP

Question 11

When would investigation of amniocentesis be required

Answer 11

with a risk greater than 1:250

Question 12

When is amniocentesis performed

Answer 12

after 15 weeks

Question 13

What is the miscarriage rate if amniocentesis

Answer 13

1 percent

Question 14

When is chorionic villus sampling done

Answer 14

after 12 weeks

Question 15

What is the miscarriage rate of chorionic villus sampling

Answer 15

2 percent

Question 16

What is now the standard down;s screening

Answer 16

Combined test = Nuchal transclucency +HCG + PAPP-A

Question 17

When is the combined test done

Answer 17

11-14 weeks

Question 18

What happens if women requests downs screening after 14 weeks

Answer 18

triple or quadruple test between 15-20wks

Question 19

define triple test

Answer 19

alpha-fetoprotein, unconjugated oestriol, human chorionic gonadotrophin

Question 20

define quadruple test

Answer 20

alpha-fetoprotein, unconjugated oestriol, human chorionic gonadotrophin and inhibin-A

Question 21

What is first line treatment for nausea in pregnancy

Answer 21

Anti histamines - Promethazine NICE recommended

Question 22

How much vitamin D should pregnancy women supplement

Answer 22

10mg daily - in healthy start vitamins

Question 23

What women are at risk of vit D deficiency

Answer 23

Asian
obese
poor diet

Question 24

What vitamin is tetatrogenic in high doses

Answer 24

Vitamin A- liver should be avoided.

Question 25

How much folic acid should be supplemented and when

Answer 25

400mcg from before conception until 12 weeks to reduce risk of neural tube defects

Question 26

What food should be avoided in pregnancy

Answer 26

Liver - vit A
Ripened soft cheeses eg brie, pate or undercooked meat = LISTERIA
Raw or part cooked eggs and meat = SALMONELLA