Ethics + Antenatal Care Flashcards
how long is embryo research permitted up to?
14 days (primitive streak)
when is abortion permissable?
up to 23+6 weeks
ethics around infertility
new treatments leading to leftover embryos
confidentiality of donors
resource allocation
requirements for NHS-funded infertility treatment
unexplained infertility for at least 2 years
female <40
BMI 18.5-30
both partners must be non-smokers and abstain from illegal substances
no alcohol
no children living in home
what body is in charge of overseeing the use of gametes and embryos?
HFEA
when is the booking visit?
before 10 weeks
what does the booking visit screen for?
haemoglobinopathies, Hep B&C, HIV, syphilis, red cell antibodies, anemia, number fetuses, viability, PMH, PSH, Obstetric hx, meds, allergies, SH, FH, past mental health history, FGM, BMI (& trisomy screening offered), domestic abuse
when is the anomaly scan?
20 weeks
what is Naegale’s rule?
due date based on woman’s LMP + 280 days until scan and CRL measurement
how is foetal growth measured?
from 24 weeks via serial SFH
who gets anti-D
rhesus -ve women
what to do if HDFN already developed?
do Kleinhauer test to measure amount of blood in maternal circulation to assess dosing
women at high-risk of pre-eclampsia should take what?
aspirin from 12-36 weeks
trisomy risk assessment in first trimester?
11-13+6 weeks measure nuchal thickness on USS + hCG, PAPP-A and maternal age
normal nuchal lucency?
< 3.5mm
second trimester trisomy risk assessment
bloods 15-20 weeks for assay of hCG and AFP
screening for trisomy if first trimester screening missed?
maternal age + markers (AFP, hCG, UE3 and inhibin A
pathway of trisomy screening
screening results
NIPT
amniocentesis (>15 weeks) or CVS (>12 weeks)
smear test
3 yearly from 25-49
5 yearly 50-64
when is smear testing done annually?
if abnormal result
pathway in smear test sample?
HPV test > cytology > colposcopy
what to do if foetus is <3rd centile at <32 weeks
repeat USS of growth and umbilical artery doppler every 2 weeks.
If umbilical artery doppler end diastolic flow becomes absent, early onset FGR is present requiring specialist management with ductus venosus doppler and CTG assessment every 48-72 hours.
when should foetal movements start?
16-24 weeks and move more and more until 32 weeks
