Ethics + Antenatal Care

Question 1

how long is embryo research permitted up to?

Answer 1

14 days (primitive streak)

Question 2

when is abortion permissable?

Answer 2

up to 23+6 weeks

Question 3

ethics around infertility

Answer 3

new treatments leading to leftover embryos
confidentiality of donors
resource allocation

Question 4

requirements for NHS-funded infertility treatment

Answer 4

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

Question 5

what body is in charge of overseeing the use of gametes and embryos?

Answer 5

HFEA

Question 6

when is the booking visit?

Answer 6

before 10 weeks

Question 7

what does the booking visit screen for?

Answer 7

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

Question 8

when is the anomaly scan?

Answer 8

20 weeks

Question 9

what is Naegale’s rule?

Answer 9

due date based on woman’s LMP + 280 days until scan and CRL measurement

Question 10

how is foetal growth measured?

Answer 10

from 24 weeks via serial SFH

Question 11

who gets anti-D

Answer 11

rhesus -ve women

Question 12

what to do if HDFN already developed?

Answer 12

do Kleinhauer test to measure amount of blood in maternal circulation to assess dosing

Question 13

women at high-risk of pre-eclampsia should take what?

Answer 13

aspirin from 12-36 weeks

Question 14

trisomy risk assessment in first trimester?

Answer 14

11-13+6 weeks measure nuchal thickness on USS + hCG, PAPP-A and maternal age

Question 15

normal nuchal lucency?

Answer 15

< 3.5mm

Question 16

second trimester trisomy risk assessment

Answer 16

bloods 15-20 weeks for assay of hCG and AFP

Question 17

screening for trisomy if first trimester screening missed?

Answer 17

maternal age + markers (AFP, hCG, UE3 and inhibin A

Question 18

pathway of trisomy screening

Answer 18

screening results
NIPT
amniocentesis (>15 weeks) or CVS (>12 weeks)

Question 19

smear test

Answer 19

3 yearly from 25-49

5 yearly 50-64

Question 20

when is smear testing done annually?

Answer 20

if abnormal result

Question 21

pathway in smear test sample?

Answer 21

HPV test > cytology > colposcopy

Question 22

what to do if foetus is <3rd centile at <32 weeks

Answer 22

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.

Question 23

when should foetal movements start?

Answer 23

16-24 weeks and move more and more until 32 weeks