Karamursel

Question 1

Definition of Antenatal care

Answer 1

Comprehensive health supervision(examination /advise) of a pregnant woman before delivery

Question 2

Goals of ANC

Answer 2

Provision of information and advice on lifestyle:
Nutrition/Exclusive breastfeeding practices/Exerciseand sexual intercourse in pregnancy/Need to avoid smoking, alcohol, use of harmful drugs, etc. /Early detection and treatment of problems and complications:
◦ Anemia
◦ Urinary tract infections
◦ Sexually transmitted infections including syphilis and HIV
◦ Pre-eclampsia
◦ Diabetes

Question 3

Return Visits:

Answer 3

First 28 weeks-once a month Up to 36 weeks- twice in a month There after weekly till delivery

Question 4

Pregnancy symptoms

Answer 4

Missed period (amenorrhea) ◦Morning sickness (nausea/vomiting) ◦Fatigue or weakness ◦Breast changes (fullness, pain) ◦Urinary symptoms (increased frequency, feeling
of pressure, etc.) ◦Constipation,bloating ◦Enlarging abdomen

Question 5

The normal fetal heart rate is…

Answer 5

120-160 beats/min

Question 6

Pregnancy tests:

Answer 6

All pregnancy tests measure levels of circulating beta human chorionic gonadotrophins (also called pregnancy hormone)/can ⑧
detect pregnancy from 5 weeks after last normal menstrual period (LNMP)->urine test

Bl ood tests are quantitative and can detect pregnancy &
from 10–12 days after ovulation (before missed period)

Question 7

If the crown–rump length is above 84 mm, the gestational age should be estimated using head circumference

Question 8

The uterus may be higher than expected due
to

Answer 8

large fetus, multiple pregnancy,
polyhydrammnios or mistaken date of last
menstrual period.

Question 9

The uterus may be lower than expected due
to

Answer 9

small fetus, intrauterine growth
retardation, oligohydramnios or mistaken
date of last menstrual period.

Question 10

Screening for fetal chromosome abnormalities

Answer 10

Double test(80%)between 11 weeks 0 days and 13 weeks 6 day
triple or quadruple test (less preferred)between 15 weeks 0 days and 20 weeks 0 days.
NI PT(98%)NIPT works by examining the small fragments of DNA-known as cell free DNA(cfDNA) floating in the mother’s blood

Question 11

Ri sk Approach

Answer 11

Age< 18 or >35 Anemia Cardiac disease ->
somecardiac
diseasepatientshouldbeseen
Hypertension, Pre eclampsia -eclampsia
Diabetes Multiple pregnancies Elderly grand multiparas Prolonged pregnancies C/S or operative delivery history, IUGR, stillbirth history

Question 12

Risk factors for gestational diabetes :

Answer 12

Body mass index above 30 kg/m2
Previous macrosomic baby weighing 4.5 kg or above
Previous gestational diabetes
Family history of diabetes (first-degree relative with diabetes)

Question 13

If the pregnant woman is rh negative and her husband is rh positive then:

Answer 13

ICT should be ordered
Prophylactic anti-D administration at 28 weeks - after ->
delivery if the baby Rh(+)

Question 14

Asymptomatic Bacteriuria

Answer 14

Urine should be tested for sugar, ketones and protein
reduces the risk of pyelonephritis and preterm birth

Question 15

Co mmon Discomforts of Pregnancy, Etiology, and Relief Measures

Answer 15

Decrease fluid intake at night. ◦ Maintain fluid intake during day. ◦ Void when feel the urge.(urinary)
Rest frequently ,Go to bed earlier(fatigue)
Avoid decongestants. ◦Use humidifiers, and normal saline drops.(Nasal stuffiness and epistaxis)

Perform frequent mouth care.
◦Chew gum.
◦Decrease fluid intake at night.
◦Maintain fluid intake during day.(Ptyalism(excessive salivation)