Lecture 2 Antenatal Care and Screening

Question 1

Causes of maternal death

Answer 1

• Heart disease- most common
• Blood clots
• Epilepsy and stroke
• Other physical conditions
• Sepsis
• Mental health
• Bleeding
• Cancer
• Pre-eclampsia

Question 2

Name 6 general health measures for pregnant women to follow

Answer 2

Improve diet
Optimise BMI
Reduce alcohol consumption 
Smoking cessation
Folic acid (400mcg, 5mg)
Up to date cervical smear

Question 3

What drugs for chronic hypertension and epilepsy should be avoided in pregnancy

Answer 3

ACE-I and Sodium Valproate

Question 4

What medication would you recommend for a pregnant women with previous pre-eclampsia

Answer 4

Aspirin 150mg and regular BP monitoring

Question 5

What would you recommend for a pregnant women with previous gestational diabetes

Answer 5

HbA1C at booking and OGTT at 28 weeks

Question 6

What would you recommend for a pregnant women with previous c-section

Answer 6

Consider elective c-section

Question 7

What would you recommend for a pregnant women with previous DVT or PE

Answer 7

antenatal thromboprophylaxis and 6 weeks postnatal treatment

Question 8

What should be recommended for intrauterine growth restriction

Answer 8

Aspirin 150mg during pregnancy and serial US scans

Question 9

What should be recommended for ask of pre-term birth

Answer 9

Transvaginal cervical length scans or cervical suture

Question 10

What is involved in abdominal palpation

Answer 10

• Assess symphyseal fundal
• Height (SFH)
• Estimate size of baby
• Estimate liquor volume

Question 11

If a baby presents in breech after 36 weeks what is offered

Answer 11

Elective C-section

Question 12

Which trimester is screening for infections carried out

Answer 12

1st Trimester

Question 13

What infections are screened for in the 1st trimester

Answer 13

Hep B, Syphilis, HIV, MSSU-UTI

Question 14

When is anaemia nd isoimmunisation screened for

Answer 14

1st trimester and at 28 weeks

Question 15

What is Rhesus disease

Answer 15

Rhesus disease only happens when the mother has rhesus negative blood (RhD negative) and the baby in her womb has rhesus positive blood (RhD positive). The mother must have also been previously sensitised to RhD positive bloo

Question 16

What is a Rhesus negative mother given

Answer 16

Anti-d at 28 weeks

Question 17

What is the purpose of the first visit scan (11-14 weeks gestation)

Answer 17

Ensure pregnancy is viable
Multiple pregnancy
Identify abnormalities
Downs syndrome screening

Question 18

What is a Nuchal Translucency measurement used for

Answer 18

To screen for Down’s syndrome

Question 19

What measurements are screened during the 2nd trimester

Answer 19

hCG, unconjugated oestrodiol, alpha-fetoprotein, inhibition-A

Question 20

If results from 2nd trimester are abnormal what further tests can be done

Answer 20

CVS
Amniocentesis
Non-invasive Prenatal testing: maternal blood to detect foetal cell free DNA

Question 21

What is the purpose of 2nd trimester ultrasound

Answer 21

Detects neural tube defects

Question 22

What is Edward’s Syndrome

Answer 22

Additional copy of chromosome 18

Heart, swallowing, breathing,, issues, hearing loss

Question 23

What is Patau’s Syndrome?

Answer 23

Additional copy of chromosome 13. Low birth weight, severe heart defects

Question 24

What risks are associated with multiple pregnancies

Answer 24

Miscarriage, Preterm birth, twin to twin transfusion syndrome, selective foetal growth restriction

Question 25

Monochorionic

Answer 25

1 placenta

Question 26

Monoamniotic

Answer 26

1 amniotic sac

Question 27

Dichorionic

Answer 27

2 placenta

Question 28

Diamniotic

Answer 28

2 amniotic sac

Question 29

What months are the 1st trimester

Answer 29

one-three month

Question 30

What months are the 2nd trimester

Answer 30

four-six months

Question 31

What months are the 3rd trimester

Answer 31

seven-nine