MFM

Question 1

Cleft lip

Answer 1

Structural/environmental/genetic facotrs

Association with cleft PALATE 70% of time
Can be associated with other issues approx 10% of time

MFM review
Paeds review and counselling

Can cause issues with speech, feeding, language

Postnatal
-examine before first feed
-inspect airway for obstruction/palate/ability to suck
-assoc abnormality
-BF support
MDT care - reapir 3-4 months for lip, 6-9 months for palate

Question 2

FNAIT

Answer 2

Fetal neonatal alloimmune thrombocytopenia

HPLA - 1a NEGATIVE mother
Need to test father
If heterozygote - could do amnio or CFDNA

Mgmt
MDT - MFM, haem, nicu
IvIG, prednisone
ELCS from 36 weeks

IvIG - weekly from 16/40 if prev affected sib
If considering vag, FBS + platelet count >100
Could consider IUT w platelets if needed, but moving away from cordocentesis and IUT

Question 3

Cervical length USS

Answer 3

HIGH risk = 2-4 weeks, 16-24 weeks

• Prev PTB or 2nd tri loss (16-34 weeks)
• prev PPROM <34/40
• prev cerclage
• known uterine variant
• intrauterine adhesions
• trachelectomy

Intermediate risk (single scan by 18-22 weeks)

• prev CS @ fully
• LLETZ >10mm, or cone, or multiple LLETZ