Normal Antenatal Progress Flashcards
What is the normal Folic Acid supplementation dose?
400 micrograms OD
Why should women supplement folic acid?
To prevent NTD’s
When does folic acid supplementation need to be carried on until?
12/40
Some women at higher risk of NTD must take a higher dose of folic acid, what is this dose?
5mg OD
Which women are at higher risk of NTD?
- Women with an NTD or their partner has an NTD
- Mum/dad family have an Hx of NTD
- Previous pregnancy with NTD
- Diabetic patient
- Mother’s have bowel issues (IBD or Coeliac)
- Obese mothers
- Mothers taking anti-epileptic medication
When are women screened for haematological disorders?
By 10/40
What haematological diseases are screened for?
- Sickle cell disease
2. Thalassaemia
When can the combined test for Down’s, Edward’s and Patau’s be completed?
Between 11+0 and 13+6/40
List the risk factors that increase the chance of a mother developing GDM
- BMI >30kg/m2
- Previous macrosomic baby
- Previous GDM
- FHx of DM
- Family origin of South Asian, black Carribbean, Middle Eastern
What will a midwife want to know about a new mum?
- Full name, age and address
- Ethnic background
- Partner’s details (or next of kin)
- PMHx and PSHx
- MHx
- FHx of any illness or pregnancy related problems
- Personal Hx of smoking (current or within the last 12months), or if there are any smokers in their house
- Alcohol Hx
- Illicit drug use
- Previous obstetric or gynae Hx (including smears)
- LMP
List the factors that make a pregnancy high risk.
- Advanced maternal age (>40)
- Low maternal age (<20)
- Hx of any medical problems
- Previous surgery
- IVF treatment
- Previous Caesarean section
- Previous pregnancy complications
When is a dating scan undertook?
8+0-13+6/40
When is an anomaly scan undertook?
18+0-20+6/40
What is the dose of Vitamin D that should be taken throughout pregnancy?
10 micrograms OD
Which women need to be highly encouraged to supplement their vitamin D?
- Those with darker skin
- Those with limited sunlight exposure (housebound or need to cover their skin for cultural reasons)
What routine bloods must be carried out on all women that present with a pregnancy?
- FBC (anaemias, platelet count)
- Blood Group
- Rhesus status (antibodies)
- HIV
- Hepatitis B
- Syphyllis
- STI check offered if they are under 25
- Haemaglobinopathies check (sickle cell, thalassaemia)
What sample should also be taken in the first midwife appointment and why?
MSU to check for asymptomatic bacterial vaginosis that may cause harm to the foetus including miscarriage.
When can foetal heartbeat be heard by doppler?
As early as 11 weeks in a slim mother, up to 14 weeks in a larger woman
When should foetal movements start?
From week 16-20. If there is no foetal movement at 24 weeks, further investigation must be undertook to work out why.
What is parity?
The number of times a woman has been pregnant and given birth to a foetus (live or still birth) after 24/40 or if they have had a live birth before 24/40.
What is gravidity?
The number of times a woman has been pregnant, including the current pregnancy. This includes miscarriages and abortions.
How many antenatal appointments are sufficient for nulliparous women?
10
How many appointments are suitable for parous women?
7
What 4 pieces of information are needed to assess a woman’s VTE risk?
- Do they have a Hx of VTE?
- Any thrombophilias? (Factor V Leiden, APS etc)
- Any PMHx of relevance (stroke. heart disease, sickle cell, obesity, anaemia, DM, HTN)
- Are they a smoker?
In which months are pregnant women offered an influenza vaccination?
October to January
What can alcohol consumption in early pregnancy cause?
- Miscarriage
- SGA
- Preterm delivery
- Foetal alcohol syndrome
What is the recommendation from RCOG about flying in a; single pregnancy?
Up to 37 weeks
What is the recommendation from RCOG about flying in a; multiple pregnancy?
Up to 32 weeks
