O&G antenatal care

Question 1

8-12 weeks (ideally <10 weeks)

Answer 1

Booking visit

• general information e.g. diet, alcohol, smoking, folic acid, vitamin D, antenatal classes
• BP, urine dipstick, check BMI

Booking bloods/urine

• FBC, blood group, rhesus status, red cell alloantibodies, haemoglobinopathies
• hepatitis B, syphilis
• HIV test is offered to all women
• urine culture to detect asymptomatic bacteriuria

Question 2

10 - 13+6 weeks

Answer 2

Early scan to confirm dates, exclude multiple pregnancy

Question 3

11 - 13+6 weeks

Answer 3

Down’s syndrome screening including nuchal scan

Question 4

16 weeks

Answer 4

• Information on the anomaly and the blood results.
• If Hb < 11 g/dl consider iron
• Routine care: BP and urine dipstick

Question 5

18 - 20+6 weeks

Answer 5

Anomaly scan

Question 6

25 weeks (only if primip)

Answer 6

Routine care: BP, urine dipstick, symphysis-fundal height (SFH)

Question 7

28 weeks

Answer 7

• Routine care: BP, urine dipstick, SFH
• Second screen for anaemia and atypical red cell alloantibodies
• If Hb < 10.5 g/dl consider iron
• First dose ofanti-Dprophylaxis to rhesus negative women

Question 8

31 weeks (only if primip)

Answer 8

Routine care as above

Question 9

34 weeks

Answer 9

• Routine care as above
• Second dose ofanti-Dprophylaxis to rhesus negative women (depending on trust, sometimes only one dose)
• Information on labour and birth plan

Question 10

36 weeks

Answer 10

• Routine care as above
• Check presentation -offer external cephalic version if indicated
• Information on breast feeding, vitamin K, ‘baby-blues’

Question 11

38 weeks

Answer 11

Routine care as above

Question 12

40 weeks (only if primip)

Answer 12

• Routine care as above

- Discussion about options for prolonged pregnancy

Question 13

41 weeks

Answer 13

• Routine care as above

- Discuss labour plans and possibility of induction