O&G - Normal and Complex antenatal care

Question 1

What tests are done at booking appointment? (4)

Answer 1

1. FBC: anaemia
2. blood group: rhesus status, anti-D requirement
3. haemoglobinopathies
4. infection screen: HIV, Hep B, Syphilis

Question 2

all pregnant women in England are offered screening for:

Answer 2

Down’s (21)

Edward’s (18)

Pataus (13)

Question 3

when is the dating scan performed?

Answer 3

• between 8 and 14 weeks

provides info on
- viability, confirms intrauterine pregnancy, EDD, single or multiple

Question 4

when is anaomly scan performed?

Answer 4

between 18 and 20+6 weeks

Question 5

low Hb and low MCV in blood results may indicate?

Answer 5

• microcytic anaemia

- commence iron thera[y and repeat FBC at 4 weeks

Question 6

What nutritional supplements are recommended in pregnancy?

Answer 6

• folic acid for first 12 weeks, prevents neural tube defects
• vitamin D supplements
• AVOID VITAMIN A

Question 7

what advice could be given to a pregnant lady suffering with morning sickness and heart burn?

Answer 7

• nausea and vomiting are common, should subside by 16-20 weeks
• non pharmacological: ginger
• antiemetics: cyclizine
• hyperemesis? hospital admission for rehydration
• heartburn: omeprazole, ranitidine, gaviscon

Question 8

what tests are performed at routine midwife appointment?

Answer 8

1. Urine dip: proteinuria, pre-eclampsia, glucosuria, asymptomatic bacteruria
2. BP: gestational HTN, pre-eclampsia
3. fundal height
4. abdominal palpation to determine lie
5. auscultation of fetal heart

Question 9

Why might gestational diabetes occur?

Answer 9

• insulin resistance

- promoted by placental and pregnancy hormones such as human placental lactogen, progesterone and cortisol