Obs: Antenatal care

Question 1

At what time should pregnant woman be in contact with healtcare during normal pregnancy

Answer 1

10 appt for nulliparous, 7 for parous

ASAP-first contact -

Before 10w- booking appt

10-14- Dating scan

16w -

Question 2

What should be discussed at a womans first contact with healthcare

Answer 2

Info on diet *folic acid, vit D (pregnicare)
Nutrition, diet and food hygene (avoid cheese (listeria), cats (toxo), etc)
Lifestyle smoke, alcohol

Question 3

What should be discussed at a womans second contact with healthcare (<10w)

Answer 3

Check BP, BMI, RF for GDM , PET, psych hx
Info on - how baby will grow
pelvic floor exercises
Antenatal screenings
Preg care pathway, place of birth, breast feed etc

Screening- BT- Group, Rhesus, aneamia, HepB, HIV, syphillis
Urine - proteinuria and bacturia (MCS)
Dating Scan (at 10-14)
Downs combined scan - PAPPA, nuchal thickness,

Question 4

What happens at 10-14w in antental care

Answer 4

Dating scan-nuchal thickness,

gestiation, viabilit, multiparity

Question 5

What happens at 16w in antental care

Answer 5

R/v and discuss screening test results
measure BP/proteinura
Iron supplements
OGTT if previous GDM

Question 6

What happens at 18-20w in antenatal care

Answer 6

Anomaly scan - structural, placennta loquation, liquor volume
if low placenta- repeat at 32w

Question 7

What happens at 28w in antenatal care

Answer 7

Measure BP and proteinuria
SFH (should be around 29)
Secon aneamia screen
OGTT if risk (not previous GDM)
RHESUS D prophylaxis dose (either one or two)

Question 8

What are the 2 extra meeting for nulliparous woman in antenatal care

Answer 8

25w- another BP and proteinuria + SFH

and 31w - Discuss 28w results, BP, protein and SFH

Question 9

What happens at 34w in antenatal care

Answer 9

Second dose of rh D
R/v 28w results
BP/protein/SFH
Info about labour and birth

Question 10

What happens at 36w in antenatal care

Answer 10

assess presentation via USS
BP/urine/SFH
ECV if needed
Info on postnatal care and breastfeedign

Question 11

What happens 38-40w in antental care

Answer 11

BP, urine and SFH checked at 38, 40, 41w

offer IOL for >40w

Question 12

what happens at 42w in antenatal care

Answer 12

IOL offered at 41w, so for 42w refusing offer at least twice weekly CTG monitor and USS

Question 13

when do you give RhD prophylaxis normally

Answer 13

at 28 and 34w

Or 1dose at 28w