Obstetrics (4th year) Flashcards
How much folic acid is usually prescribed and how long is it taken for?
400mg
pre-conception to 12 weeks gestation
Which patients should be given 5mg of folic acid?
Diabetes
On AEDs
BMI of 30+
Anyone at an increased risk of neural tube defects
When should vitamin D be taken?
Throughout pregnancy and breast-feeding
When is booking visit done?
10-12 weeks
What is done at the booking visit/
Blood grouping and Hb levels
Screened for any haemoglobinopathies (e.g. sickle cell)
Infection - HIV/AIDS, syphilis, Hep B and C
What is carried out during screening for chromosomal abnormalities?
USS
Blood test - triple or quadruple
What is looked for in the USS for suspected Down Syndrome?
Nuchal translucency - normal is less than 3.5mm
Anything more indicates risk of chromosomal abnormality
What can be seen on the blood test of suspected Down syndrome?
Decreased PAPP-A, aFP, Oestradiol
Increased beta-hCG, inhibin-A
What is the risk of miscarriage in diagnostic testing for Down Syndrome?
CVS - 2% risk
Amniocentesis - 1%
When can diagnostic testing for Down Syndrome be carried out?
CVS - 11-13+0 weeks
Amniocentesis - After 15 weeks (needs to be enough amniotic fluid to take a sample)
In what scenario does the Anti-D injection need to be given?
Mum rhesus -ve
Baby rhesus +ve
What are some sensitising events where mum and baby’s blood may mix?
Miscarriage after 12 weeks
Abdominal trauma
At birth
When should anti-D be given? (5)
Late miscarriage (12+ weeks)
Abdominal trauma
Any bleeding
Routinely at 28 weeks
At birth (sample of baby’s blood from umbilical cord, give if Rh +ve)
What is chorionicity?
How many placentas - determined at the booking scan
What sign is seen on the USS of dichorionic-diamniotic twins?
Lambda sign
