Obstetrics

Question 1

Pre-conceptual Care

Answer 1

Cervical smear
Rubella status
Diabetic control
Folic acid
Medication (lamotrigine safe for epileptics)
Lifestyle - smoking, BMI, alcohol/drugs

Question 2

Booking Visit

Answer 2

8-12 weeks

Screen for complications (pregnancy, labour, puerperium)

Questions: alcohol/smoking/drugs, mental health, support, domestic abuse, FGM, social services, FHx

Decode frequency + type of antenatal care, + delivery

Question 3

Booking visit Investigations

Answer 3

BP - baseline

US - viability, CRL, multiple?

Bloods - FBC, glucose, antibodies, rubella, HIV, HBV, syphilis, HB electrophoresis (sickle cell/thalassaemia), ABO/rhesus status

Urine - glucose, protein, nitrites

Height, weight, BMI

Question 4

Antenatal Screening -Down’s

Answer 4

1st Trimester (combined): 10-14 weeks (at same time as dating US scan) -> gestation, physical development +
   -> ^ BhCG, ^ NT, low PAPP-A

2nd Trimester (quad test): 14-20 weeks
  ^BhCG, ^inhibin, low AFP, low unconjugated oestradiol

Question 5

Feral Anomaly Screening

Answer 5

Dating scan: 10-14 weeks
CRL (dating), viability. Can detect ^NT, multiple,

Anomaly scan: 18-20 weeks
Structural abnormalities (gastroschisis, exomphalos, spina biffida, cardiac)
-> plan delivery + post-care