Obstetrics Bank

Question 1

Down’s syndrome risk - maternal rage 20

Answer 1

1 in 1,500

Question 2

Down’s syndrome risk - maternal rage 30

Answer 2

1 in 800

Question 3

Down’s syndrome risk - maternal rage 35

Answer 3

1 in 270

Question 4

Down’s syndrome risk - maternal rage 40

Answer 4

1 in 100

Question 5

Down’s syndrome risk - maternal rage 45

Answer 5

1 in 50 or greater

Question 6

Booking visit - when?

Answer 6

8 - 12 weeks (ideally <10 weeks)

Question 7

Booking visit components

Answer 7

• diet, alcohol, smoking, folic acid, vitamin D, antenatal classes
• BP, urine dipstick, check BMI
• Booking bloods

Question 8

Booking bloods

Answer 8

• FBC, blood group, rhesus status, red cell alloantibodies, haemoglobinopathies
• hepatitis B, syphilis, rubella
• HIV test offered
• urine culture for asymptomatic bacteriuria

Question 9

Early scan

Answer 9

10 - 13+6 weeks

Confirm dates, exclude multiple pregnancy

Question 10

Down’s syndrome screenig + nuchal scan

Answer 10

11 - 13+6 weeks

Question 11

16 week appointment

Answer 11

Information on anomaly and blood results
If Hb <11g/dl iron
BP + urine dipstick

Question 12

Anomaly scan

Answer 12

18 - 20+6 weeks

Question 13

25 week appointment

Answer 13

Primip only

BP, dipstick, SFH

Question 14

28 week appointment

Answer 14

BP, dipstick, SFH
Second screen for anaemia and atypical red cell alloantibodies
If Hb <10.5 consider iron
First dose anti-D prophylaxis for rhesus negative women

Question 15

31 week appointment

Answer 15

Primip only

Routine care

Question 16

34 week appointment

Answer 16

Routine care
Second dose of anti-D prophylaxis to rhesus negative women
Information on labour and birth plan

Question 17

36 week appointment

Answer 17

Routine care
Check presentation - offer ECV if indicated
Information on breast feeding, vitamin K, ‘baby-blues’

Question 18

38 week appointment

Answer 18

Routine care

Question 19

40 weeks

Answer 19

Primip only
Routine care
Discussion options for prolonged pregnancy

Question 20

41 weeks

Answer 20

Routine care

Discuss labour plans and possibility of induction

Question 21

Earliest time anomaly scan can be done

Answer 21

18 weeks

Question 22

Earliest time dating scan can be done

Answer 22

8 weeks

Question 23

Earliest time nuchal scan can be done

Answer 23

11 weeks

Question 24

Congenital rubella triad

Answer 24

• Sensorineural deafness
• Eye abnormalities
• Congenital heart disease

Question 25

Congenital CMV

Answer 25

- Sensorineural deafness - Cerebral calcification - Microcephaly

Question 26

Congenital parvovirus B19

Answer 26

Hydrops fetalis + death

Question 27

Congenital toxoplasmosis

Answer 27

- Intracranial celcification - Hydrocephalus - Epilepsy in child

Question 28

Down's syndrome combined test

Answer 28

Include nuchal scan | 11 - 13+6 weeks

Question 29

Triple or quadruple test

Answer 29

Between 15 and 20 weeks

Question 30

Chickenpox during pregnancy - maternal disease

Answer 30

Increased maternal morbidity, pneumonia, hepatitis, encephalitis Oral aciclovir if present within 24hr of rash onset and >20 weeks gestation

Question 31

Chickenpox during pregnancy - fetal disease

Answer 31

- Skin scarring - Limb hypoplasia - Microcephaly - Eye defects Greatest risk before 20 weeks