Pre-conception care

Question 1

Recommendations for folic acid in pregnancy? (2)

Answer 1

400mg once daily for all pregnant women from planning pregnancy until 13 weeks
5mg once daily in certain clinical circumstances

Question 2

When should the higher dose of folic acid be recommended? (3)

Answer 2

Previous child with neural tube defect
Family history of NTD
Maternal coeliac disease/DM/obesity/taking anticonvulsants

Question 3

When should Vitamin D supplementation be considered? (3)

Answer 3

Poor diet
Limited exposure to sunlight
Black/Asian/Middle-Eastern ethnicity

Question 4

Foods to avoid in pregnancy? (4)

Answer 4

Pate and ripened/blue cheeses
Liver and vitamin A supplements
Fish- swordfish, marlin, shark. Limit tuna consumption
Avoid alcohol and limit caffeine

Question 5

How long should pregnancy be avoided for after the rubella vaccine?

Answer 5

3 months

Question 6

Employed women cannot work from what stage in pregnancy?

Answer 6

beyond 33 weeks unless informed by employer that she can continue

Question 7

Drugs which should be discontinued in pregnancy? (5)

Answer 7

NSAIDs except low dose aspirin
Tetracyclines, and TMP in first trimester and near term
ACE/ARBs
Warfarin- liaise with obstetrician
Anticonvulsants- require specialist advice

Question 8

Analgesics which can be used in pregnancy?

Answer 8

Paracetamol and codeine

Question 9

Which complementary therapy confers a possible increase in risk of premature membrane rupture?

Answer 9

Evening primrose oil

Question 10

When is best to travel during pregnancy?

Answer 10

2nd trimester

Question 11

Routine vaccination in pregnancy? (2)

Answer 11

Influenza

Combined diptheria, tetanus, pertussis, polio vaccine