Pregnancy Flashcards
Last menstrual period (LMP)
Date of the first day of the most recent menstrual period
Gestational age
Duration of the pregnancy starting from the date of the last menstrual period
Estimated date of delivery (EDD)
Estimated date of delivery (40 weeks gestation)
Gravida
Total number of pregnancies a woman has had
Para
Number of times the woman has given birth after 24 weeks gestation, regardless of whether the fetus was alive or stillborn
First trimester
Start of pregnancy until 12 weeks gestation
Second trimester
From 13 weeks until 26 weeks gestation
Third trimester
From 27 weeks gestation until birth
When do foetal movements occur
Around 20 weeks gestation, and continue until birth
Booking clinic
Before 10 weeks
With midwife
Baseline assessment and plan the pregnancy - green book
Dating scan
Between 10 and 13 + 6
Accurate gestational age is calculated from the crown rump length (CRL), and multiple pregnancies are identified
Antenatal appointment
16 weeks
Discuss results and plan future appointments
Anomaly scan
Between 18 and 20 + 6
Ultrasound to identify any anomalies
Women with gestational diabetes
Oral glucose tolerance test between 24 - 28 weeks
Women who are rhesus negative
Anti D injections at 28 to 34 weeks
Women who are rhesus negative
Anti D injections at 28 - 34 weeks
Women who have placenta praevia on the anomaly scan
Ultrasound scan at 32 weeks
Women at risk of fetal growth restriction
Serial growth scans
What happens at a routine antenatal appointment
Discuss plans for the remainder of the pregnancy and delivery
Symphysis–fundal height measurement from 24 weeks onwards
Fetal presentation assessment from 36 weeks onwards
Urine dipstick for protein for pre-eclampsia
Blood pressure for pre-eclampsia
Urine for microscopy and culture for asymptomatic bacteriuria
Vaccines on pregnancy
Whooping cough (pertussis) from 16 weeks gestation
Influenza (flu) when available in autumn or winter
MMR and live vaccines are avoided
Lifestyle advice for pregnant women
Folic acid 400mcg from before pregnancy to 12 weeks (reduces neural tube defects)
Take vitamin D supplement (10 mcg)
Avoid vitamin A supplements and eating liver or pate (vitamin A is teratogenic at high doses)
Don’t drink alcohol when pregnant (risk of fetal alcohol syndrome)
Don’t smoke
Avoid unpasteurised dairy or blue cheese (risk of listeriosis)
Avoid undercooked or raw poultry (risk of salmonella)
Continue moderate exercise but avoid contact sports
Sex is safe
Flying increases the risk of venous thromboembolism (VTE)
Place car seatbelts above and below the bump (not across it)
Side effects of alcohol in early pregnancy
Miscarriage
Small for dates
Preterm delivery
Fetal alcohol syndrome
Fetal alcohol syndrome
Microcephaly (small head)
Thin upper lip
Smooth flat philtrum (the groove between the nose and upper lip)
Short palpebral fissure (short horizontal distance from one side of the eye to the other)
Learning disability
Behavioural difficulties
Hearing and vision problems
Cerebral palsy
Side effects of smoking during pregnancy
- Fetal growth restriction (FGR)
- Miscarriage
- Stillbirth
- Preterm labour and delivery
- Placental abruption
- Pre-eclampsia
- Cleft lip or palate
- Sudden infant death syndrome (SIDS)
Flying during pregnancy
Flying is okay in uncomplicated pregnancies up to:
37 weeks in a single pregnancy
32 weeks in a twin pregnancy
Topics covered in a booking clinic
What to expect at different stages of pregnancy
Lifestyle advice in pregnancy (e.g. not smoking)
Supplements (e.g. folic acid and vitamin D)
Plans for birth
Screening tests (e.g. Downs screening)
Antenatal classes
Breastfeeding classes
Discuss mental health
What bloods are taken at the booking clinic
Blood group, antibodies and rhesus D status
FBC for anaemia
Screening for thalassaemia (all women) and sickle cell disease (women at higher risk)
Infection screening:
- HIV
- Hepatitis B
- Syphilis
Measurements taken at the booking clinic and risks of abuse
- Weight, height and BMI
- Urine for protein and bacteria
- Blood pressure
- Discuss female genital mutilation
- Discuss domestic violence
Risk Assessment at the booking clinic
Rhesus negative (book anti-D prophylaxis)
Gestational diabetes (book oral glucose tolerance test)
Fetal growth restriction (book additional growth scans)
Venous thromboembolism (provide prophylactic LMWH if high risk)
Pre-eclampsia (provide aspirin if high risk)
