Pregnancy

Question 1

Last menstrual period (LMP)

Answer 1

Date of the first day of the most recent menstrual period

Question 2

Gestational age

Answer 2

Duration of the pregnancy starting from the date of the last menstrual period

Question 3

Estimated date of delivery (EDD)

Answer 3

Estimated date of delivery (40 weeks gestation)

Question 4

Gravida

Answer 4

Total number of pregnancies a woman has had

Question 5

Para

Answer 5

Number of times the woman has given birth after 24 weeks gestation, regardless of whether the fetus was alive or stillborn

Question 6

First trimester

Answer 6

Start of pregnancy until 12 weeks gestation

Question 7

Second trimester

Answer 7

From 13 weeks until 26 weeks gestation

Question 8

Third trimester

Answer 8

From 27 weeks gestation until birth

Question 9

When do foetal movements occur

Answer 9

Around 20 weeks gestation, and continue until birth

Question 10

Booking clinic

Answer 10

Before 10 weeks

With midwife

Baseline assessment and plan the pregnancy - green book

Question 11

Dating scan

Answer 11

Between 10 and 13 + 6

Accurate gestational age is calculated from the crown rump length (CRL), and multiple pregnancies are identified

Question 12

Antenatal appointment

Answer 12

16 weeks

Discuss results and plan future appointments

Question 13

Anomaly scan

Answer 13

Between 18 and 20 + 6

Ultrasound to identify any anomalies

Question 14

Women with gestational diabetes

Answer 14

Oral glucose tolerance test between 24 - 28 weeks

Question 15

Women who are rhesus negative

Answer 15

Anti D injections at 28 to 34 weeks

Question 16

Women who are rhesus negative

Answer 16

Anti D injections at 28 - 34 weeks

Question 17

Women who have placenta praevia on the anomaly scan

Answer 17

Ultrasound scan at 32 weeks

Question 18

Women at risk of fetal growth restriction

Answer 18

Serial growth scans

Question 19

What happens at a routine antenatal appointment

Answer 19

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

Question 20

Vaccines on pregnancy

Answer 20

Whooping cough (pertussis) from 16 weeks gestation

Influenza (flu) when available in autumn or winter

MMR and live vaccines are avoided

Question 21

Lifestyle advice for pregnant women

Answer 21

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)

Question 22

Side effects of alcohol in early pregnancy

Answer 22

Miscarriage

Small for dates

Preterm delivery

Fetal alcohol syndrome

Question 23

Fetal alcohol syndrome

Answer 23

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

Question 24

Side effects of smoking during pregnancy

Answer 24

• Fetal growth restriction (FGR)
• Miscarriage
• Stillbirth
• Preterm labour and delivery
• Placental abruption
• Pre-eclampsia
• Cleft lip or palate
• Sudden infant death syndrome (SIDS)

Question 25

Flying during pregnancy

Answer 25

Flying is okay in uncomplicated pregnancies up to:

37 weeks in a single pregnancy
32 weeks in a twin pregnancy

Question 26

Topics covered in a booking clinic

Answer 26

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

Question 27

What bloods are taken at the booking clinic

Answer 27

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

Question 28

Measurements taken at the booking clinic and risks of abuse

Answer 28

• Weight, height and BMI
• Urine for protein and bacteria
• Blood pressure
• Discuss female genital mutilation
• Discuss domestic violence

Question 29

Risk Assessment at the booking clinic

Answer 29

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)