Pregnancy timeline Flashcards
first trimester?
start of pregnancy until 12 weeks gestation
second trimster?
13- 26 week gestation
third trimester?
27 weeks until birth (40 weeks)
when is the first appointment (the booking visit)?
done before 10 weeks gestation
what screening is offered at the booking visit (first appointment done before 10 weeks gestation)?
Trisomy screening
T21 (Down syndrome)
T18 (Edwards)
T13 (Patau’s)
not performed at this point
performed between 11 and 14 weeks gestation
what is screened in trisomy screening?
Trisomy 21 (Down’s)
Trisomy 18 (Edward’s)
Trisomy 13 (Patau’s)
when is trisomy screening done?
between 11 and 14 weeks gestation
when is dating scan (first scan) done?
between weeks 10 and 13 + 6
what is done in the dating scan?
-an accurate gestation age is calculated (using crown rump length)
-check for viability
-check for single/ multiple pregnancies
-check for any major structural abnormalities
-offer trisomy screening
what appointment is had at 16 weeks and what is done?
antenatal appointment
-discuss results and plan future appointments
when is the anomaly scan?
between weeks 18 and 20 + 6
what is placenta praevia?
when placenta is low lying in uterus and covers all or part of cervix
what is done in anomaly scan?
-USS to identify any anomalies such as heart conditions
-Look for anencephaly, spina bifida, cleft lip. Diaphragmatic hernia, gastroschisis, exomphalos, serious cardiac abnormalities, bilateral renal agenesis, lethal skeletal dysplasia, Edwards syndrome, pataus syndrome
Look for placental site – placenta praevia is when placenta is low lying in uterus and covers all or part of the cervix
Offer trisomy testing again – low risk doesn’t exclude and high risk doesn’t 100% mean have it
When are antenatal appoinments?
10 weeks (booking visit)
11- 13+ 6 weeks (dating scan)
16 weeks
18- 20 + 6 weeks (anomaly scan)
25, 28, 31, 34, 36, 38, 40, 41, 42 weeks
and additional appointments if necesary
at what week is it important to know babys position in utero?
36 weeks
-want to check baby isnt breech
when is oral glucose tolerance test done if at risk of gestational diabetes?
24 - 28 weeks
when are anti D injections given to rhesus negative women?
28 and 34 weeks
what additional scan is given to women with placenta praevia?
USS at 32 weeks
when is whooping cough/ pertussis vaccine offered to pregnant women?
16 weeks
what vaccines should be avoided in pregnant women?
live vaccines such as MMR
when is chorionic villus sampling done?
11-14 weeks
when is amniocentesis done
15 weeks or >15 weeks
what is NIPT?
-Form of secondary screening test
-Blood sample
Placenta releases DNA into mothers blood, which represent foetus DNA, look at this and see if there’s a slight excess of a certain chromosome
when should folic acid be taken in pregnancy?
Take folic acid 400mcg from before pregnancy to 12 weeks (as this is when brain and spinal cord are fully formed in foetus)
when should more folic acid be taken in pregnancy?
5mg (higher dose) in:
-obese
-diabetic
-history of baby with neural tubal defect or FH
-on antiepileptics
when should Vit D be given?
10mcg through pregnancy and continue if breast feeding
