Pregnancy timeline

Question 1

first trimester?

Answer 1

start of pregnancy until 12 weeks gestation

Question 2

second trimster?

Answer 2

13- 26 week gestation

Question 3

third trimester?

Answer 3

27 weeks until birth (40 weeks)

Question 4

when is the first appointment (the booking visit)?

Answer 4

done before 10 weeks gestation

Question 5

what screening is offered at the booking visit (first appointment done before 10 weeks gestation)?

Answer 5

Trisomy screening
T21 (Down syndrome)
T18 (Edwards)
T13 (Patau’s)

not performed at this point
performed between 11 and 14 weeks gestation

Question 6

what is screened in trisomy screening?

Answer 6

Trisomy 21 (Down’s)
Trisomy 18 (Edward’s)
Trisomy 13 (Patau’s)

Question 7

when is trisomy screening done?

Answer 7

between 11 and 14 weeks gestation

Question 8

when is dating scan (first scan) done?

Answer 8

between weeks 10 and 13 + 6

Question 9

what is done in the dating scan?

Answer 9

-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

Question 10

what appointment is had at 16 weeks and what is done?

Answer 10

antenatal appointment
-discuss results and plan future appointments

Question 11

when is the anomaly scan?

Answer 11

between weeks 18 and 20 + 6

Question 12

what is placenta praevia?

Answer 12

when placenta is low lying in uterus and covers all or part of cervix

Question 13

what is done in anomaly scan?

Answer 13

-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

Question 14

When are antenatal appoinments?

Answer 14

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

Question 15

at what week is it important to know babys position in utero?

Answer 15

36 weeks
-want to check baby isnt breech

Question 16

when is oral glucose tolerance test done if at risk of gestational diabetes?

Answer 16

24 - 28 weeks

Question 17

when are anti D injections given to rhesus negative women?

Answer 17

28 and 34 weeks

Question 18

what additional scan is given to women with placenta praevia?

Answer 18

USS at 32 weeks

Question 19

when is whooping cough/ pertussis vaccine offered to pregnant women?

Answer 19

16 weeks

Question 20

what vaccines should be avoided in pregnant women?

Answer 20

live vaccines such as MMR

Question 21

when is chorionic villus sampling done?

Answer 21

11-14 weeks

Question 22

when is amniocentesis done

Answer 22

15 weeks or >15 weeks

Question 23

what is NIPT?

Answer 23

-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

Question 24

when should folic acid be taken in pregnancy?

Answer 24

Take folic acid 400mcg from before pregnancy to 12 weeks (as this is when brain and spinal cord are fully formed in foetus)

Question 25

when should more folic acid be taken in pregnancy?

Answer 25

5mg (higher dose) in:
-obese
-diabetic
-history of baby with neural tubal defect or FH
-on antiepileptics

Question 26

when should Vit D be given?

Answer 26

10mcg through pregnancy and continue if breast feeding