Routine Antenatal Care Flashcards
What is a singleton pregnancy?
Pregnancy of one child.
How long is the first trimester?
4-12 weeks
How long is the second trimester in pregnancy?
13-27 weeks
How long is the third trimester in pregnancy?
28 weeks to birth
How is delivery date estimated?
Based on Naegle’s rule by adding 39 weeks+7 days/40 weeks from the day of the last menstrual period.
What is the aim of antenatal care?
Monitor the pregnancy, prepare parents for birth and optimise choice and recognise deviations in pregnancy.
What are the NICE guidelines for pregnancy?
Parity is the number of times a woman has given birth to a live baby. The number of appointments depends on the parity, with nulliparous women receiving more appointments.
What is the booking appointment?
First midwife appointment. This is where a detailed history is taken with blood tests and baseline observations. Referral to obstetrician may be done.
What is an obstetrician?
Provides prenatal care to pregnant women.
What is screened in antenatal care?
Infectious disease
Sickle cell and thalassemia: ideally before 10 weeks
Foetal anomaly screening programme
What is the foetal anomaly screening programme?
Assesses the risk in babies for :
Down’s syndrome, Patau’s or Edward’s syndrome
Spinal bifidia
Renal agenesis
Cleft lip
What is Edward’s syndrome?
Genetic condition which causes severe disability
What is measured in a standard antenatal visit?
BP
Urinalysis for UTI
Abdominal examination
Auscultation for foetal heart rate
What happens in an antenatal abdominal examination?
Location of uterine fundus
Distance between symphysis and fundus
Location of foetus for:
-> lie (position if breech)
-> engagement (head passes through pelvic brim)
What is foetal engagement?
Position of foetal head in the pelvis. THis is measured on a scale of 0-5 with:
0-head is on pelvic floor
5-Head is above the pelvic brim
What are the risk factors for adverse pregnancy outcomes?
Social factors such as smoking, alcohol, BMI, safeguarding
Chronic or acute disease
-> mental health
Proteinuria
Bleeding
Infection
High BP
Short/Large symphysis fundal height
What is the significance of symphysis-fundal height?
Smaller than 34cm
-> slow growing foetus
Larger than 37cm: too much amniotic fluid
When does early foetal miscarriage occur?
Foetal demise before 14 weeks
When does late foetal miscarriage occur?
Foetal demise between 14 weeks and before 24 weeks
What happens in foetal demise after 24 weeks?
Labour must be induced for stillbirth
What is spontaneous miscarriage?
Sudden loss before 20 weeks, generally due to chromosomal abnormalities.
What is a missed miscarriage?
Foetal demise where the body continues to produce pregnancy hormones, and is typically diagnosed in an ultrasound scan.
What is a recurrent miscarriage?
Three or more consecutive miscarriages.
What is an inevitable miscarriage?
Cervical os remains open so there is bleeding and cramping
What is a molar pregnancy?
Abnormal fertilised egg with chromosomal abnormality at conception which implants and forms a non-cancerous tumour that invades the trophoblast. No formation of foetus.
What is neonatal death?
Death of live born infant within the first 28 days of life
What is the booking appointment?
First appointment that happens with the midwife after diagnosis of pregnancy, which should occur before 10 weeks ideally to obtain:
A detailed social and medical history
Referral to obstetrician if necessary
Baseline observations and blood tests
