Routine Antenatal Care

Question 1

What is a singleton pregnancy?

Answer 1

Pregnancy of one child.

Question 2

How long is the first trimester?

Answer 2

4-12 weeks

Question 3

How long is the second trimester in pregnancy?

Answer 3

13-27 weeks

Question 4

How long is the third trimester in pregnancy?

Answer 4

28 weeks to birth

Question 5

How is delivery date estimated?

Answer 5

Based on Naegle’s rule by adding 39 weeks+7 days/40 weeks from the day of the last menstrual period.

Question 6

What is the aim of antenatal care?

Answer 6

Monitor the pregnancy, prepare parents for birth and optimise choice and recognise deviations in pregnancy.

Question 7

What are the NICE guidelines for pregnancy?

Answer 7

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.

Question 8

What is the booking appointment?

Answer 8

First midwife appointment. This is where a detailed history is taken with blood tests and baseline observations. Referral to obstetrician may be done.

Question 9

What is an obstetrician?

Answer 9

Provides prenatal care to pregnant women.

Question 10

What is screened in antenatal care?

Answer 10

Infectious disease
Sickle cell and thalassemia: ideally before 10 weeks
Foetal anomaly screening programme

Question 11

What is the foetal anomaly screening programme?

Answer 11

Assesses the risk in babies for :
Down’s syndrome, Patau’s or Edward’s syndrome
Spinal bifidia
Renal agenesis
Cleft lip

Question 12

What is Edward’s syndrome?

Answer 12

Genetic condition which causes severe disability

Question 13

What is measured in a standard antenatal visit?

Answer 13

BP
Urinalysis for UTI
Abdominal examination
Auscultation for foetal heart rate

Question 14

What happens in an antenatal abdominal examination?

Answer 14

Location of uterine fundus
Distance between symphysis and fundus
Location of foetus for:
-> lie (position if breech)
-> engagement (head passes through pelvic brim)

Question 15

What is foetal engagement?

Answer 15

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

Question 16

What are the risk factors for adverse pregnancy outcomes?

Answer 16

Social factors such as smoking, alcohol, BMI, safeguarding
Chronic or acute disease
-> mental health
Proteinuria
Bleeding
Infection
High BP
Short/Large symphysis fundal height

Question 17

What is the significance of symphysis-fundal height?

Answer 17

Smaller than 34cm
-> slow growing foetus
Larger than 37cm: too much amniotic fluid

Question 18

When does early foetal miscarriage occur?

Answer 18

Foetal demise before 14 weeks

Question 19

When does late foetal miscarriage occur?

Answer 19

Foetal demise between 14 weeks and before 24 weeks

Question 20

What happens in foetal demise after 24 weeks?

Answer 20

Labour must be induced for stillbirth

Question 21

What is spontaneous miscarriage?

Answer 21

Sudden loss before 20 weeks, generally due to chromosomal abnormalities.

Question 22

What is a missed miscarriage?

Answer 22

Foetal demise where the body continues to produce pregnancy hormones, and is typically diagnosed in an ultrasound scan.

Question 23

What is a recurrent miscarriage?

Answer 23

Three or more consecutive miscarriages.

Question 24

What is an inevitable miscarriage?

Answer 24

Cervical os remains open so there is bleeding and cramping

Question 25

What is a molar pregnancy?

Answer 25

Abnormal fertilised egg with chromosomal abnormality at conception which implants and forms a non-cancerous tumour that invades the trophoblast. No formation of foetus.

Question 26

What is neonatal death?

Answer 26

Death of live born infant within the first 28 days of life

Question 27

What is the booking appointment?

Answer 27

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