Routine antenatal care Flashcards

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Q

Routine antenatal care

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Antenatal care: timetable

NICE issued guidelines on routine care for the healthy pregnant woman in March 2008.
They recommend:
-10 antenatal visits in the first pregnancy if uncomplicated
-7 antenatal visits in subsequent pregnancies if uncomplicated
-women do not need to be seen by a consultant if the pregnancy is uncomplicated

> 8-12 weeks:
Booking visit (Lifestyle, Bloods & Urine)
Booking blood/urine:
-1st screen for anemia and atypical red cell alloantibodies
10-13+6 weeks: Early Date scan
11-13+6 weeks: Nuchal scan for Down’s syndrome
16 weeks: Anomaly info & the blood results
18-20+6 weeks: Anomaly scan
25 weeks (only if primip) Routine & SFH
28 weeks:
-1st anti-D prophylaxis for rhesus negative
-2nd screen for anaemia and atypical red cell alloantibodies
31 weeks (only if primip) Routine & SFH
34 weeks:
-2nd anti-D prophylaxis for rhesus negative
36 weeks: Check presentation - offer external cephalic version if indicated
38 weeks: Routine care
40 weeks: (only if primip)
Routine care as above
Discussion about options for prolonged pregnancy
41 weeks:
Routine care as above
Discuss labour plans and possibility of induction

NICE recommend:
10 antenatal visits in the first pregnancy if uncomplicated
7 antenatal visits in subsequent pregnancies if uncomplicated
women do not need to be seen by a consultant if the pregnancy is uncomplicated

8 - 12 weeks (ideally < 10 weeks) Booking visit:
general information e.g. diet, alcohol, smoking, folic acid, vitamin D, antenatal classes
BP, urine dipstick, check BMI

Booking bloods/urine:
FBC, blood group, rhesus status, red cell alloantibodies, haemoglobinopathies
hepatitis B, syphilis
HIV test is offered to all women
urine culture to detect asymptomatic bacteriuria

10 - 13+6 weeks
Early scan to confirm dates, exclude multiple pregnancy

11 - 13+6 weeks
Down’s syndrome screening including nuchal scan

16 weeks
Information on the anomaly and the blood results. If Hb < 11 g/dl consider iron
Routine care: BP and urine dipstick

18 - 20+6 weeks Anomaly scan

25 weeks (only if primip)
Routine care: BP, urine dipstick, symphysis-fundal height (SFH)

28 weeks
Routine care: BP, urine dipstick, SFH
Second screen for anaemia and atypical red cell alloantibodies. If Hb < 10.5 g/dl consider iron
First dose of anti-D prophylaxis to rhesus negative women

31 weeks (only if primip) Routine care as above

34 weeks
Routine care as above
Second dose of anti-D prophylaxis to rhesus negative women*
Information on labour and birth plan

36 weeks
Routine care as above
Check presentation - offer external cephalic version if indicated
Information on breast feeding, vitamin K, ‘baby-blues’

38 weeks Routine care as above

40 weeks (only if primip)
Routine care as above
Discussion about options for prolonged pregnancy

41 weeks
Routine care as above
Discuss labour plans and possibility of induction

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