Routine Antenatal Care Flashcards
What is the purpose of routine antenatal care?
Routine antenatal care aims to monitor maternal and fetal health, identify and manage complications, and provide education and support to the mother.
When is the first antenatal appointment typically scheduled?
The first appointment, called the booking appointment, is usually scheduled by 10 weeks of gestation.
What key assessments are made during the booking appointment?
Assessments include medical and obstetric history, risk factors for pregnancy complications, initial blood tests, and baseline observations.
What initial blood tests are taken during the booking appointment?
Blood tests include full blood count (FBC), blood group and Rhesus status, rubella immunity, syphilis, hepatitis B, and HIV screening.
What is the purpose of dating ultrasound?
The dating ultrasound, performed at 10-14 weeks, confirms gestational age, viability, and number of fetuses.
What is the combined screening test, and when is it offered?
The combined test, offered between 11+2 and 14+1 weeks, screens for chromosomal abnormalities (e.g., Down’s syndrome) using nuchal translucency, beta-hCG, and PAPP-A.
When is the anomaly scan performed?
The anomaly scan is performed at 18-20+6 weeks to assess fetal anatomy and detect structural abnormalities.
What is measured at every routine antenatal appointment?
Blood pressure, urine dipstick for proteinuria, and symphysis-fundal height (after 24 weeks) are measured at each appointment.
How often are routine antenatal appointments for nulliparous women?
Nulliparous women typically have 10 appointments throughout the pregnancy.
How often are routine antenatal appointments for multiparous women?
Multiparous women typically have 7 appointments, as they are considered lower risk if no complications arise.
When is gestational diabetes screening performed, and in whom?
Screening is performed at 24-28 weeks using an oral glucose tolerance test (OGTT) in women with risk factors like obesity or a history of gestational diabetes.
What vaccinations are recommended during pregnancy?
Vaccinations include influenza vaccine (any stage) and pertussis vaccine (from 16 weeks).
What is the purpose of the 28-week antenatal appointment?
At 28 weeks, the second round of blood tests is taken to check haemoglobin levels and antibodies, and anti-D prophylaxis is offered to Rhesus-negative women.
When is anti-D immunoglobulin given to Rhesus-negative women?
Anti-D is given at 28 weeks and within 72 hours of delivery if the baby is Rhesus-positive.
What additional monitoring is required for women with hypertension during pregnancy?
Women with hypertension require more frequent blood pressure checks, urine protein monitoring, and fetal growth ultrasounds.
What lifestyle advice is given during antenatal care?
Advice includes a balanced diet, folic acid supplementation, avoiding alcohol and smoking, and regular physical activity.
When is the fetal growth scan performed?
Fetal growth scans are performed if there are concerns about fetal growth, maternal conditions (e.g., hypertension), or multiple pregnancies.
What is the purpose of the 36-week antenatal appointment?
At 36 weeks, discussions about birth plans, signs of labour, and postnatal care are addressed, and fetal position is checked.
What is symphysis-fundal height (SFH), and when is it measured?
SFH measures uterine size and fetal growth from 24 weeks onward using a tape measure from the pubic symphysis to the uterine fundus.
What is the significance of reduced fetal movements?
Reduced movements may indicate fetal compromise and warrant urgent assessment with cardiotocography (CTG) or ultrasound.
What is the role of urine dipstick testing in antenatal care?
Urine dipstick checks for proteinuria (pre-eclampsia) and signs of infection or glycosuria (gestational diabetes).
When is Group B Streptococcus (GBS) screening performed?
Routine screening is not performed in the UK, but high-risk women may be tested, or it may be identified incidentally during urine or vaginal swab cultures.
What is the purpose of antenatal education classes?
Classes provide information about pregnancy, labour, delivery, breastfeeding, and caring for a newborn, and help reduce anxiety.
How is pre-eclampsia monitored in antenatal care?
Monitoring involves regular blood pressure checks, urine dipstick tests for proteinuria, and fetal growth scans if needed.
What is the importance of the 40-week antenatal appointment?
At 40 weeks, the pregnancy is reviewed, induction of labour is discussed for post-term pregnancies, and maternal and fetal wellbeing are assessed.
What are some psychological aspects addressed during antenatal care?
Psychological support is provided for anxiety, depression, and preparation for labour and parenthood.
How does antenatal care differ for high-risk pregnancies?
High-risk pregnancies require additional appointments, more frequent ultrasounds, and specialised monitoring for maternal and fetal health.
