Routine Antenatal Care

Question 1

On a booking visit what advice should be given?

Answer 1

Before 10 weeks

History taken.

Advice re:

• Diet
• Folic acid supplementation
• Things to avoid (foods, alcohol smoking)

Question 2

What investigations should be done on the booking visit?

Answer 2

BP
BMI
Urine dip

Bloods:
FBC
Haemaglobinopathies
Red cell all antibodies

Rubella
Syphyllis
Hep B
HIV

Question 3

When should the second routine visit in pregnancy be and what should be done at this visit?

Answer 3

12 week scan (between 11-14 weeks)

Gestation is calculated using crown rump length.
Discuss screening results.
Treat Hb less than 11 (or symptomatic)

Question 4

When is the anomaly scan arranged for?

Answer 4

18-20 weeks

Looking for obvious abnormalities, cardiac defects and sex.

Question 5

If a women is nulliparous when should she next come in after her anomaly scan providing everything is normal?

Answer 5

25 weeks

Simple check up.

BP, urine dip and symphysis fundal height (done at every appt following this)

Question 6

What is done at the 28week appointment?

Answer 6

Screening for anaemia and atypical red cell allo-antibodies

Anti D prophylaxis is given to rhesus -ve women

Question 7

When are the appointments in the 3rd trimester?

Answer 7

31 weeks*
34 weeks
36 weeks
38 weeks
40 weeks

Only for nulliparous women routine appt (BP, urine dip, SFH)

Question 8

What is discussed at the 34 week appointment?

Answer 8

Labour + birth

Give anti D prophylaxis second dose to rhesus -ve mothers

+ usual BP, urine dip, SFH

Question 9

What is discussed at the 36 week appointment?

Answer 9

Breast feeding
Vitamin K prophylaxis
Postnatal self care
Post natal depression

+ usual BP, urine dip, SFH

Question 10

What happens at the 38 week appointment?

Answer 10

Usual BP, urine dip, SFH

Question 11

What happens at the 40 week appointment?

Answer 11

Usual BP, urine dip, SFH + give information about prolonged labour.

Question 12

If a women hasn’t delivered what happens?

Answer 12

Membrane sweep at 41 weeks (separates the membranes of the amniotic sac surrounding your baby from your cervix.)

Induction of labour at 42 weeks

Question 13

Which of the following are recommended or not during pregnancy: Iron, folic acid, Ca, zinc, Vit A and Vit D?

Answer 13

Iron: not routinely taken only if there is anaemia

Folic acid: Routinely given 400micrograms/day for 1st trimester. Give 5mg/day in high risk (previous neural tube defect, epileptics or diabetics)

Ca: supplementation not needed diet should suffice

Zinc: increased dietary intake is sufficient

Vitamin A: teratogenic in high doses, avoid every day supplements with Vitamin A, avoid eating liver (high source of vitamin A)

Vitamin D: 10micrograms/day throughout pregnancy recommended