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Obs & Gynae (Obs) > Routine Antenatal Care > Flashcards

Routine Antenatal Care Flashcards

1
Q

The booking appointment should ideally be completed by when?

A

10 weeks

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2
Q

The fundus of a pregnant uterus is usually palpable by when for a singleton pregnancy?

A

12 weeks

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3
Q

What urine tests should be performed at the booking visit?

A

Urinalysis and MSSU for microscopy, culture and sensitivity

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4
Q

At booking, what conditions should a mother be screened for?

A

Anaemia, HIV, hep B, syphilis and rubella

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5
Q

When should the early ultrasound scan be performed?

A

11 - 14 weeks

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6
Q

What part of the early ultrasound scan can be used for Down’s syndrome screening?

A

Nuchal translucency

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7
Q

What measurement on the early ultrasound scan can be used to assess gestational age between 10 and 13+6 weeks?

A

Crown rump length

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8
Q

If the crown rump length is > 84mm or if the pregnancy is beyond 14 weeks, what measurement should be used to estimate the gestational age?

A

Head circumference

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9
Q

What are the most important parts of a history that should be discussed at every antenatal visit?

A

Physical and mental health and foetal movements

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10
Q

What investigations should be performed at every antenatal visit?

A

BP and urinalysis

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11
Q

Symphyseal fundal height should be measured at every antenatal visit from what gestation?

A

24 weeks

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12
Q

At what gestation is the foetal anomaly scan performed?

A

18 - 20+6 weeks

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13
Q

When should gestational diabetes screening be done in women who are deemed to be high risk?

A

24 - 28 weeks

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14
Q

When should a second blood test for anaemia and atypical antibodies be performed in routine antenatal screening?

A

28 weeks

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15
Q

When should the first dose of anti-D be offered to Rh negative women?

A

28 weeks

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16
Q

If a woman is found to have a low lying placenta at the anomaly scan, when should they undergo a second scan?

A

32 weeks

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17
Q

When should the second dose of anti-D be offered to Rh negative women?

A

34 weeks

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18
Q

What additional examination should be performed at the 36 week antenatal visit?

A

Assess position of the baby, and offer external cephalic version if the baby is in breech position

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19
Q

What should be offered to women who have not yet given birth by 41 weeks?

A

Membrane sweep and induction of labour

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20
Q

What is the most common cause of anaemia in pregnancy and how can this be treated?

A

Iron deficiency- treat with iron supplements

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21
Q

If an HIV test is decline at booking, it should be offered again to women at which antenatal visit?

A

28 weeks

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22
Q

When can the sex of the baby be determined?

A

At the 18 - 20+6 week anomaly scan

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23
Q

When can the ‘combined test’ for Down’s syndrome be performed?

A

11 - 14 weeks

24
Q

What are the two areas of the combined test for Down’s syndrome screening?

A

Ultrasound scan for nuchal translucency and bloods for PAPP-A and HCG

25
Q

When the crown rump length is 45-84mm, what would a normal nuchal translucency be?

A

< 3.5

26
Q

What happens to concentrations of PAPP-A and HCG in Down’s syndrome?

A

PAPP-A is low and HCG is high

27
Q

At what gestation can second trimester screening for Down’s syndrome be done?

A

15 - 20 weeks

28
Q

What blood tests are measured in second trimester screening for Down’s syndrome?

A

HCG, AFP, unconjugated oestradiol, inhibin-A

29
Q

Which blood tests in second trimester screening will be high in Down’s syndrome?

A

HCG and inhibin-A

30
Q

Which blood tests in second trimester screening will be low in Down’s syndrome?

A

AFP and unconjugated oestradiol

31
Q

An isolated raised AFP is suggestive of what complication?

A

Neural tube defect

32
Q

The results of both first and second trimester Down’s syndrome screening are combined with what other two factors to create a personalised risk?

A

Gestational age and maternal age

33
Q

Further investigation is required if Down’s syndrome screening is deemed high risk. A likelihood of more than what is considered to be high risk?

A

> 1 in 150

34
Q

What method is used to obtain a sample for Down’s syndrome testing from 11-14 weeks?

A

Chorionic villus sampling

35
Q

What method is used to obtain a sample for Down’s syndrome testing > 15 week?

A

Amniocentesis

36
Q

Which contains a slightly higher risk of iatrogenic miscarriage- chorionic villus sampling or amniocentesis?

A

Chorionic villus sampling

37
Q

The sample obtained for Down’s syndrome testing from CVS or amniocentesis is sent for analysis via what? How soon should the results come back?

A

PCR, in 48 hours

38
Q

Non-invasive prenatal testing can be used for Down’s syndrome screening after what gestation?

A

10 weeks

39
Q

Foetal growth and wellbeing is assessed at each antenatal visit by assessing what two things?

A

Foetal movements and symphyseal-fundal height

40
Q

If the foetal growth is less than expected at an antenatal visit, what investigation should be done next?

A

US assessment of foetal weight and amniotic fluid volume

41
Q

When measuring symphyseal-fundal height, the fundus should reach the umbilicus by what gestation?

A

20 weeks

42
Q

When measuring symphyseal-fundal height, the fundus should reach the xiphisternum by what gestation?

A

36 weeks

43
Q

Foetal movements are usually felt from around what gestation?

A

20 weeks

44
Q

If a change in foetal movements is reported, what further investigation is required?

A

CTG +/- ultrasound

45
Q

If breech presentation is suspected on abdominal palpation, what investigation should be used to confirm this?

A

Ultrasound

46
Q

What maternal condition should be being screened for at the foetal anomaly scan?

A

Placenta praevia

47
Q

What condition is being screened for by doing urinalysis and BP at every antenatal visit?

A

Pre-eclampsia

48
Q

What are some conditions predisposing to pre-eclampsia?

A

Hypertension, diabetes, CKD, autoimmune disease

49
Q

Any woman who is deemed high risk for pre-eclampsia should be given what medication?

A

75mg aspirin daily from 12 weeks onwards

50
Q

What is the screening test for gestational diabetes?

A

2 hour oral glucose tolerance test

51
Q

All women should take what supplement for the first 12 weeks of pregnancy? What is the purpose of this?

A

Folic acid, to reduce the risk of neural tube defects

52
Q

What is the normal dose of folic acid?

A

0.4mg

53
Q

What dose of folic acid is given to women who are deemed high risk of having a baby with neural tube defects?

A

5mg

54
Q

Other than folic acid, what other vitamin supplement is routinely recommended to pregnant women?

A

10mcg vitamin D

55
Q

Women who smoke in pregnancy undergo what additional tests?

A

Carbon monoxide testing and serial growth scans

Obs & Gynae (Obs) (10 decks)

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