Routine antenatal care in pregnancy

Question 1

A normal pregnancy is taken to begin from which specific date?

Answer 1

The woman’s last period (LMP)

Question 2

Aims of antenatal care

Answer 2

1. Monitor pregnancy
   - Maintenance of the mother’s physical, mental and social well-being
2. Develop a relationship between HCP and families
3. Deliver information that promotes choice
4. Recognise deviations from the norm
   - Screening for conditions and diseases
5. Raise awareness of public health issues
6. Prepare parents for birth and beyond
   - Provide safe delivery for mother and educate mother about the physiology of pregnancy, and breastfeeding etc..
   - Teach the mother about childcare, nutrition, sanitation and hygiene

Question 3

Which baseline observations would be carried out at the first booking appointment?

Answer 3

1. Pulse
2. BP
3. Blood test
4. Dipstick and urinalysis

Question 4

What happens at a standard antenatal visit?

Answer 4

1. BP
   - Pre-eclampsia
2. Urinalysis
   - >risk of UTI during pregnancy
3. Abdominal examination
4. Auscultation of foetal heart
5. Oedema
   - Pre-eclampsia
6. Discussion of test results
7. Wellbeing discussion

Question 5

Give examples of what the antenatal screening process is looking for

Answer 5

1. Infectious diseases

2. Sickle cell and thalassaemia

Question 6

What is the foetal anomaly screening programme? Which conditions are screened for?

Answer 6

Screening for 11 physical conditions as part of the 20-week scan is offered to all pregnant women and takes place between 18⁺⁰ and 20⁺⁶ weeks of pregnancy. Scans can be completed up to 23⁺⁰ weeks of pregnancy

1. Edward’s syndrome: trisomy 18
2. Patau’s syndrome: trisomy 13
3. Anencephaly
4. Spina bifida
5. Cleft lip
6. Congenital diaphragmatic hernia
7. Gastroschisis
8. Exomphalos
9. Congenital heart disease
10. Bilateral renal agenesis
11. Lethal skeletal dysplasia

Question 7

Risk factors for adverse outcomes to pregnancy

Answer 7

1. Chronic or acute disease including mental health
2. Social factors
   - BMI
   - Smoking
   - Safeguarding
3. Findings from observations in antenatal care
   - BP
   - Proteinuria
   - SFH (IUGR)
4. Bleeding
5. Infection

Question 8

Definition of an early miscarriage

Answer 8

Fetal demise prior to 14/40

Question 9

Definition of a late miscarriage

Answer 9

Foetal demise between 14/40 and 23+6

Question 10

What is a molar pregnancy?

Answer 10

Abnormal placental development, no foetus is formed

Question 11

Early vs later neonatal death

Answer 11

Early = neonate born after 20/40 and dies within the first 7 days
Late = dies between 7 and 28 days