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1. Reproduction > Screening in Pregnancy > Flashcards

Screening in Pregnancy Flashcards

1
Q

What is the equation for sensitivity?

A

true positive/ (positive + false negative)

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2
Q

What is the equation for specificity?

A

true negative/ (negative + false positive)

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3
Q

What are the two possible pathways in pregnancy?

A

green

red

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4
Q

What is the green pathway?

A

midwife led

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5
Q

What is the red pathway?

A

obstetrician led

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6
Q

At what date does the booking visit + first dating scan happen?

A

10-13+6 weeks

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7
Q

At what date does the follow up scan happen?

A

18-20 weeks

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8
Q

What is the mother checked for at the first booking visit?

A

Take medical, surgical, drug, obstetric, family and social history to identify additional care needs.

Discuss mental health

Measure BP

Blood tests - FBC, blood group, rhesus status, check for infection [HIV, hepatitis C, B, syphilis) and haemoglobinapathies (thalasseamias, sickle cell disease).

Check immunity against chicken pox, rubella etc

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9
Q

What is the baby checked for at the first booking visit?

A

Dating scan - Ultrasound scan to check for viability, determine gestation using fetal pole measurements, intrauterine pregnancy, number of pregnancies

Nuchal translucency

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10
Q

What is Naegeles rule?

A

predicts an estimated due date based on last menstrual period then + 90 weeks and 7 days (280 days)

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11
Q

What is screened for at the 20 week scan?

A

structural fetal anomalies (anomaly scan) such as cleft palate, heart anomalies, limb defects, CNS defects, renal abnormalities

Placental site position to aid in delivery

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12
Q

What foetal anomalies are incompatible with life?

A

anencephaly

major heart defects

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13
Q

If at the 20 week scan there is a low lying placenta, when should the mother be rescanned?

A

32 weeks

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14
Q

What is a normal nuchal thickness at the booking scan?

A

<3.5mm

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15
Q

What is done to screen for aneuploidy in those that have missed their first trimester screening?

A

screening option from 15-20+6 weeks

Amniocentesis and Chorionic Villus sampling

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16
Q

What biochemical markers are screened for in the aneuploidy screening?

A

Alpha feto protein (AFP)
HCG
Unconjugated oestradiol
inhibin A

17
Q

How are HCG and AFP changed in downs syndrome?

A

reduced

18
Q

When is amniocentesis performed? What is its miscarriage rate?

A

15 weeks

1%

19
Q

When is chorionic villus sampling performed? What is its miscarriage rate?

A

12 weeks

2%

20
Q

When is sickle haemoglobin screened for?

A

booking scan

21
Q

What is the inheritance pattern of sickle haemoglobin?

A

autosomal recessive

22
Q

When is maternal anaemia screened for?

A

booking and 28 weeks

need to optimise Hb before birth to prevent haemorrhage

23
Q

When is Rhesus D screened for?

A

28 weeks

24
Q

When would the two dose of Rhesus D be given?

A

28 weeks and 34 weeks

25
Q

In what situation would Anti D-immunoglobulins be given to a mother within 72 hours?

A 
delivery of a Rh +ve foetus 
termination of pregnancy 
miscarriage if gestation >12 weeks
ectopic pregnancy if managed surgically
antepartum haemorrhage
abdominal trauma
amniocentesis and CVS
fetal blood sampling
26
Q

What is the test called that diagnoses a foetus’ Rhesus status?

A

Coombs test

27
Q

How would a baby affected by Rhesus appear?

A 
oedema
jaundice
anaemia
heart failure
kernicterus
28
Q

What is the pathogenesis behind Rhesus?

A

Rh +ve father and Rh-ve mother BUT Rh +ve baby
Babies blood enters the mothers bloodstream and causes antibodies to be formed against the baby
Rh antibodies attack the babies blood cells causing Rh disease

29
Q

What is the diagnostic criteria for gestational diabetes?

A

fasting glucose of >5.6mmol/litre OR

2 hour plasma glucose of >7.8mmol/litre

30
Q

How is gestational diabetes diagnosed?

A

2 hour 75g oral glucose tolerance test (OGTT)

1. Reproduction (50 decks)

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