W2 - Antenatal Care Flashcards
what is in the normal routine pre-pregnancy counselling
Optimise maternal weight
up to date cervical smears
Stop smoking
address mental health issues
Start on 400mcg (low dose) folic acid (OTC) 3 months prior to conception (until 12 weeks gestation)
Address any maternal medical conditions PRIOR to pregnancy
what conditions need to be accounted for before pregnancy
diabetes
epilepsy
mental health
headaches and migraine
why do you need to take folic acid
neural tube development
wht is the effect of diabetes on baby
Macrosomic baby; shoulder dystocia; high caesarean section rate, neonatal jaundice
increased miscarrige rates
what should you do if someone is taking statins and ACE and wants to have a baby
stop statin and ACE
control BP with labetolol
what should you do when you have a positive pregnancy test
inform GP
book appointment with midwife at 8-10 weeks
pregnancy vitamins - vit D and folic acid
avoid unpasteurised or dangerous foods
what needs to be covered in the initial booking appointment
Personal and family history and assessment:
- Aspirin prophylaxis for pre-eclampsia
- Smoking and obesity
- Gestational diabetes
what infections need to be screened for in antenatal care
Hepatitis B
HIV
Syphillis
what blood tests need to be monitored and tested for
anaemia
blood group
Rh
haemoglobinopathies - sickle cell and thalassaemia
what trisomies are tested for and at what stage
trisomy 13, 18 and 21
tested at 10 and 13+6 weeks
what is used to test for trisomies
Nuchal Translucency; serum free βHCG and Pregnancy Associated Plasma Protein-A (PAPP-A)
AND Fetal age (CRL)
AND Maternal age
what bacteria need to be avoided
listeriosis
salmonella
what is the quadruple test and when is it offered
If dating scan late, offered16-20 weeks
Blood test:
- AFP
- Unconjugated oestriol
- hCG
- Inhibin A
what is the NIPT test
Cell-free fetal DNA (cffDNA) in maternal plasma is detectable from about 4–5 weeks ofgestation
test for trisomy 21
what are the physical characteristics of downs syndrome
Low-set eyes that slope upwards - epicanthic folds
Small mouth – tongue appears big, may stick out
Flattening at back of the head
Flattened nose bridge
Broad hands, single crease
Floppiness - loose muscle tone
Low set ears
Low birth weight
what is chronic villus sampling
prenatal test for birth defects and chromosome and genetic abnormalities
when do you do a chronic villus sampling
11-14 weeks
1-2% miscarriage risk
<1% failure
Results
PCR 3-4 working days
Micro-array approx 3 weeks
what is amniocentesis
amniotic fluid test
when is amniocentesis done
15 weeks +
½-1% miscarriage risk
PCR 3-4 working days
Micro-array approx 3 weeks
when do women get offered a foetal anatomy scan
18+6 and 20+6 weeks
what does an anatomy scan check for
Checks all organs and structures present and in the correct place
what is this abnormality
anencephaly
what is this
spina bifida
what is this
cleft lip
