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Phase 3a - Women's Health > Women's Health : Management of Uncomplicated Pregnancy > Flashcards

Women's Health : Management of Uncomplicated Pregnancy Flashcards

1
Q

How many routine appointments are there for parous women?

A

Eight appointments

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2
Q

How many routine appointments are there for nulliparous women?

A

Eleven appointments

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3
Q

If the woman has not yet delivered, what other appointment option is there?

A

There is also the possibility of a 41 week appointment if the woman has not yet delivered.

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4
Q

Screening offered before 10+0 weeks?

A

Height, weight, BP, urinalysis, Assess risk for GDM, pre-eclampsia, FGR, VTE, FGM

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5
Q

Vaccines offered before 10+0 weeks?

A

Influenza, pertussis

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6
Q

When does the dating scan happen?

A

11+2 to 14+1 weeks

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7
Q

Purpose of the dating scan?

A

Estimate gestational age, assess for multiple pregnancy, foetal anomally screening

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8
Q

What happens at 16 weeks?

A

Blood pressure and urinanalysis

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9
Q

When does the anatomy scan happen?

A

18+0 to 20+6 weeks

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10
Q

What is assessed during the anatomy scan?

A

Foetal anatomy (More detailed scan to assess for various anatomical anomalies e.g. anencephaly, meningocele, exomphalos - part of screening programme.
- Assess position of placenta (low-lying, praevia)
- Foetal movements typically felt at this point)

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11
Q

What is assessed with the position of the placenta?

A

Low-lying, praevia

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12
Q

When are foetal movements typically felt?

A

18+0 to 20+6 weeks

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13
Q

What assessments are done at 25 weeks?

A

Blood pressure and urinalysis + Symphyseal-fundal height (SFH)

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14
Q

What assessments are done at 28 weeks?

A

Height, weight, BP, urinalysis, SFH

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15
Q

What prophylaxis is given to Rhesus negative women at 28 weeks?

A

Anti-D (first dose)

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16
Q

What is assessed at 31 and reassessed at 34 weeks?

A

BP, urinalysis, SFH

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17
Q

What is done at 34 weeks for Rh-ve women?

A

Anti-D (second dose)

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18
Q

36 weeks check-up includes?

A

Blood pressure, urinalysis, SFH

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19
Q

What to assess at 36 weeks?

A

Breech presentation (Palpate abdomen to assess for breech presentation)

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20
Q

38 weeks check-up includes?

A

Blood pressure, urinalysis, SFH

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21
Q

Discussion at 38 weeks?

A

Possibility of prolonged pregnancy and its management

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22
Q

40 weeks check-up includes?

A

Blood pressure, urinalysis, SFH

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23
Q

41 weeks check-up includes?

A

Blood pressure, urinalysis, SFH

24
Q

When is induction of labour offered?

A

41 weeks

25
Q

What are the 3 extra routine appointments for nulliparous women?

A

25 week appointment. 31 weeks and 40 weeks

26
Q

When is BP, Urinalysis and SFH checked throughout pregnancy?

A

Every 3 weeks - starting at 25 weeks . Then every 2 weeks - starting at 34 weeks. Also at 41 weeks

27
Q

What are the 3 elements of pregnancy screening in the UK?

A

infectious diseases, sickle cell & thalassaemia, and foetal anomaly

28
Q

When are all the screening tests offered?

A

Booking visit (Before 10+0 weeks)

29
Q

Which infectious diseases are screened for in pregnancy?

A

HIV, Syphillis, Hepatitis B

30
Q

What is the risk of developing HIV in pregnancy?

A

25% risk MTC transmission if untreated

31
Q

What are the risks associated with Syphilis in pregnancy?

A

risk of miscarriage, stillbirth, congenital syphilis

32
Q

What is the risk of developing Hep B in pregnancy?

A

70-90% risk MTC transmission if HBeAg positive

33
Q

What are the risks associated with sickle cell disease in pregnancy?

A

immunosuppression, risk of miscarriage, anaemia, vaso-occlusive crises

34
Q

What are the risks associated with thalassaemia in pregnancy?

A

Anaemia

35
Q

Which Foetal Anomaly’s are screened for?

A

Down’s Syndrome, Edward’s Syndrome, Patau’s Syndrome

36
Q

Chromosome abnormality associated with Down’s Syndrome

A

Trisomy 21

37
Q

Chromosome abnormality associated with Edward’s Syndrome

A

Trisomy 18

38
Q

Chromosome abnormality associated with Patau’s Syndrome

A

Trisomy 13

39
Q

What components make up the combined test which is used during the booking visit?

A

Maternal Age, beta-hCG, PAPP-A, USS scan

40
Q

PAPP-A

A

Pregnancy Associated Plasma Protien A

41
Q

How does maternal age impact likelihood of having a baby with Down’s Syndrome?

A

chance of baby with T21 is 1/1500 at 20yo vs 1/100 at 40yo

42
Q

When is an USS Scan done?

A

11+2 to 14+1 weeks

43
Q

What does an USS look for?

A

nuchal translucency (NT), crown-rump length (CRL)

44
Q

When is the quadruple test used?

A

If mother is late-booking (>14+0), the quadruple test is used to screen for T21

45
Q

What components make up the quadruple test?

A

Maternal age, beta-hCG, AFP, inhibin-A, unconjugated oestriol

46
Q

What is “high chance” post screening tests?

A

> 1/150

47
Q

What are the 3 options for pregenant women who have come out as “high chance” post screening?

A
  1. No further testing 2. Non-invasive prenatal testing (NIPT) - placental cell-free DNA 3. Prenatal diagnosis (PND) - chorionic villus sampling (11-14 weeks), amniocentesis (15+ weeks)
48
Q

What does NIPT stand for?

A

Non-invasive prenatal testing

49
Q

What is analyzed in NIPT?

A

Placental cell-free DNA

50
Q

What is the gestational age for chorionic villus sampling?

A

11-14 weeks

51
Q

What is the gestational age for amniocentesis?

A

15+ weeks

52
Q

What is the CRL range for the combined test?

A

45-84mm (if too low, wait for it to get higher)

53
Q

What test is offered if CRL is too high?

A

Quadruple test

54
Q

T21 markers

A

high beta-hCG, low PAPP-A, high NT (>3.5mm) // low AFP, high inhibin-A, low unconjugated oestriol

55
Q

T18 markers

A

low beta-hCG, low PAPP-A, high NT

56
Q

T13 markers

A

low beta-hCG, low PAPP-A, high NT

57
Q

Additional T21 markers

A

low AFP, high inhibin-A, low unconjugated oestriol

Phase 3a - Women's Health (21 decks)

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