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Antenatal care (Aims (Monitor and promote foetal wellbeing, Monitor trends…
Antenatal care
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Booking visit
History
PGH
Menses: LMP, cycle length/regularity, any bleeding, due date
Contraception: any used
STIs: risk
Smears: up to date, any abnormal
Fertility: conception, any problems, IVF
POH
Gravidy/parity
Dates and gestations
Delivery methods
Gender, birth weight, outcome
Complications (pre, peri, post)
PMH
Inherited disease
Infectious disease
Chronic disease e.g. DM, epilepsy
Psychiatric illness
Previous surgery e.g. abdo, CS
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SH
Alcohol, smoking, drugs
Diet and exercise
Occupation
Social support, domestic violence
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Investigations
Bedside
Height, weight (BMI)
Obs (sats, RR, HR, BP, temp)
Bloods
FBC (anaemia)
RBC type (allo antibodies)
BBV (syphilis, HIV, HBV)
Rubella
Haemaglobinopathies
Urine
HCG (pregnant)
Dipstick (glucose, blood, protein)
Imaging
USS - gestational age, gross abnormalities
Management
Conservative
Identify high-risk women
Lifestyle advice (diet, nutrition)
Information on screening tests, care pathway,
maternal benefits, baby development
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Bloods
Routine
Blood group and Abs
Rhesus status
Abnormal Abs e.g. Duff, Kell
Infectious diseases
Rubella
BBV (syphilis, HIV, HBV)
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Congenital abnormalities
T21, T13, T18 (combo test)
Specific
Hb electrophoresis
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Risk factors
Cypriot, E Med, M East,
Indian subc, SE Asia
Gestational DM
Indication
?who, when, how
Risk factors
Mother: obese (BMI>30), glycosuria, prev GDM, FH DM
Previous children: prev macrosomic baby, stillbirth
Current baby: polyhydraminos, LGA
Scans
2nd trimester
18-20wk
Foetal anomaly scan
External sructural abnormalities e.g. NTDs seen
better than internal structural defects e.g. heart defects
'Soft signs' can give false +ves
1st trimester
11-13wk
Dating, nuchal translucency, chorionicity