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Franqui
Antaenatal Screening
| Question | Answer |
|---|---|
| What is the name of the equation used to calculate EDD? | Naegele's Rule |
| How does Naegele's Rule work? | 28 Day Cycle - Subtract three months from the first day of the LMP and add seven days to that date |
| How does Naegele's Rule work on a 24 Day Cycle? | LMP date - 3 months + 7 days LESS 4 days from EDD date given |
| How does Naegele's Rule work on a 30 Day Cycle? | LMP date - 3 months + 7 Days PLUS 2 days |
| Jane telephones you as she suspects she is pregnant. Discuss your response... | Why?? - Amenorrhoea - When was her LMP? - Any pregnancy symptoms? - Length of cycle - Conception/Contraception - Has she done a pregnancy test? - Ask if this is her first pregnancy - ?? Primip/Multip = Organise an appt + DOCUMENT |
| What is Amenorrhoea? | The absence of a menstrual period in a woman of reproductive age |
| What are some reasons for Amenorrhoea? | - Pregnancy - Contraception - BF - Stress - Medication - Hormone imbalance - Low weight - Thyroid malfunction - Ovarian insufficency - Uterine scaring |
| Ways for a MW to confirm pregnancy | - Blood Test - Urine Test - USS |
| Symptoms of early pregnancy | - Nausea - Sore breasts - increased micturition (urine) - tiredness |
| Routine antenatal bloods | - Blood Group + rhesus factor - Rhesus antibodies - FBC - Syphilis - Hep B - Rubella antibodies - HIV (with consent) - Hb (haemoglobin) |
| What does a urine test screen for? | PROTEINURIA - marker for pre-eclampsia + UTI, GLYCOSURIA - marker for gestational diabetes |
| Why use a MSU? | All hypertensive pregnant women with positive proteinuria should do a MSU confirm pre-eclampsia and to exclude a UTI |
| What does an MSU test for? | - Blood - Protein - Nitrites - Leukocytes |
| Sue is 15/40 and would like to book you as her LMC. What is your PHYSICAL ASSESSMENT? | - Weight + Height = BMI - Basic Obs = BP + Pulse - Urinalysis = MSU (asymptomatic bacteria) - Bloods = FBC, Blood Group, + Antibodies, Rubella, Heb B, Haemoglobin, Syphylis, HIV (w consent) - Palpate = Observe scars, Fundal height, FHR - DOCUMENT |
| Routine antenatal bloods | - Blood Group + rhesus factor - Rhesus antibodies - FBC - Syphilis - Hep B - Rubella antibodies - HIV (with consent) - Hb (haemoglobin) |
| What does a urine test screen for? | PROTEINURIA - marker for pre-eclampsia + UTI, GLYCOSURIA - marker for gestational diabetes |
| Why use a MSU? | All hypertensive pregnant women with positive proteinuria should do a MSU confirm pre-eclampsia and to exclude a UTI |
| What does an MSU test for? | - Blood - Protein - Nitrites - Leukocytes |
| Sue is 15/40 and would like to book you as her LMC. What is your PHYSICAL ASSESSMENT? | - Weight + Height = BMI - Basic Obs = BP + Pulse - Urinalysis = MSU (asymptomatic bacteria) - Bloods = FBC, Blood Group, + Antibodies, Rubella, Heb B, Haemoglobin, Syphylis, HIV (w consent) - Palpate = Observe scars, Fundal height, FHR - DOCUMENT |
| Sue is 36/40 this visit. What assessments will you make? | Discuss physiological changes |
| What are some CIRCULATORY physiological changes of pregnancy? | CIRCULATORY - Oedema, Carpal Tunnel, Fainting + Dizziness, Palpatations, Varicose Veins (leg, vulval, anal), bleeding gums or nose. |
| What are some MUSCLE + LIGAMENT physiological changes of pregnancy? | MUSCLE + LIGAMENT - Leg Cramps, Abdominal Pain, Back Pain, Sciatica, Symphysis Pubis Dysfunction, Incontinence, Uterine Cramps (braxton hicks) |
| What are some DIGESTIVE physiological changes of pregnancy? | DIGESTIVE - Nausea + Vomiting. Constipation, Heartburn + Indigestion, Ptyalism, Bloating + excessive wind, Diarrhoea |
| Breast changes during pregnancy | - tenderness - growth - colour+size of areola - leaking |
| Vagina changes during pregnancy | - increased discharge - pH (thrush susceptibility) |
| Urinary changes during pregnancy | - Frequency - UT Dilation + Shortening (increased UTI susceptibility) |
| Sleep changes during pregnancy | - pattern - insomnia - nature - dreams |
| Nose changed during pregnancy | - congestion - bleeds - hay fever |
| Hair changes during pregnancy | - growth on skin (abdomen + face) - loss from head |
| Skin changes during pregnancy | - itching - pregnancy rash (PUPP) - acne - chloasma, - linea nigra - stretch marks |
| Dietary changes during pregnancy | Hypersensitivity to smell, taste, pica, appetite and metabolism changes |
| Sexuality changes during pregnancy | Libido changes |
| Emotional changes during pregnancy | Volatility and mood swings |
| Tiredness and fatigue increase | 1st and 3rd trimesters |
| Ways to reduce morning sickness | - increase rest periods - eat carbs 20min b4 getting out of bed - eat protein before bed or during night - low energy/impact exercise after eating - avoid refined/fried/spicy foods - eat food rich in B group vit - increase fluids - reduce coffee/te |
| MW skills for antenatal care | - establish EDD - Abdominal Palp - BP - Routine blood + urine screening - nature + significance of fetal movements - physiological changes associated with pregnancy + issues + management - antenatal education |
| What history do you take at a clinical booking? | - Medical - Surgical - Obstetric - Social - Gravida/Parity - LMP + EDD - Previous labour outcomes - Breastfeeding |
| Examples of MEDICAL Hx | - Cardiac - Hypertension - Epilepsy - Bleeding disorders - Asthma - Current meds |
| Examples of SURGICAL Hx | - Previous gynaecological surgery - Prev GA |
| Examples of SOCIAL Hx | - Mental health - Family Violence - Smoking/drugs - Relationship/whanau - Diet/nutrition |
| 38+/40 risk markers | - fresh blood loss - Reduced FM - Signs of pre-eclampsia - Rupture of membranes without contractions - Meconium stained liquor |
| Fundal Assessment - 5 Stages | - Initial visual (observe) - Fundal assessment - Lateral assessment - Pelvic assessment - Listening or auscultation |
| In a Visual Assessment, we look for | - initial impression of progress - physiological changes (linea nigra, stretch marks - size, shape, contours in relation to gestation/presentation/position - surgical scars - bruising or other signs of FV |
| In a Fundal Assessment, we look for | - upper most part of fundus - Lie (position of babes spine relative to mum) - Presentation - Landmark of fundal height re gestation - Measurement of fundal height |
| Reasons for discrepancies with fundal height and gestation are | - large/small baby - multiple preg - molar preg - poly/oligohydramnios - errors in gestational age estimation - oblique or transverse lie |
| In a Lateral Assessment, we look for | - confirms lie+presentation with orientation of baby - identifies position (anterior, posterior, lateral) - identifies denominator in relation to points of the pelvis |
| In a Pelvic Palpation, we look for | - presenting part - descent into womens pelvis |
| Cephalo Pelvic Disproportion (CPD) should be considered | if the babies head is not engaged at 40 weeks gestation |
| The purpose of Auscultation is to | Listen to baby's FHR, to confirm baby is alive |
| The FHR is audible with a dopplar at | 12 weeks |
| The FHR can be heard with a pinard at | 24-28/40 |
| Fetal movement can be felt from around | 18/40 |
| Most women will feel fetal movements by | 22-24/40 |
Created by:
boylan.r@gmail.com
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