Antenatal Care
Preconceptual care
Antenatal care
Screenings
<16/40: 1T screening(@10/40, before 14/40), USS nuchal translucency (@12/40, before 14/40), blood tests, dating scan
16/40: 2TSST
20/40: Discuss results
26/40: OGTT, FBC, ab
(28/40): anti D
30/40: Discuss results
33/40: Routine checkup (can do at 34/40 with anti D)
36/40: Weight, urinalysis, GBS swab, discuss labour plans
38/40: Discuss results
40/40: Deliver
Source
John Murtagh, 4th Ed 2007
- Diet: Eat healthy to maintain body in optimal shape
- Folate 3/12 prior (0.4mg daily, if PGhx or antiepileptics, use 5mg daily)
- Vit D
- Avoid processed/ refined foods. Fresh is best. > Frozen.
- Lifestyle:
- Exercise
- No smoking
- No alcohol
- No illicit drugs
- No caffeine
Antenatal care
- Investigations (1st visit)
- FBC
- Blood x-match
- Cervical cytology
- Rubella ab
- HIV
- HBV (HCV)
- Syphillis
- Urine MCS
- Record
- Wt (1st 20/40=3kg; 0.5kg/w thereafter)
- BP
- Urinalysis (protein + sugar)
- Fundal ht (umbilical = 20cm; primigravida = 36/40 max then regress to 34/40)
- Foetal heart (earliest 25/40, definitely by 28/40)
- Foetal movements (mo record, primigravida: 17-20/40, multi: 16-18/40; >10 movements/d)
- Presentation/ position of foetus (3rd trimester)
- Oedema
- Others
- Sex = encouraged, with caution. Posterior entry/ female superior.
- Travel = avoid int'l 28/40, airlines limit 36/40
- <20/40 bleed (<6/40, measure b-HCG - should double q2d; >6/40, US)
- Pregnancy sickness (only during 1st trimester. Rx: small frequent meals, avoid smells, Pyridoxine +/- Metoclopramide)
- Dyspnoea (Rx: reassure)
Screenings
<16/40: 1T screening(@10/40, before 14/40), USS nuchal translucency (@12/40, before 14/40), blood tests, dating scan
16/40: 2TSST
20/40: Discuss results
26/40: OGTT, FBC, ab
(28/40): anti D
30/40: Discuss results
33/40: Routine checkup (can do at 34/40 with anti D)
36/40: Weight, urinalysis, GBS swab, discuss labour plans
38/40: Discuss results
40/40: Deliver
Source
John Murtagh, 4th Ed 2007