Very important: marriage & consent, social class and maternal mortality, domestic violence, child protection, smoking, EtOH, drugs, occupation, support. PMH Important esp DM, HT, Epliepsy, Renal disease, Venous thromboembolism (VTE). FH Obstetric examination BP & urine dip Abdominal Examination comfort of the mother. – Inspection: scars, foetal mvt, striae gravidarum, linea nigra Palpation: Symphisis-fundal height (SFH) in cm. of pregnancy? What next? Macrosomia, multiples, polyhydramnios IUGR, oligohydramnios Foetal poles Lie after 34/40. Longitudinal, transverse, oblique. – Presentation after 34/40. – Engagement 5ths palpable. – Ausculatation Pinard stechoscope or dopper sonicaid – Cervical screening Cervical screening is not a test for cancer. It is a method of preventing cancer by detecting and treating early abnormalities 25 49 screened 3 yearly – 50 64 screened 5 yearly – 65+ screened only if recent abnormalities or no tests since aged 50 Liquid based Cytology (LBC) A sample of cells is taken from the cervix for analysis. Antenatal screening Basic Screening Rhesus incompatibility Infections Rubella susceptibility Hepatitis B & C Haemoglobinopathies HIV Diabetes VDRL Foetal Abnormality Bacterial Down’s Syndrome Pre-eclampsia Open neural tube defect Foetal Growth Other structural defects Additional Screening Amniocentesis (>35yrs/ In addition to Toxoplasmosis serum screening) Alcohol/Drug Misuse questioning/testing Genetic screening (FHx) DV/ CP issues TaySachs (Ashkenazy Jews etc) Mental health GDM Screening
Very important: marriage & consent, social class and maternal mortality, domestic violence, child protection, smoking, EtOH, drugs, occupation, support. PMH Important esp DM, HT, Epliepsy, Renal disease, Venous thromboembolism (VTE). FH Obstetric examination BP & urine dip Abdominal Examination – comfort of the mother. Inspection: scars, foetal mvt, striae gravidarum, linea nigra Palpation: Symphisis-fundal height (SFH) in cm. of pregnancy? What next? Macrosomia, multiples, polyhydramnios IUGR, oligohydramnios Foetal poles Lie – after 34/40. Longitudinal, transverse, oblique. Presentation – after 34/40. Engagement – 5ths palpable. Ausculatation – Pinard stechoscope or dopper sonicaid Cervical screening Cervical screening is not a test for cancer. It is a method of preventing cancer by detecting and treating early abnormalities 25 – 49 screened 3 yearly 50 – 64 screened 5 yearly 65+ screened only if recent abnormalities or no tests since aged 50 Liquid based Cytology (LBC) A sample of cells is taken from the cervix for analysis. Antenatal screening Basic Screening Rhesus incompatibility Rubella susceptibility Haemoglobinopathies Diabetes Foetal Abnormality Down’s Syndrome Open neural tube defect Other structural defects Infections Hepatitis B & C HIV VDRL Bacterial Pre-eclampsia Foetal Growth Additional Screening Amniocentesis (>35yrs/ In addition to serum screening) Genetic screening (FHx) TaySachs (Ashkenazy Jews etc) Toxoplasmosis Alcohol/Drug Misuse questioning/testing DV/ CP issues Mental health GDM Screening