Summary
Here is a good summary of Prof Stone's view of aspects of antenatal care:
The history and examination should guide you to be able to make a pregnancy care plan based on any identifiable risk factors for the pregnancy. We are aiming to prevent or reduce the adverse effects of primary pathology and identify risk factors in pregnancy as they arise. Both maternal and partner satisfaction in pregnancy are important. Care plans also need to be made around the best evidence available. We also ensure that pregnancy outcomes are regularly audited to ensure that standards are being met.
The motto is the 3 Ps:
Predict
Plan
Prevent
You should be able to summarize your history and examination to present to other health professional. In Obstetrics, we begin our presentations with a brief description of the G's and P's, the presenting complaint, the relevant examination findings, and a provisional diagnosis. Further detail is then added to complete the presentation
Here is an example:
Ms Smith is a 31 yr old secretary, gravida 2 para 1, admitted at 35 weeks with an antepartum haemorrhage
On examination, the vital signs were all normal and clinical palpation confirmed a transverse lie.
Provisional diagnosis is placenta praevia
Remember there are two patients -the mother and the baby. You want to be thorough, friendly, confident and professional. Be precise about dates, diagnoses and treatments.
Activity- MCQs
Now you might like to have a look at a couple of MCQs regarding your learning in this section -see how you get on. As is usual there is a stem and then one correct answer.
1. Which of these statements regarding timing of antenatal visits, for a normal pregnancy with no risk factors, is incorrect ?
a) Weekly from 36 weeks
b) Monthly visits till 28 weeks
c) Weekly from 12 weeks
d) Fortnightly from 28 - 36 weeks
e) Booking visit in the 1st trimester
2. Which of these statements regarding screening for Down's Syndrome is incorrect ?
a) The blood test for first trimester combined screening is always free
b) The screening includes a nuchal translucency scan
c) The 1st Trimester blood test measures 2 maternal serum markers
d) The nuchal translucency scan is always free
e) The 1st trimester screening is reported as a single combined risk result
Activity- When should antenatal tests occur? Drag and drop your answers
First trimester
10+0 weeks onwards
9+0-13+6 weeks
14-20 weeks
18-20 weeks
24-26 weeks
Every antenatal visit
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