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Flashcards in Antenatal screening Deck (16)
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1

Define screening

A process of identifying apparently healthy people who may be at increased risk of a disease or a condition

2

What are the benefits of screening?

-Identify high risk group for diagnostic testing
-Counsel about risk of disease being present
-Offer treatment for prevention

3

What are the downsides to screening?

-False positives
-Harm from screening or further testing
-Cost-from screening,diagnosis,treatment

4

What disease characteristics are required for a screening test to be developed for a disease?

-must be an important health problem
-must have a recognizable early or latent phase
-acceptable treatment for disease or condition exists

5

What test characteristics are required for the screening test|?

-Valid&reliable
-Acceptable to population
-Cost is proportionate to medical care as a whole

6

Outline screening for sickle cell& thalassaemia:
1.) who gets screened
2.) when does screening happen?
3.) How is screening performed?

1.)High incidence: all pregnant women
Low incidence: based on ethnic origin
2.)pre-conception to 10 weeks
3.) Blood test

7

Outline screening for Infectious disease:
1.) who gets screened
2.) What gets screened for ?
3.) when does screening happen?
4.) How is screening performed?

1.)Offered to all women
2.) HIV, hep B, syphillis
3.) at the booking
4.) Serology

8

Outline screening for Chromosomal abnormalities:
1.) who gets screened
2.) when does screening happen?
3.) How is screening performed?

1.) offered to all pregnant women
2.) between 11(+0) - 13(+6) weeks gestation by ultrasound
3.) -Combined test
-Fetal nuchal translucency
-Maternal serum BetaHCG
-Maternal serum PAPP-A

9

How do we screen for downsyndrome?

Fetal nuchal translucency
-The normal babies had a thin back of neck
-Those affected by down-syndrome had a really thick back of the neck

10

Compared and contrast the different trisomy markers

T21:
-Nuchal translucency= big increase
-Beta-hCG= slightly increased
-PAPP-A= slightly decreased
T18:
-Nuchal translucency= big increase
-Beta-hCG= big decrease
-PAPP-A=big decrease
T13:
-Nuchal translucency= slightly increased
-Beta-HCG= slightly decreased
-PAPP-A=big decrease

11

What is acrania ?

-Malformation of the babies head
-No brain tissue or ossified skull
-Lethal within 1st week of life
ultrasound diagnosis:
-12 weeks: absence of ossified skull
-16 weeks anencephaly

12

Outline screening for fetal anomalies:
1.) who gets screened
2.) when does screening happen?
3.) How is screening performed?

1.) all pregnant women are offered
2.)Between 18-22 weeks
-earlier detection becoming more common

13

List some fetal abnormalities

-spina bifida
-diaphragmatic hernia
-cleft lip & palate
-Alobar holopresencephaly: when there is a complete failure of the brain to divide into right and left hemispheres which results in the loss of mid-line structures of the brain and face as well as fusion of the cavities of the brain, known as lateral ventricles and the third ventricle (which are normally separated).

14

What are the high risk factors for pre-eclampsia?

-Hypertensive disease in a previous pregnancy
-Chronic renal disease
-Chronic hypertension
-Diabetes mellitus
-Autoimmune disease such as SLE or APS

15

What are the moderate risk factors for pre-eclampsia?

-1st pregnancy
-age>/=40yrs
-BMI>/= 35kg/m^2
-Inter-pregnancy interval>10 yrs
-family history of pre-eclampsia

16

What kind of scenarios indicate a women high-risk of pre-eclampsia & in need of aspirin

-pre-eclampsia in >/= 2 previous pregnancies
-pre-eclampsia <34 weeks in previous pregnancy