Antenatal screening Flashcards

1
Q

Define screening

A

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

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2
Q

What are the benefits of screening?

A
  • Identify high risk group for diagnostic testing
  • Counsel about risk of disease being present
  • Offer treatment for prevention
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3
Q

What are the downsides to screening?

A
  • False positives
  • Harm from screening or further testing
  • Cost-from screening,diagnosis,treatment
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4
Q

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

A
  • must be an important health problem
  • must have a recognizable early or latent phase
  • acceptable treatment for disease or condition exists
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5
Q

What test characteristics are required for the screening test|?

A
  • Valid&reliable
  • Acceptable to population
  • Cost is proportionate to medical care as a whole
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6
Q

Outline screening for sickle cell& thalassaemia:

  1. ) who gets screened
  2. ) when does screening happen?
  3. ) How is screening performed?
A

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

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7
Q

Outline screening for Infectious disease:

  1. ) who gets screened
  2. ) What gets screened for ?
  3. ) when does screening happen?
  4. ) How is screening performed?
A
  1. )Offered to all women
  2. ) HIV, hep B, syphillis
  3. ) at the booking
  4. ) Serology
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8
Q

Outline screening for Chromosomal abnormalities:

  1. ) who gets screened
  2. ) when does screening happen?
  3. ) How is screening performed?
A
  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
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9
Q

How do we screen for downsyndrome?

A

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
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10
Q

Compared and contrast the different trisomy markers

A
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
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11
Q

What is acrania ?

A

-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

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12
Q

Outline screening for fetal anomalies:

  1. ) who gets screened
  2. ) when does screening happen?
  3. ) How is screening performed?
A
  1. ) all pregnant women are offered
  2. )Between 18-22 weeks
    - earlier detection becoming more common
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13
Q

List some fetal abnormalities

A
  • 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).
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14
Q

What are the high risk factors for pre-eclampsia?

A
  • Hypertensive disease in a previous pregnancy
  • Chronic renal disease
  • Chronic hypertension
  • Diabetes mellitus
  • Autoimmune disease such as SLE or APS
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15
Q

What are the moderate risk factors for pre-eclampsia?

A
  • 1st pregnancy
  • age>/=40yrs
  • BMI>/= 35kg/m^2
  • Inter-pregnancy interval>10 yrs
  • family history of pre-eclampsia
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16
Q

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

A
  • pre-eclampsia in >/= 2 previous pregnancies

- pre-eclampsia <34 weeks in previous pregnancy