| Antenatal care and ultrasound services for fetal wellbeing |
|
Saurabh antenatal service offers a high level of personal support throughout pregnancy as well as providing 24 hour on-call Consultant cover.
Your first consultation will include an ultrasound scan and a detailed assessment by our Consultant Gynaecologist and Obstetrician and you will have an opportunity to discuss, agree and establish a pregnancy care plan. Our ultrasound service offers a nuchal fold scan at 12 weeks, an anomaly scan at 20 weeks and a growth scan at 34 weeks. Advice is also offered on nutrition and diet during pregnancy.
|
|
|
The first appointment needs to be earlier in pregnancy (prior to 12 weeks) than may have
traditionally occurred and, because of the large volume of information needs in early pregnancy,
two appointments may be required. At the first (and second) antenatal appointment:
|
|
| • |
Give information, with an opportunity to discuss issues and ask questions; offer verbal
information supported by written information (on topics such as diet and lifestyle
considerations, pregnancy care services available, maternity benefits and sufficient
information to enable informed decision making about screening tests) |
| • |
Identify women who may need additional care (see Algorithm and Section 1.2) and plan
pattern of care for the pregnancy |
| • |
Check blood group and rhesus D (RhD) status |
| • |
Offer screening for anaemia, red-cell alloantibodies, Hepatitis B virus, HIV, rubella
susceptibility and syphilis |
| • |
Offer screening for asymptomatic bacteriuria (ASB) |
| • |
Offering screening for Down’s syndrome |
| • |
Offer early ultrasound scan for gestational age assessment |
| • |
Offer ultrasound screening for structural anomalies (20 weeks) |
| • |
Measure BMI and blood pressure (BP) and test urine for proteinuria. |
|
After the first (and possibly second) appointment, for women who choose to have screening, the
following test should be arranged before 16 weeks of gestation (except serum screening for
Down’s syndrome, which may occur up to 20 weeks of gestation): |
| • |
Blood tests (for checking blood group and RhD status and screening for anaemia, red-cell
alloantibodies, hepatitis B virus, HIV, rubella susceptibility and syphilis) |
| • |
Urine tests (to check for proteinuria and screen for ASB) |
| • |
Ultrasound scan to determine gestational age using |
| |
- Crown–rump measurement if performed at 10 to 13 weeks
- Biparietal diameter or head circumference at or beyond 14 weeks |
| • |
Down’s syndrome screening using |
| |
- Nuchal translucency at 11 to 14 weeks
- Serum screening at 14 to 20 weeks. |
|
| 16 weeks |
| The next appointment should be scheduled at 16 weeks to: |
| • |
Review, discuss and record the results of all screening tests undertaken; reassess planned
pattern of care for the pregnancy and identify women who need additional care |
| • |
Investigate a haemoglobin level of less than 11g/dl and consider iron supplementation if indicated |
| • |
Measure BP and test urine for proteinuria |
| • |
Give information, with an opportunity to discuss issues and ask questions; offer verbal
information supported by antenatal classes and written information. |
|
|
| 18–20 weeks |
At 18–20 weeks, if the woman chooses, an ultrasound scan should be performed for the
detection of structural anomalies. For a woman whose placenta is found to extend across the
internal cervical os at this time, another scan at 36 weeks should be offered and the results of
this scan reviewed at the 36-week appointment. |
|
| 25 weeks |
At 25 weeks of gestation, another appointment should be scheduled for nulliparous women. At
this appointment: |
| • |
Measure and plot symphysis–fundal height |
| • |
Measure BP and test urine for proteinuria |
| • |
Give information, with an opportunity to discuss issues and ask questions; offer verbal
information supported by antenatal classes and written information. |
|
| Antenatal care: routine care for the healthy pregnant woman |
|
| 28 weeks |
| The next appointment for all pregnant women should occur at 28 weeks. At this appointment: |
| • |
Offer a second screening for anaemia and atypical red-cell alloantibodies |
| • |
Investigate a haemoglobin level of less than 10.5 g/dl and consider iron supplementation, if
indicated |
| • |
Offer anti-D to rhesus-negative women |
| • |
Measure BP and test urine for proteinuria |
| • |
Measure and plot symphysis–fundal height |
| • |
Give information, with an opportunity to discuss issues and ask questions; offer verbal
information supported by antenatal classes and written information. |
|
|
