Antenatal Timetable

When a woman suspects that she is pregnant, there are a number of following tests and appointments.

– Clinical signs of that suggest pregnancy are amenorrhoea, nausea/vomiting, breast enlargement and increased urinary frequency and fatigue.

– For uncomplicated pregnancies, NICE recommend women with first pregnancy have 10 antenatal visits.

– For subsequent pregnancies, they only need 7 antenatal visits and do not need to be seen by a consultant. 

Usual route of pregnancy

i) Positive pregnancy test at home:

Women suspecting pregnancy take a urine dipstick pregnancy test

ii) GP:

If positive, women book an appointment with their GP and fill in required paperwork.

iii) Booking:

This is the first major milestone which occurs at 8-12 weeks: 

iv) 16 weeks:

– Assess BP and urine dip, inform of the screening results and screen for anaemia

– Here you also give the Pertussis (whooping cough) vaccine (anytime from 16-32 weeks)

v) Anomaly Scan:

– This is taken at 18-20(+6) weeks

– Here ultrasound is used to look for the heart, spine (spina bifida) and brain (anencephaly)

– The midwife also looks for the location of the placenta to diagnose potential placenta accreta/previa

vi) 28 weeks:

– Assess BP, urine dip and measure symphysis-fundal height (SFH)

– Screen for anaemia and red cell alloantibodies (iron given if Hb<10.5g/dl)

– First dose of anti-D for rhesus negative women

vii) 34 weeks:

– Assess BP, urine dip and measure symphysis-fundal height (SFH)

– Second dose of anti-D for rhesus negative women

viii) 36 weeks:

– Assess BP, urine dip and measure symphysis-fundal height (SFH)

– Ask whether baby is still moving and check presentation for breach position

– Give information on breastfeeding, vitamin K and “baby blues”

iv) 37 weeks:

– Baby is at term and ready to be delivered 

Screening

During the pregnancy, there are some important conditions that the baby and mother must be screened for:

Fetus:

Down’s Syndrome, Neural Tube defects and foetal anomalies

Mother:

– Blood (FBC, blood group, rhesus state + haemoglobinopathies)

– Infections –> HIV, Hepatitis B, syphilis, Rubella

– Asymptomatic bacteria in urine

– Pregnancy associated conditions – Pre-eclampsia + placenta praevia

– Psychiatric disease

– Tay-Sachs Disease

– Those with risk factors or previous disease (e.g. diabetes) will have additional tests for these conditions