Presentation on theme: "Care of the pregnant woman Year 2 Lent term. The Case 38 year old booked at 12 weeks gestation in the antenatal clinic Expecting her third baby 1 st baby."— Presentation transcript:
The Case 38 year old booked at 12 weeks gestation in the antenatal clinic Expecting her third baby 1 st baby 2.8kg (6lb 3oz) at term 2 nd baby 2.4 kg (5lb 6oz) at term Smokes 20/day BMI 25
What investigations are routinely offered in antenatal care?
Investigations: blood Standard at booking: Hb, Blood group, antibodies, rubella antibodies, serum test for syphilis. Optional at booking: triple test, tests for hepatitis B, HIV Varies with units: random blood sugar
Investigations: ultrasound Dating scan ?nuchal scan (under development nationally) Anomaly scan
How would you advise her if this was her baby’s growth chart?
Treatment plan Refer (if willing) to smoking-cessation programme Monitor fetal growth in third trimester using ultrasound- measure head circumference and abdominal circumference Biometric tests for fetal well-being: liqour volume, Doppler, cardiotocography
Despite your advise the patient requests to have her baby at home
She sees the midwife, who goes through the checklist with her:
Is the midwife obliged to deliver this patient at home?
Yes, if she insists. Second midwife recommended as back- up