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  • Print publication year: 2008
  • Online publication date: August 2009

2 - Antenatal care

Summary

The National Institute for Health and Clinical Excellence (NICE) produced guidelines for antenatal care provision. The first antenatal visit or 'booking visit' is essential to identifying potential risk factors. Most women in the UK attend for booking in the late first trimester or early second trimester. Those attending in the third trimester are likely to have risk factors placing them in a higher risk category. Blood pressure (BP) should be measured at booking. Pregnant women are offered screening for rubella, syphilis, hepatitis B and HIV. Screening policies for fetal abnormality vary from region to region. The National Screening Committee suggested that women with a risk of 1:250 or more should be offered additional testing in the form of amniocentesis or chorionic villus sampling. Serum alphafetoprotein (AFP) testing in the second trimester is offered as a screening test for neural tube defects.
REFERENCES
Chan, K. and Kean, L., Routine antenatal care at the booking clinic. Curr. Obstet. Gynaecol., 14:2 (2004), 79–85.
Doherty, D. A., Magann, E. F., Francis, J., Morrison, J. C. and Newnham, J. P., Pre-pregnancy body mass index and pregnancy outcomes. Int. J. Gynaecol. Obstet., 95:3 (2006), 247–7.
Fraser, R. and Chan, K., Problems of obesity in obstetric care. Curr. Obstet. Gynaecol., 13:4 (2003), 239–43.
Gardosi, J., Vanner, T. and Francis, A., Gestational age and induction of labour for prolonged pregnancy. Br. J. Obstet. Gynaecol., 104:7 (1997), 792–7.
Vankayalapati, P. and Hollis, B., Role of ultrasound in obstetrics. Curr. Obstet. Gynaecol., 14 (2004), 92–8.
Tan, J. Y.-L., Cardiovascular disease in pregnancy. Curr. Obstet. Gynaecol., 14 (2004), 155–65.
FURTHER READING
Antenatal screening for Down's Syndrome – Policy and Quality Issues. June 2003. National Screening Committee. www.screening.nhs.uk
National Institute for Health and Clinical Excellence, Antenatal care: routine care for the healthy pregnant women. Clinical Guideline (London: Department of Health, 2003). www.nice.org.uk.
Nelson-Piercy, Handbook of Obstetric Medicine, 3rd edn. (London: Taylor and Francis, 2006).
Royal College of Obstetricians and Gynaecologists, Thromboprophylaxis During Pregnancy, Labour and After Vaginal Delivery. Guideline Number 37. (London: Royal College of Obstetricians and Gynaecologists Press, 2004).