Hi everone, found this:
First (booking) appointment
Should be before 12 weeks of pregnancy. May need to be two appointments because of volume of information required to be imparted. All information should initially be offered verbally and backed up in writing with an opportunity to discuss and ask questions.
Should cover lifestyle topics such as diet, alcohol, smoking, exercises etc; together with antenatal care services available and maternity benefits.
Initial measurement of weight, BMI and BP. Repeated weighing is only appropriate in later pregnancy where it is likely to affect management.
Clinician needs to provide enough information to make an informed decision about undergoing available screening tests.
Offer screening of mother for:
Anaemia
Red cell allo-antibodies
Hepatitis B virus
HIV
Rubella susceptibility
Syphilis
Asymptomatic bacteriuria
Arrange as agreed. There is no evidence to support routine screening for gestational diabetes.1
Offer early scan for assessment of gestational age, preferably performed at 10-13 weeks, measuring the crown-rump length. Alternatively, at or after 14 weeks, measure bi-parietal diameter, or circumference of head.
Offer screening of fetus for Down's syndrome. NB: ensure patient is aware that she is not obliged to have Down's screening tests and that they have (depending on test) 60% detection rate and 5% false positive rate. Screening may involve nuchal translucency on ultrasound before 14 weeks or serum tests at 14-20 weeks, e.g. double, triple, quadruple.
Offer screening of fetus for other structural anomalies by ultrasound scan at 20 weeks, if available.
Need to identify those women who may require extra care and create a plan for this.13 Ask about any current or previous significant medical or psychiatric illnesses. Use of the Edinburgh PND score to screen antenatally is NOT appropriate.
Routine breast and pelvic examinations are not recommended, as not shown to give any benefits. Where appropriate, the question of genital mutilation should be raised sensitively.
Further appointments
16 weeks: this appointment should be used to review the results of earlier tests, discuss them with the patient and if necessary institute a changed pattern of antenatal care having identified those women who require additional care. Consider offering oral iron to women with a haemoglobin