EBCOG P1 – 3 Month – Early Pregnancy – Day 6

A. Advice against pregnancy
B. Advice regarding diet, nutrition and contraception for 6 months
C. Cessation of smoking and lifestyle modification
D. Complete blood count, HbA1c, blood sugar and renal function tests
E. Complete blood count, screening for asymptomatic bacteriuria
F. Genetic counselling
G. lifestyle advice and high-dose folic acid supplement
H. omega fatty acids supplement
I. Immune status and partner screening
J. Folic acid 1 mg
K. Prophylactic antibiotics
L. Prophylactic cervical cerclage
M. Rubella screening and 400 mcg folic acid daily
N. Screening for sexually transmitted infections
O. Multidisciplinary review

For each of the following questions, choose the single-most appropriate option from the list A–O. Each option may be chosen once, more than once or not at all.
Questions:

1. A 34-year-old Asian woman attends the preconception clinic for advice before planning
her pregnancy. She weighs 98 kg and her BMI is 35. Her recent blood sugar levels are within
normal limits. Her HbA1c is 5.2%.

2.A 42-year-old woman seeks preconception advice. She is a known epileptic and is on polytherapy AED.

3.A 29-year-old banker seeks advice regarding pregnancy. She is a hemophila carrier and smokes socially. She was never in a long-term relationship and was screened negative for STIs recently. She is now planning pregnancy with her current partner

4.A27-year-old woman attends the outpatient clinic for advice. She has undergone a weight reduction surgery 6 months back and has achieved her target BMI of 28. She is having regular cycles but complains of easy fatiguability.

A.No further tests required
B.Measure PAPP-A
C.CTG
D.Uterine artery doppler 20-24 weeks
E.Assessment fetal size and umbilical artery doppler in 3rd trimester
F.Serial assessment fetal size and umbilical artery doppler 26-28 weeks
G.MCA doppler
H.Caesarian section delivery
I.Measure fetal abdominal circumference
J.Repeat surveillance in 14 days
For the following scenarios select the most appropriate next management option



5.A 29 year old attends antenatal clinic for her first pregnancy. She smokes 5 cigarettes per day. Her BMI is 27kg/m2 and her BP is 110/65. Urinalysis is negative for protein, blood and leucocytes.

6.A 41 year old attends antenatal clinic for her second pregnancy. She is a non-smoker. Her BMI is 24kg/m2 and her BP is 108/67. Urinalysis is negative for protein, blood and leucocytes. She has no significant medical problems and her previous pregnancy was uncomplicated.