SUGGESTED GUIDELINES FOR SPECIAL INVESTIGATIONS REQUESTED IN ANTE NATAL CARE OF WOMEN.
SUGGESTED GUIDELINES FOR SPECIAL INVESTIGATIONS
REQUESTED IN ANTE NATAL CARE OF WOMEN.
A sonar examination at the first ante natal visit to
confirm am intra uterine pregnancy and exclude ectopic
pregnancy, to determine viability of the pregnancy and
to diagnose or exclude possible multiple pregnancy.
Blood tests.
FBC and Platelets.
ABO and RH blood groups. If Rh negative antibodies be
done and repeated at 20, 28 and 34 weeks.
Rubella (Igg only).
VDRL.
HIV.
Hepatitis B surface antigen.
A urine specimen is tested with “dipstix” and if
positive for leukocytes or nitrites the specimen be sent
to the laboratory for microscopy and culture.
(It is suggested the patient’s urine be tested at every
ante natal visit for glucose, protein and
nitrites/leucocytes).
A combined vaginal and rectal swab at 35 weeks gestation
on every patient planning a vaginal delivery. It is not
necessary if an elective caesarean section is planned.
Congenital anomaly screen.
A sonar with nuchal translucency and nasal bones
together with a free Beta HCG and PAPP A at 10 to
14weeks gestation and a fetal anatomical screen at 20 to
24 weeks.
If the clinician does not have the equipment, expertise
or certification to perform this examination to refer on
to an appropriate unit.
If a patient is too late for the above a “Triple test”
at 15 to 20 weeks gestation is performed.
Members are encouraged to attend the training courses
and obtain the appropriate certification in performing
sonar examinations.
Tests at physician’s discretion in the presence of risk
factors.
Tay Sachs screen.
Thallasemia screen.
Urea and creatinine,TSH, CMV, Toxoplasma antibodies and
Listeria monocytogenes antibodies.
Thrombophilia screen.
A modified GTT at 35 weeks gestation.
The above are guidelines and it is the prerogative of
the physician to perform any investigation necessary to
ensure the safety of the pregnant woman and her baby.
HIV MANAGEMENT.
1. If the patient is known to be HIV positive and
requires treatment for PMTCT to inform their Health
Funders HIV Management program that they are pregnant.
2. If a patient is diagnosed HIV Positive in the
pregnancy to notify the Health Funders HIV Management
program as soon as the diagnosis is made and preferably
as early as possible in the second trimester.
National HIV HCW Hotline 0800 212 506.
Any doctor can call for advice.
