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.
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).
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.
Urea and creatinine,TSH, CMV, Toxoplasma antibodies and Listeria monocytogenes antibodies.
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.
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.