Antenatal and Reproductive Medicine
Antenatal care
Know the schedule of visits, booking bloods (blood group, Rh, Hb, rubella, syphilis, HIV, hepatitis B, glucose), dating and anomaly scans, and routine supplementation (folic acid, vitamin D, iron where indicated). Understand preconception care - folic acid, medication review, vaccination, chronic disease optimisation.
Complications
- Hypertensive disorders: pre-eclampsia (BP ≥140/90 after 20 weeks + proteinuria or organ dysfunction), severe features, HELLP, eclampsia (magnesium sulphate).
- Gestational diabetes: screening, targets, metformin/insulin.
- Antepartum haemorrhage: placenta praevia vs abruption.
- Preterm labour: tocolysis, steroids, magnesium for neuroprotection.
- Rh isoimmunisation: anti-D prophylaxis.
Reproductive medicine
Infertility work-up (semen analysis, ovulation assessment, tubal patency), recurrent miscarriage (antiphospholipid syndrome, chromosomal, uterine), and family planning counselling.
Traps
- Missing pre-eclampsia because BP is 'borderline' - assess symptoms, platelets, LFTs, creatinine, urine PCR.
- Using ACE inhibitors/ARBs in pregnancy (contraindicated).
- Forgetting anti-D in Rh-negative women after sensitising events.
- Confusing placenta praevia (painless bleeding) with abruption (painful, tender uterus).
Worked rule
A pregnant woman at 34 weeks with headache, BP 150/100, and proteinuria: admit, assess severe features, give antihypertensives and magnesium sulphate if indicated, and plan delivery.