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UKOM SpOG study materials
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UKOM SpOG: Antenatal Care and Normal Pregnancy

UKOM SpOG · Work through your exam, one topic at a time.

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Antenatal Care and Normal Pregnancy

Domain 1 - Antenatal Care and Normal Pregnancy

This domain tests whether you can run a safe, evidence-based antenatal pathway: dating the pregnancy, scheduling contacts, ordering only justified tests, and recognising the boundary between normal and referral. UKOM SpOG vignettes are usually set in a puskesmas or district hospital, so the answer usually turns on WHO and POGI rules rather than exotic diagnoses.

Core rules

  • WHO 2016 recommends a minimum of eight antenatal contacts, the first before 12 weeks; record them in the KIA book.
  • Dating: crown–rump length at 7–13+6 weeks is the most accurate single measure (±5–7 days). Re-date when ultrasound differs from LMP by more than 7 days before 14 weeks, 14 days at 14–28 weeks, and 21 days after 28 weeks.
  • Naegele: LMP + 7 days − 3 months + 1 year, adjusted for cycle length.
  • First-visit labs: haemoglobin, blood group and Rh, HIV, syphilis, HBsAg, urinalysis. TORCH panels are not screening tests.
  • Supplementation: folic acid 400 µg daily (5 mg if previous neural tube defect, diabetes, or anticonvulsants); elemental iron 60 mg plus folate 400 µg daily from the second trimester.
  • Weight gain by pre-pregnancy BMI: 12.5–18 kg underweight, 11.5–16 kg normal, 7–11.5 kg overweight, 5–9 kg obese.
  • Fundal height from 20 weeks should track within 2–3 cm of weeks on a symphysis–fundus chart; a static or lagging curve mandates ultrasound.
  • Anti-D 500–1500 IU at 28 weeks for unsensitised Rh-negative women, plus within 72 hours of an Rh-positive delivery.

Worked example

LMP 10 March gives an EDD of 17 December. At booking, CRL 15 mm corresponds to 8+0 weeks - 9 days behind the LMP estimate. Because the discrepancy exceeds 7 days before 14 weeks, CRL dating is adopted, the EDD becomes 22 December, and the anomaly scan, GDM screening and growth chart are all re-scheduled.

Traps

Accepting an uncertain LMP over ultrasound; forgetting 28-week anti-D; prescribing doxycycline or fluoroquinolones in pregnancy; reacting to a single fundal-height value instead of the plotted curve.