Antenatal care

Pre-conceptual advice 

At Hampton Surgery we are keen that anyone contemplating pregnancy has appropriate health education advice and where appropriate, health care. Pregnancy is a normal process and the following advice should help you to have a healthy pregnancy.  

Smoking status

We ask if you smoke and it you do record this information your notes and offer smoking cessation advice given.

This is because smoking can decrease fertility, be harmful to the developing foetus. It is also thought to increase the risk of cot death and respiratory diseases in babies. Similar advice would be offered to your male partner as smoking can effect the quality of sperm.

Alcohol intake

Again we ask if you drink and if so how much each week. This would be recorded in your notes and appropriate advice given if necessary. Alcohol in excess can decrease fertility. It can also affect the development of the foetus and in some cases slow down the growth and reduce the size of a baby. Moderation is the key in pregnancy. Some health experts recommend that pregnant women play it safe by steering clear of alcohol . The Royal College of Obstetricians and Gynaecologists recommends that women should be careful about alcohol consumption in pregnancy and limit their intake to no more than one unit of alcohol per day. The amount that is safe to take is not known and probably varies between individuals.

Further information may be obtained from the following helpful website: www.babycentre.co.uk

Diet

Dietary habits are discussed with advice to avoid:

  • Unpasteurised dairy products
  • Liver
  • Shark, marlin and swordfish (due to mercury levels)
  • Pate
  • Partially cooked eggs
  • Unwashed fruit

It is possible to have coffee and other caffeinated drinks with moderation.

Folic acid

Folic acid supplementation at a dose of 400 micrograms daily is recommended for the first 12 weeks of pregnancy.

This has been shown to reduce the incidence of foetal anomalies such as spina bifida.

It may be necessary to increase this dose in a person suffering from epilepsy and

advice should be sought from a doctor regarding this.

Rubella (German Measles) status

A blood test to assess rubella immunity should be arranged in any woman considering pregnancy.

Immunisation can then be performed if necessary prior to conception.

Developing a Rubella infection in pregnancy can lead to an abnormal baby developing.

 Family history

If there is a family history of any inherited conditions, ask a doctor if you can be referred for genetic counselling prior to conception. 

Medication

Potentially no medication is safe in pregnancy. However, if you are on regular medication, do not stop your medication, but make an appointment to see the doctor to discuss if it is safe to continue your medication. 

Cervical Smear tests

These should be up-to-date prior to conception.

We are keen to provide this pre-conception advice as appropriate to three groups of women: 

(1)  Those actively seeking pre-conceptual advice

(2)  Women attending for family planning advice and contraception

(3)  Opportunistically to all women of childbearing age  

Antenatal care and screening - local guidelines for Solihull

When a person finds that they are pregnant, eg, as the result of a missed period and a positive home pregnancy test or through confirmation by a nurse, midwife or doctor there are two possible ways that they can be cared for at Hampton Surgery:

  • Complete care by a community midwife
  • Shared care with a community midwife and a hospital consultant obstetrician

Shared hospital care is recommended for anyone who has had problems in a previous pregnancy or delivery of their baby or who has medical problems, eg, heart disease or epilepsy.

Your GP will be very happy to give you further information and give advice as to which care option might be appropriate. Similarly, if you opt for complete care by the community midwife attached to the Surgery, your GP will be very happy to see you as well if you become unwell during your pregnancy.

If a problem or complication occurs during pregnancy or at the time of delivery, the midwife or the GP can refer to gain a specialist hospital consultant obstetrician opinion.

Place of Delivery / Birth

  • Complete care by a community midwife (Low risk – Solihull Hospital)
  • Shared care with a hospital consultant obstetrician (High Risk – Heartlands Hospital)

Dates of Pregnancy

6-12 weeks       

This is the time ‘booking’ will take place. This is carried out by the community midwife at home. This is when a medical and previous obstetric history is taken and a decision is made whether a mother to is of low risk or not. Choices of care are provided as well as the provision of lifestyle advice, green patient held records, details of antenatal classes, screening options, place of delivery and an individualised care plan.

12-14 weeks             

Dating Ultrasound Scan and booking blood tests

16 weeks          

Discussion of scan results – confirm expected date of delivery (EDD) and screening blood tests if requested for possible risk of neural tube defect and Downs Syndrome

22 weeks          

General check-up including analysis of urine, blood pressure measurement, checking about foetal movements and size of the foetus / baby

28 weeks          

General check-up and blood tests for possible antibodies, eg, in a mother who might have a Rhesus negative blood group. (First discussion on infant feeding)

32 weeks          

General check-up (Discussion on breast feeding)

34 weeks          

General check-up and blood tests for possible antibodies (Further discussion on breast feeding)

36 weeks          

General check-up (Further discussion on breast feeding) An assessment is made of the baby’s position (presentation).

38 weeks          

General check-up (Discussion on ‘latent’ phase)

41+ weeks        

General check-up and decision whether or not to induce (start off) the pregnancy. (Discussion of post maturity)

Nuchal Translucency (NT) scans

Nuchal translucency is a collection of fluid under the skin at the back of a baby's neck at 10-14 weeks that can be measured using ultrasound.

All babies have some fluid, but in many babies with Down's syndrome, this collection of fluid is increased. It is a screening test and so a method of assessing whether your baby is likely to have Down's syndrome. However, such a screening test can only estimate the risk of a baby having Down's syndrome, as opposed to a diagnostic test which can provide a definite diagnosis. Diagnostic tests such as amniocentesis carry a risk of miscarriage unlike this screening test. The screening test cannot state for certain that a baby is affected, but it can help a mother to be to decide whether or not to have a diagnostic test.

These screening scans are usually performed from 11 to 13 weeks + 6 days of pregnancy. Some hospitals offer a nuchal translucency scan routinely to all women on the NHS, but many hospitals do not. The combined scan and blood test is available privately in some centres across the country, and is known as the OSCAR (One Stop Clinic for Assessment of Risk).

For further information, visit the following website:  www.mums.me.uk

Midlands Ultrasound & Medical Services – “MUMS”