Raj. CHO -2020: Which of the following tests should be done in every antenatal check-up?

Raj. CHO -2020

Obstetrics & Gynaecology

Easy

Appeared in: Raj. CHO -2020

Explanation

Routine antenatal care aims to monitor for the most common and significant complications of pregnancy: anemia, pre-eclampsia, and gestational diabetes.
Hemoglobin estimation is performed at each visit to screen for and monitor anemia, which is prevalent during pregnancy.
Urine is tested for albumin (protein) at every visit as a key screening marker for pre-eclampsia, a hypertensive disorder of pregnancy.
Urine is also tested for sugar (glucose) to screen for glycosuria, which may indicate an increased risk for gestational diabetes mellitus (GDM).

Option A: This option includes several tests (HCG, HIV, HCV, VDRL) that are typically performed only once, at the initial booking visit, as part of the baseline screening, not at every subsequent check-up.
Option C: This option includes blood sugar. While screening for gestational diabetes is crucial, a blood sugar test (like the Oral Glucose Tolerance Test) is typically performed at a specific time (24-28 weeks), not at every single antenatal visit.
Option D: This option includes HPL (Human Placental Lactogen). Measuring HPL levels is not a standard or routine test in modern antenatal care for screening purposes.

Visual 1: Chart - A timeline chart showing the schedule of investigations throughout pregnancy. It would list tests for the first trimester (booking), second trimester (including the 24-28 week OGTT), third trimester, and those repeated at every visit (Hb, urine albumin/sugar, BP, weight).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Routine investigations performed during each antenatal care (ANC) visit as background academic context rather than a clinical decision trigger.
For a nurse, performing and correctly interpreting these three basic tests (Hb, urine dipstick for albumin and sugar) at every ANC visit is a fundamental skill. It forms the first line of defense in detecting major pregnancy complications.
Failure to perform these routine checks can lead to missed diagnoses of anemia, pre-eclampsia, or gestational diabetes, resulting in significant maternal and fetal morbidity and mortality.
What if? - If a patient has a blood pressure reading of 140/90 mmHg and the urine dipstick shows 2+ albumin, the nurse must immediately recognize this as a sign of pre-eclampsia, escalate to the medical officer, and prepare the patient for further management, which may include hospitalization.

How to Approach the Question

First, identify the core of the question: it asks for tests done at every antenatal visit.
Analyze each option by considering the purpose and frequency of each test mentioned.
Recall or deduce the standard antenatal care protocol. Hemoglobin is for anemia, a constant risk. Urine albumin is for pre-eclampsia, which can appear later in pregnancy. Urine sugar is for GDM, also a risk throughout.
Eliminate options containing tests done only once or at specific intervals. HCG, HIV, VDRL, and HBsAg are typically booking tests.
Eliminate options with non-routine tests like HPL.
The remaining option, which includes tests for ongoing surveillance of common pregnancy issues (anemia, pre-eclampsia, GDM risk), is the correct answer.

Concept Tested & Keywords

Concept Tested: Routine investigations performed during each antenatal care (ANC) visit.
Stem keywords: tests, every antenatal check-up
Lead-in keywords: Which of the following