Prenatal care for 2 months preconception Right Ans - Strengthening the
parents physically
Prepare through education!
13 months = Right Ans - Childbearing year
Preconception care screening includes: Right Ans - - Health risks
- Ht, Wt, BMI
- BP
- Complete physical exam
- Depression / domestic violence
- Smoking, ETOH, substance abuse
- Nutrition status / prenatal vitamins
- Medications (Rx and OTC)
- Immunizations
- Recent travel risk --> risk for Zika
Folic acid for pregnancy in those with hx of giving birth to a child with a
neural tube defect or strong family hx Right Ans - 4mg/day
Beginning several months before pregnancy
Folic acid for pregnancy in those with insulin-dependent DM, take valproic
acid, or carbamazepine Right Ans - at least 1mg/day
Folic acid supplementation dosage Right Ans - 0.4mg/day, starting at least
1 month prior to conception
Initial labs done in the first trimester Right Ans - - CBC w/diff
- Blood type and screen
- Antibody screen
- RPR or VDRI
- HIV
- Hep B surface antigen [HBsAG]
- Rubella-zoster titers
- UA with culture
- PAP
, - DNA prober (Gonorrhea / chlamydia)
Initial visit for pregnancy occurs when Right Ans - between 6-8 weeks
gestation
Stepwise integrated screening Right Ans - 1st step: between 11 0/7 - 13
6/7 weeks gestation
- US --> measure fetal nuchal translucency
- Serum test --> PAPP-A and BHCG [screen for trisimy 13, 18, 21]
2nd step: between 15-18 weeks gestation
- Maternal AFP --> detect open neural tube defect
What should be offered to women over age 35 or have a family hx of certain
risk factors for genetic disorders? Right Ans - Chorionic Villious Sampling
- Between 10-13 weeks via transabdominal or transvaginal technique
Amniocentesis
- Between 15-20 weeks --> 100% detection rate of aneuploidy
Schedule of prenatal visits Right Ans - every 4 weeks through week 28
every 2 weeks for weeks 28-36
every week for week 36 until delivery
2x per week for postdates > 40 weeks
Schedule of prenatal visits usually starts when? Right Ans - After 2 missed
periods
Will occur earlier if previous hx of ectopic or greater than 2 spontaneous
miscarriages
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