-isotretinoins (accutane)
-alcohol misuse
-anti-epileptic drugs (valproic acid)
-diabetes (preconception)
-folic acid deficiency
-Hep B
-HIV/AIDS
-Hypothyroidism (dosages of levothyroxine for hypothyroidism must be increased to
support neurological development of the fetus
-maternal phenylketonuria (risk for fetus w/ intellectual disability)
-Rubella seronegativity
-obesity
-oral anticoagulant (warfarin is a teratogen)
-STIs
-Smoking (preterm birth, low birth weight, others)
-taking folic acid supplements reduces the incidence of neural tube defects by two
thirds
→ must take 400 mcg folic acid daily
-not smoking prevents fetal nicotine addiction and preterm/low bw birth
-not drinking prevents fetal alcohol spectrum disorder
-maintaining a healthy weight reduces risk of HTN, diabetes, thromboembolic disease,
and need for cesarean birth
-not taking teratogens; isotrtinoins which can cause miscarriage and birth defects
(warfarin, accutane)
-proper management of pre-existing medical conditions
-lowering dose of anti-epileptic drugs
-get vaccinated (and partner) for Hep B (can cause hepatic failure, liver carcinoma,
cirrhosis, death)
-increase the dosage of hypothyroidism medication (levothyroxine)
-decrease phenylalanine in diet if dx w/ PKU as infant
-get rubella vaccination (prevents congenital rubella syndrome)
-treat STIs (chlamydia and gonorrhea assoc. w/ ectopic pregnancy)
*greatest environmental sensitivity for embryo development is days 17 and 56 after
conception*
,
● Expected Date of Birth
○ a birth 2 weeks before or 2 weeks after EDB is normal
○ EDB is determined by date of LMP
○ Nagele’s Rule
■ Subtract 3 mo from mo of LMP then add 7 days to the day of
LMP; then correct year
■ Alternative method→ add 7 days and 9 months
■ Less accurate in women with irregular menstrual cycles
● Gravid
○ State of being pregnant
● Gravida
○ A pregnant woman
○ Gravida I
■ Primigravida
■ First pregnancy
○ Gravida II
■ Secundigravida
■ Second pregnancy
○
● Nulligravida
○ A woman who has never experienced pregnancy
● Multigravida
○ A woman pregnant for at least the third time
● Para
○ The number of deliveries at 20 weeks or greater (point of viability)
regardless of infant mortality
● Nullipara
○ Para 0
○ Women has never produced viable offspring
● Multipara
○ A woman who has had 2 or more pregnancies resulting in viable
offspring
● GTPAL or TPAL
○ G= gravida
■ Current pregnancy included in count
○ T= term births
■ Delivered b/w 38-42 weeks
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