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Normal Prenatal Care (Week 10: 1st Tri Evaluation Screening (Pregnancy …
Normal Prenatal Care
Week 10: 1st Tri Evaluation
Screening
Pregnancy
OB Hx v. important
GPA system
A = abortion/loss of any reason
TPAL
Social
Rx
SHx
PMHx
Allergies
FHx
try to decide what are her RF's
throw in Bimanual exam
Confirmatory Testing
UPT
:stars:U/S best test :loudspeaker:
confirms IUP vs. ectopic
det. GA
assesses multiple gestations
Serum beta HCG
if can't see on U/s
mostly in pathologic states (chorio/mole)
Person
Desired?
offer termination
parenting
adoption
Barriers to care
indigent pop, difficult to access HC
V/s
no HTN!
Weight gain
Abuse/Safety
Labs to determine Mom's risk for this pregnancy
lotta STI screening
Blood
ABO
Rh Ag
⚠️ if Rh (-) = fetal anemia on next pregnancy
Hb = Hct
est. baseline, will ↓
HBV Ag
RPR (syphilis)
Tx = penicillin
Titers
VSV
Rubella
get titers to check immunity
remove from potential exposures if non-immune
Urine
Screening UA
UCx
will Tx asymptomatic bacteriuria
Baseline proteinuria
assesses preecclampsia
GC screen
Cytology
Pap
Genetic
CF
SCD: HgSS
not available for everyone
PreConception Counseling
planned pregnancies do better
Safety
Genetics
AMA :older_woman:
Domestic violence :gun:
Abuse
pregnant women at highest risk
Prenatal Vitamins (folate)
Folate : NTD
most vulnerable in earliest stage of pregnancy
Vaccines
Flu
IM (dead)
HBV
can be given during preg
MMRV
can't give once pregnant
Lifestyle
Smoking/ETOH cessation
& other drugs :no_smoking::syringe:
Sleep
get on sleep cycle :bed:
Sex
safe
Work
plan maternity leave
Optimization of Disease
DM
HTN
Rx are teratogenic
hydralazine, alpha-methyldopa
Hypothyroidism
may ↑dose
goal is to achieve adequate control, and get them off usual Rx to prepare them for management during pregnancy
F/u
Q4wk
1st 2x Trimesters; wk 28
Q2wk
until term
Q1wk
until delivery :baby: