Miscellaneous Flashcards
1
Q
Components of preconception counseling
Ref: The clinical content of preconception care, Jack BW et al, AJOG 2008 supp
A
Reproduction life plan, need for contraception Physical activity Weight status (low vs high BMI) Medical disorders Medications (Rx & OTC, supplements) Depression/anxiety screening Reproductive hx Nutrient intake (MVI if needed) Folate (0.4 mg daily) Immunizations Substance abuse STI and ID testing/counseling Prevention of Toxo, CMV, Listeria, Parvo, Malaria Consider 3-generation fam hx Domestic violence screening
2
Q
Immunizations to review in preconception counseling
Ref: The clinical content of preconception care, Jack BW et al, AJOG 2008 supp
A
TdAP HBV MMR Varicella HPV Influenza (if med dz or preg during flu season)
3
Q
Infectious diseases to consider in preconception counseling
Ref: The clinical content of preconception care, Jack BW et al, AJOG 2008 supp
A
Universal testing encouraged: HIV
Test if high risk: Gonorrhea Chlamydia Syphilis HCV TB
Counsel re: HSV vertical transmission if HSV+
4
Q
Maternal & fetal investigation for stilbirth
Ref: EB MFM
A
Predelivery: Amniotic fluid for cytogenetics Coagulopathy testing (if fetal death > 4w from delivery) CBC Antibody screen Urine drug screen KB Lupus anticoag, anticardiolipin ab, anti-B2-glycoprotein ab Parvo IgM & IgG RPR TSH A1c or oral gtt Thrombophilia workup if severe placental infarcts, FGR, or personal hx of thrombosis
Postdelivery:
Cord blood for cytogenetics
Autopsy & placental exam
Protein C & S (in selected cases, as above)
