Pre-pregnancy Counselling Flashcards
What constitutes it broadly?
How to get pregnant
- Timing of ovulation/intercourse
- ?Fertility
Optimise medical health
- Vaccinations etc
- Pre-existing disease
Planning pregnancy care
When does ovulation occur?
14 days before the end of the cycle (constant luteal phase)
When after ovulation must fertilisation occur?
48 hours
How long does sperm last?
5 days
Where does the sperm meet the egg?
Fallopian tube
How often should you have intercourse?
Every second day between day 10-20
What do you ask about previous pregnancies?
Miscarriages - 1st trimester or late?
Termination
Ectopics
To term
What can you do in the presence of chance of autosomal genetic condition?
Pre-implantation genetic testing
CVS +/- termination
Which occupations are you worried about in pregnancy?
Working with children
Who gets a higher dose of folic acid?
Diabetes
History of neural tube defects, spina bifida, anencephaly
People on anti-epileptics
Twins
Which other supplements should be taken?
Iodine - comes in multivitamin
Vit D - if low or high risk
Ca - if high risk IUGR and preeclampsia
Which medications should be changed?
Anti-epileptics - newer agent if possible
ACE-inhibitors
Methotrexate
Metformin
Which vaccinations are given pre-pregnancy?
Flu
Rubella and varicella hep B - test first
Pertussis given at 30 weeks now
Which genetic conditions might you test for?
Thalassaemia
CF/FX/SMA
Tay Sachs
Which diseases should be optimised?
Thyroid Diabetes Epilepsy Lupus Hypertension
