Preconception & Pregnancy Counseling Flashcards
What are the core interventions of a preconception visit
- folic acid
- glycemic control/DM screening
- abstinence from alc & drugs
- nicotine & THC cessation
- vaccines up to date/plan to complete
- healthy BMI
- avoidance of teratogens
- behavioral changes (nutrition, exposures)
What exams & labs should be completed on a preconception visit
Exam
- BP & BMI
- Thyroid, mouth, heart, lungs, breasts, abdomen, pelvic
Labs
- HIV & STIs
- Rubella & Varicella immunity
When should folic acid be started & what is it helpful for in fetal development
Should be started immediately (at least prior to 8 weeks)
- reduces risk of neural tube defects & promotes neural tube closure at 25 days gestation
What is the acceptable threshold for alcohol consumption in pregnancy
NONE - any consumption can result in harmful effects & fetal alcohol syndrome/spectrum disorders
What are some harmful effects of smoking & secondhand smoke on pregnancies and babies
Pregnancy: difficulty conceiving, tissue damage (lung, brain, cleft lip), miscarriage
Baby: early, low birth weight, SIDS, weaker lungs
How long does it take for toxins to clear from a male who was previously taking cytotoxic/mutagenic substances
6 months (two sperm cycles)
Describe the medication risk classifications
A: no risk in human studies
B: no risk in animal studies
C: risk can’t be ruled out
D: evidence of risk
X: contraindicated
List the W/TERATO-genic mnemonic
W: warfarin
T: Thalidomide
E: epileptic drugs (valproic acid, phenytoin, carbamazepine)
R: retinoids
A: ACEi (lisinopril)
T: third element Li
O: OCPs & other hormones
What are some of the risks of late pregnancy (age)
- amniotic fluid embolism, obstetric shock, renal failure, ICU admit, hemorrhage, thrombosis, preeclampsia, gestational DM
- fetal aneuploidy, miscarriage, stillbirth
List the 3 goals of preconception care
- ID potential risks to mom/baby
- educate & mitigate risks
- initiate interventions
Approximately how many pregnancies in the US are unintended & at what milestone do people typically begin prenatal care
- 50% unintended
- prenatal care starting in 2nd trimester
