Preconceptional Care Flashcards by Medicine Files

when should preconceptional phase be considered?

at 26 weeks or 5-6 months before conception

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when does the most active phase of of ovarian follicular development commence?

around 14 weeks preconception

this is called the preconceptional period

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“a set of
interventions that aim to identify and modify biomedical,
behavioral, and social risks to a woman’s health or
pregnancy outcome through prevention and
management.

preconceptional care

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ultimate aim of preconceptional care?

improve maternal and child health in both long term and short term

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best time for pre pregnancy counseling

the time a reproductive aged patient is currently using contraception or planning pregnancy

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Accdg to ACOG when should women be counseled to seek medical care for preconception?

before attempting to become pregnanct or as soon as they believe they are pregnant

purpose is to establish correct gestational age and to monitor medical conditions

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What age group when pregnant is most prone to iron deficiency?

adolescents

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Maternal undernutrition is prevalent among what age group?

Vey young and advanced age

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Most common type of maternal undernutrition in the philippines

iron deficiency anemia

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Preconceptional care only involves the women related to preconceptional health? t or f

False

men and women

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fundamental aspect of pre pregnancy counselling

Family planning

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Using this drug is recommended to prevent pre eclampsia, recurrent pregnancy loss and unexplained fetal death from recurring

Low Dose Aspirin

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Medications used during pregnancy should be?

of the lowest effective dose of the safest medication

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most thorough method for obtaining family history as part of genetic screening?

Pedigree method with symbols

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those with genetic disease should be referred to a?

geneticist

for counseling

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this is available to determine a
patient’s carrier status for some autosomal
recessive conditions

genetic testing

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most common fetal structural fetal malformation

cardiac anomalies (TOF etc)

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second most common fetal structural malformation?

Neural tube defects

seen in diabetic patients

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Neural tube defect is associate with what gene mutation?

667T substitution in the gene that encodes methylene tetrahydrofolate reductase

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What can be done to prevent neural tube defects?

Preconceptional folic acid therapy

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is an example of a disease in which
the fetus is not at risk to inherit the disorder, but
may be damaged by maternal disease

Phenylketonuria

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recommendation for patients with phenyketonuria?

Phenylalanine levels to be normalized 3 months before pregnancy and maintained throughout the pregnancy

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complications of PKU?

Spontaneous abortion
mental retardation
microcephaly
congenital heart disease 
fetal growth restriction

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most common single gene disorder worldwide

Thalassemia

globin chain synthesis disorder
can cause bleeding and anemia to the mother

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Ashkenazi Jewish communities are at risk of?

autosomal recessive diseases (tay sachs, canavan, cystic fibrosis, fanconi anemia, NPD type A, mucolipidosis, Bloom syndrome, gaucher type 1)

what kind of vaccine are not recommended during pregnancy?

Live vaccines

which vaccine should be offered to all women at high risk?

Hepatitis B

women with unknown Tdap vaccination should receive how many doses?

single dose

Tdap vaccine should be given to all women during when regardless of prepregnancy immunization history?

27-36 weeks

which vaccine can give protective cocooning to the infant

Tdap gives atleast 1-2 months of passive immunity

We can give HPV vaccine during pregnancy? t or f?

false

when should we give rubella and varicella vaccination pre pregnancy?

at least 28 days before pregnancy or after delivery if not previously given

if a women receive a live attenuated vaccine, how many months should she delay pregnancy?

1 months

when should a women planning to get pregnant start getting vaccinated?

before getting pregnant

for vaccines that need 2 doses, how many months should we advice to delay the pregnancy?

2 months

Screening for gonorrhea, chlamydial infection, | syphilis, and HIV should be done based on

patient's risk factor

What virus can cause microencephaly?

Zika Virus

what should be the goal of a woman with HIV before getting pregnant?

goal of a suppressed plasma viral load to an undetectable level before achieving getting pregnant.

What is the safest way to get pregnant without transmission of the virus to the partner who is HIV-negative

artificial insemination

This may be beneficial in reducing risk of transmission to HIV uninfected partners?

Pre-pregnancy PrEP with anti retrovirals

what complications can smoking cause in a pregnant women and her child?

mother- miscarriage | child - bronchial asthma, child obesity, infantile colic

What is the safe level of alcohol use during pregnancy?

there is no safe level of alcohol use during pregnancy

What is the most sever result of of drinking during pregnancy and are associated with central nervous system (CNS) abnormalities, growth defects, and facial dysmorphism

Fetal alcohol spectrum disorder

What ages of gestation can be affected by alcohol drinking?

All ages of gestation

alcohol related birth defects include?

growth deformities, facial abnormalities CNS impairment, behavioral disorders impaired intellectual development.

includes a range of behavior that a partner may use related to sexual decisionmaking to pressure another person to have sexual intercourse without using physical force such as sabotage of contraceptive methods, pregnancy coercion, and pregnancy pressure

Sexual coercion

during pregnancy, RDA for vitamins are met except?

folic acid an iron

during pregnancy RDA for minerals are met except?

iodine and iron

those with malabsorptive GI diseases, bariatric surgery and those on vegan diet benefit from?

Multivitamin supplementation

For women of low- risk, supplementation with __ of folic acid is adequate

400mcg/ day

Patients at increased risk for NTDs, including women with a prior pregnancy with an NTD or women with seizure disorders, should be advised to take

4mg folic acid per day

Women of reproductive age are at risk for iron | deficiency with or without anemia because of the

menstrual losses

Apart from weakness, easy fatigability, difficulty of breathing with severe cases of iron deficiency anemia, patients in the reproductive age who are iron-deficient may suffer from

poor cognition and | concentration

WHO recommends receiving iron ____ for menstruating adult women and adolescents esp those who are living in settings where anemia is prevalent

30-60 mg of elemental iron per day, 5 days a | week

Poor folate status during pregnancy is associated with?

- abruptio placentae - pre-eclampsia - spontaneous abortion - congenital heart defects - preterm delivery, stillbirth - low birth weight

Effects of Maternal Anemia During Pregnancy:

- Preeclampsia - Postpartum hemorrhage - Low birth weight - Preterm birth1

During pregnancy, supplementation of at least _____ is recommended to achieve the RDA

27 mg of elemental iron

What is recommended by WHO for post partum women for reducing the risk of anemia in settings anemia is of public health concern applicable to all postpartum women, regardless if they are breastfeeding or not.

oral iron supplementation, | either alone or in combination with folic acid for 6-12 weeks after delivery

abnormal, high or low BMI is associated with

infertility and maternal | and fetal pregnancy complications

Weights should be optimized

before a | woman attempts to becoming pregnant

ACOG recommends that patients should perform | moderate exercises, at least

30 minutes a day, 5 | days a week, for a minimum of 150 minutes

examples of ubiquitous endocrine disrupting chemicals

Parabens, phthalates, BPA's

Man-made chemicals that can alter hormonal responses to physiologic processes such as reproduction and immune system. They have the capability to mimic, block or interfere with our own hormones, hence, altering the normal physiological processes.

ENDOCRINE DISRUPTING CHEMICALS (EDC’s

Everyday endocrine disruptors

Cookware (tefal) - Scented candles/fragrances - Cosmetics - Cleaning supplies - Plastic water bottles - Hair spray/shampoo

this may y directly damage spermatozoa, alter Sertoli cell or Leydig cell function or disrupt the endocrine function in any stage of hormonal regulation.

pesticides

exposure to this has been shown to | affect sperm motility

Heavy metals

it affects the ovary by reducing ovarian weight, follicle growth and oocyte viability and /or increasing atresia

Organophosphates

also show reduced | fertility and increased fetal loss in women

pesticides

associated with decreased mature oocytes and oocyte yield following ovarian stimulation

heavy metals

causes women to have lower antral follicle counts, shortened menstrual cycles, decreased estradiol

parabens

tissues most affected by high phenylalanine levels

cardiac and neural tissues