Putting it all together...Module 2 Flashcards
Infections that are highest priority to screen for during a preconception visit:
HIV
Hepatitis B
Hepatitis C
Chlamydia
Gonorrhea
STI
Syphillis
TB
Vaccinations assessment and counseling for preconception patients
Influenza: during flu season…inactivated vaccine
Tdap: 1 dose Tdap, then Td or Tdap booster q 10 years…..Tdap 3rd trimester every pregnancy
MMR: before pregnancy wait at least 1 month prior to pregnancy …Rubella can cause pregnancy loss or birth defect
Varicella: Contraindicated during pregnancy…..consider vaccination prior to pregnancy
HPV: Not recommended until after pregnancy. No intervention needed if vaccinated while pregnant; pregnancy testing not needed before vaccination
Hepatitis B: Ideal before pregnancy…however, pregnancy is not contraindication for Hepatitis B vaccination
Genetic carrier screening counseling for preconception patients
Goal of carrier screening: to provide individuals/couples with information that they can use to make reproductive decisions, based on their preferences and values.
Once someone is tested and is not a carrier, they do not need to be tested again.
If a patient has a family hx of a genetic condition or an individual issue that is suggestive of a genetic condition we should consult or arrange for a patient to see a genetic counselor BEFORE carrier screening.
We should consult or arrange for a patient to see a genetic counselor after carrier screening if one or both partners are carriers.
Pre/periconceptual folic acid, tobacco cessation and physical activity counseling
Folic Acid…neutral tube defect..
recommended 0.4 mg or 400 mcg
high risk: 4 mg.
Smoking:
Behavioral intervention/FDA approved drugs can help women stop smoking
Physical activity: 150 minutes of moderate exercise per week if safe.
Evidence supporting preconception health behaviors, as differentiated from the evidence supporting a clinician’s health promotion counseling
Intercourse-timing-enhancing advice for couples who want to get pregnant
Estimating ovulation based on the number of cycle days.
Measuring the basal body temperature.
Monitoring cervical mucus.
Using ovulation predictor kits.
Post conceptual weeks vs menstrual cycle weeks
Post conceptual 1-2 weeks = Menstrual 3-4 weeks
How soon is fertilization after ovulation
24 hours
When does blastocyst occur
12 days after fertilization
What is the all or nothing period
The pre embryonic period beginning with fertilization and ending with full implantation about 2 weeks later
When is the embryonic period
Begins 2 weeks after fertilization and ends 6 weeks later
Week 3-8 post-conceptual weeks
Week 5-10 post menstrual weeks.
Period of Organogenesis
what is the organogenesis period
same as embryonic period
Around the same time the first missed period, when many people are unaware of pregnancy.
This is the period of highest vulnerability to exposures that can affect embryonic development.
week 3-8 post conceptual week
week 5-10 post menstrual week
When does brain and spinal cord begin to develop
post conceptual week 3….when person is expecting next menstrual cycle
What do ovulation predictor kits identify
Luteinizing hormone (LH)
