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OB Guideline 6: Preconception Care

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OB Guideline 6: Preconception Care

Related to: Communication, Documentation, Nursing, Obstetrics, Teamwork Training

When feasible, the clinician should discuss pregnancy and preconception issues with a woman who is anticipating pregnancy. The patient should be encouraged to consider a preconception visit. Such a visit may include:

  1. lifestyle issues including tobacco, alcohol, drugs of abuse, diet, exercise, caffeine, weight, oral care;
  2. assessment for domestic violence and psychosocial issues;
  3. safety of prescribed medications and alternative choices;
  4. safety of non-prescribed medications, including herbal remedies;
  5. dietary supplements, including recommendation for folic acid supplementation; and
  6. review of major medical problems or risk factors, such as hypertension, diabetes, advanced maternal age, obesity, eating disorders.

Review of previous pregnancy problems should include:

  1. family history with specific attention to conditions that may place the woman at risk (e.g., parental thromboembolic disease) or increase the risk of genetic disease of the fetus, and
  2. risk of genetic diseases with offer for genetic testing if appropriate (e.g., Tay Sachs, Canavan’s, Cystic Fibrosis, Hemoglobin electrophoresis, PKU).

Review environmental exposures such as:

  1. lead, pesticides, workplace hazards;
  2. infectious exposures, including toxoplasmosis, HIV, STIs with offer of HIV, STD testing; and
  3. evaluation of vaccine status and offer vaccines if indicated (e.g.TdaP, rubella, varicella, influenza). 

 

 <<   Guideline 5             Web Guideline Home Page              Guideline 7 >>

May 1, 2014
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