Chapter 9 – Preconception Care and Pregnancy
CONTENTS
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Part 1: Preconception care
- Diet, nutrition and body weight
- Nutritional supplementation
- Exercise
- Smoking, alcohol and substance use
- Optimising pre-existing medical conditions
- Reproductive and obstetric history
- Vaccination status and infectious disease advice
- Other pre-conception care
- Preconception genetic counselling and screening
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Part 2: Pregnancy and antenatal care
- Early pregnancy care and the first antenatal visit
- Early pregnancy problems
- First trimester screening options including prenatal tests for chromosomal abnormalities
- Screening tests available in the first trimester
- Screening tests available in the second trimester
- Subsequent visits and antenatal tests
- Vaccinations recommended during pregnancy
- Blood borne viruses and sexually transmitted infections in pregnancy
- Part 3: Postnatal care
- Resources
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References
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Part 3: Postnatal care
Postnatal check
The purpose of the postnatal visit is to ensure that the mother is coping well both physically and emotionally and identify early any perinatal mental health issues, assess any delays in recovery of the genital tract, assess breastfeeding, ensure that any medical issues are managed and that contraceptive needs are addressed.
Important issues in history taking
Delivery details, including gestation at delivery, mode of delivery and any complications; birth “debrief”- ensure the patient has opportunity for questions to be answered about their birth experience and any concerns addressed. General health since delivery. Do they have any concerns about their health, or that of the baby? Review any pregnancy complications such as gestational diabetes, hypertension, cholestasis or pre-eclampsia. Some pregnancy complications have implications for the future health of the mother.Patients who have had pre-eclampsia have been shown to have a higher rate of coronary artery disease independent of other risk factors than patients who have not had pre-eclampsia, with the degree of future CVD risk comparable to traditional risk factors for coronary artery disease (see Table 9.6). Aggressive risk factor and lifestyle management is imperative for these patients to manage long term cardiovascular risk.(79)
Table 9.6 Comparative risk ratios for the main causes of coronary ... Buy now
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Buy nowDorney E, Black K. Preconception Care. Australian Journal of General Practice. 2018;47(7).
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