Prenatal Care [2006 update]
Introduction to this self-study CME activity
Purpose
Prenatal care has three basic components: early and continuing risk assessment, health promotion, and medical and psychosocial follow-up. All three components are detailed with timelines for routine care. Providing this prenatal care can help reduce maternal mortality, morbidity, and fetal complications (e.g., preterm birth, intrauteine growth retardation), and promote healthy growth and development. The objective of this guideline, used as a CME self-study activity, is to update clinicians knowledge regarding key aspects of prenatal care.
What's new in this update!
- Offer first-trimester screening for trisomies, and early second trimester quad testing for trisomies and open neural tube defects.
- Offer early prenatal testing for selected genetic diseases such as Tay-Sachs, cystic fibrosis, and sickle cell.
- All patients should be screened for group B streptococcus (GBS) carrier status between 35 and 37 weeks' gestation. The risk-factor-based strategy is no longer considered acceptable.
- Influenza vaccination is recommended for all women who will be pregnant during influenza season, including women in the first trimester.
Key aspects of care
- Preconception care is an important part of prenatal care and permits early identification of risk factors that can then be treated before pregnancy. Issues to be addressed include, but are not limited to:
- Assessing family history, and candidacy for genetic screening
- Counseling and treating for smoking, alcohol, and drugs
- Folic acid supplementation at least 3 months prior to conception if at all possible, or immediately upon diagnosis of pregnancy (0.4 mg for women without risk factors and up to 4 mg for those at risk).
- The first pregnancy visit should occur during the first trimester. If a preconception visit has not taken place, the content of the preconception visit must be addressed at the first pregnancy visit.
- Offer first- or early second-trimester testing for trisomies and open neural tube defects
- An ultrasound test is recommended to determine gestational age if: (1) the gestational age as determined by the last menstrual period and uterine size do not agree within 2 weeks of each other; or (2) the patient presents after the first trimester.
All women should be screened for HBsAg and GBS carrier status prior to delivery.
Audience
This self-study activity on asthma is appropriate for primary care clinicians and other health care providers involved in prenatal care.
Authors
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Author Disclosures |
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No member of the Prenatal Care Guideline Team has relationships with commercial companies whose products are discussed in this guideline. |
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Other Acknowledgements
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CME Accreditation and Credit Designation
The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The University of Michigan Medical School designates this educational activity for a maximum of 1 AMA/PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
This CME activity was released in June 2006 with CME credit designated through August 2009. The activity was reviewed for currency of content in June 2009 and availability of credit extended through June 2012.
Method of Participation
- View the web pages. You may print the self-study text to read off-line.
- Complete the on-line learning assessment test. It will be electronically scored and the correct answers returned immediately for your review.
- Complete the electronic credit request and activity evaluation. An electronic certificate of participation will be provided immediately.
- Print the certificate of participation for your personal records.
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