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Chapter 1 - Routine Prenatal Care

from Section 1 - Obstetric Aspects of Antenatal Care

Published online by Cambridge University Press:  23 February 2023

By
Megan Schneiderman  and
Amira El-Messidi
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow

Summary

A 27-year-old primigravida at 11+1 weeks’ gestation by menstrual dating presents for her first visit for routine prenatal care, accompanied by her husband. While discussing the comprehensive medical history with you before you meet the couple, your obstetric trainee mentions that the patient is allergic to penicillin.

Keywords

Antenatal careChemical exposureGestational ageImmunizationsIron-deficiency anemiaAnti-D immunoglobulinPhysical activityAir travelLyme diseaseGroup B Streptococcus bacteriaUmbilical cord blood bankingCervical lengthContraception
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 3 - 21
Publisher: Cambridge University Press
Print publication year: 2023

A 27-year-old primigravida at 11+1 weeks’ gestation by menstrual dating presents for her first visit for routine prenatal care, accompanied by her husband. While discussing the comprehensive medical history with you before you meet the couple, your obstetric trainee mentions that the patient is allergic to penicillin.

Learning Objectives

  1. 1. Take a comprehensive prenatal history, demonstrating the ability to appropriately assign a gestational age based on clinical and sonographic parameters

  2. 2. Appreciate defining features for a severe penicillin allergy and provide safe alternative intrapartum pharmacologic treatment where clinically indicated

  3. 3. Address common aspects of prenatal care for a low-risk patient, including, but not limited to, routine prenatal investigations and pharmacologic treatments, vaccinations, nutritional intake, chemical exposure, umbilical cord blood banking, and potential for air travel during pregnancy

  4. 4. Appreciate the importance of maintaining a low threshold for multidisciplinary collaboration where unexpected events occur among low-risk singleton pregnancies

  5. 5. Recognize important elements of the routine postpartum visit

References

Primary Sources

National Institute for Health and Care Excellence. Antenatal care; NICE guideline NG201, August 2021. Available at www.nice.org.uk/guidance/ng201. Accessed October 11, 2021.Google Scholar

Secondary Sources

Royal College of Obstetricians and Gynaecologists. Chemical exposures during pregnancy: dealing with potential but unproven risks to child health; Scientific Impact Paper No. 37. May 2013. Available at www.rcog.org.uk/en/guidelines-research-services/guidelines/sip37/. Accessed October 11, 2021.Google Scholar
Butt, K, Lim, KI. Guideline No. 388 – determination of gestational age by ultrasound. J Obstet Gynaecol Can. 2019;41(10):1497–1507.Google Scholar
Committee Opinion No. 700: Methods for estimating the due date. Obstet Gynecol. 2017;129(5):e150–e154.CrossRefGoogle Scholar
Van den Hof, MC, Smithies, M, Nevo, O, et al. No. 375 – clinical practice guideline on the use of first trimester ultrasound. J Obstet Gynaecol Can. 2019;41(3):388–395.CrossRefGoogle ScholarPubMed
ACOG Committee Opinion No. 718: Update on immunization and pregnancy: tetanus, diphtheria, and pertussis vaccination. Obstet Gynecol. 2017;130(3):e153–e157.CrossRefGoogle Scholar
ACOG Committee Opinion No. 732: Influenza vaccination during pregnancy. Obstet Gynecol. 2018;131(4):e109–e114.Google Scholar
Castillo, E, Poliquin, V. ACOG Committee Opinion No. 357 – Immunization in pregnancy. J Obstet Gynaecol Can. 2018;40(4):478–489.CrossRefGoogle Scholar
ACOG Committee on Practice Bulletins – Obstetrics. Anemia in pregnancy: ACOG Practice Bulletin, No. 233. Obstet Gynecol. 2021;138(2):e55–e64.CrossRefGoogle Scholar
Fung, KFK, Eason, E. ACOG Committee Opinion No. 133 – Prevention of Rh alloimmunization. J Obstet Gynaecol Can. 2018;40(1):e1–e10.CrossRefGoogle Scholar
Pavord, S, Daru, J, Prasannan, N, et al. UK guidelines on the management of iron deficiency in pregnancy. Br J Haematol. 2020;188(6):819–830.Google Scholar
Practice Bulletin No. 181: Prevention of Rh D alloimmunization. Obstet Gynecol. 2017;130(2):e57–e70.CrossRefGoogle Scholar
Qureshi, H, Massey, E, Kirwan, D, et al. BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn. Transfus Med. 2014;24(1):8–20.Google Scholar
Mottola, MF, Davenport, MH, Ruchat, SM, et al. No. 367 – 2019 Canadian guideline for physical activity throughout pregnancy. J Obstet Gynaecol Can. 2018;40(11):1528–1537. [Correction in J Obstet Gynaecol Can. 2019 Jul;41(7):1067]Google Scholar
Physical activity and exercise during pregnancy and the postpartum period: ACOG Committee Opinion, No. 804. Obstet Gynecol. 2020;135(4):e178–e188.CrossRefGoogle Scholar
ACOG Committee Opinion No. 746: Air travel during pregnancy. Obstet Gynecol. 2018;132(2):e64–e66.CrossRefGoogle Scholar
Antony, KM, Ehrenthal, D, Evensen, A, et al. Travel during pregnancy: considerations for the obstetric provider. Obstet Gynecol Surv. 2017;72(2):97–115.CrossRefGoogle ScholarPubMed
Royal College of Obstetricians and Gynaecologists. Air travel and pregnancy; Scientific Impact Paper No. 1. May 2013. Available at www.rcog.org.uk/en/guidelines-research-services/guidelines/sip1/. Accessed October 11, 2021.Google Scholar
Van de Venne, M, Mahmood, T. EBCOG position statement – travelling when pregnant. Eur J Obstet Gynecol Reprod Biol. 2019;233:158–159.Google Scholar
ACOG Committee Opinion No. 771: Umbilical cord blood banking. Obstet Gynecol. 2019;133(3):e249–e253.Google Scholar
Armson, BA, Allan, DS, Casper, RF. Umbilical cord blood: counselling, collection, and banking. J Obstet Gynaecol Can. 2015;37(9):832–844.CrossRefGoogle ScholarPubMed
AIUM-ACR-ACOG-SMFM-SRU Practice parameter for the performance of standard diagnostic obstetrical ultrasound examinations. 2018. Available at https://onlinelibrary.wiley.com/doi/full/10.1002/jum.14831. Accessed October 14, 2021.Google Scholar
Butt, K, Crane, J, Hutcheon, J, et al. No. 374 – universal cervical length screening. J Obstet Gynaecol Can. 2019;41(3):363–374.CrossRefGoogle ScholarPubMed
Committee on Practice Bulletins – Obstetrics and the American Institute of Ultrasound in Medicine. Practice Bulletin No. 175: Ultrasound in pregnancy. Obstet Gynecol. 2016;128(6):e241–e256.CrossRefGoogle Scholar
FIGO Working Group on Best Practice in Maternal-Fetal Medicine, International Federation of Gynecology and Obstetrics. Best practice in maternal-fetal medicine. Int J Gynaecol Obstet. 2015;128(1):80–82. [Correction in Int J Gynaecol Obstet. 2015 Apr;129(1):89]Google Scholar
McIntosh, J, Feltovich, H, Berghella, V, et al. The role of routine cervical length screening in selected high- and low-risk women for preterm birth prevention. Am J Obstet Gynecol. 2016;215(3):B2–B7.Google Scholar

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