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Prenatal Care and Testing

Prenatal Care and Testing is a topic covered in the 5-Minute Clinical Consult.

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Basics

The goal of prenatal care is to ensure the birth of a healthy baby with minimal risk for the mother by the following:

  • Identifying the patient who is at risk for complications
  • Estimating the gestational age (GA) as accurately as possible
  • Evaluating the health status of mother and fetus
  • Encouraging and empowering the patient to do her part to care for herself and her baby-to-be
  • Intervening when fetal abnormalities are present to prevent morbidity

General Prevention

  • A recommended but not evidence-based prenatal care schedule consists of the following:
    • Monthly visits to a health care professional for weeks 4 to 28 of pregnancy
    • Visits twice monthly from 28 to 36 weeks
    • Weekly after week 36 (delivery at weeks 38 to 40)
  • Recommendations for use of dietary supplements in pregnancy
    • Folic acid 0.4 mg daily beginning at least 1 month prior to attempting conception and continuing throughout pregnancy; 1 to 4 mg for women at higher risk of having child with neural tube defect beginning 1 to 3 months before conception, continued through first 12 weeks of gestation, and then reduced to 0.4 mg daily
    • Calcium: 1,000 to 1,300 mg/day; supplement may be beneficial for women with high risk for gestational hypertension or communities with low dietary calcium intake.
    • Iron: Screen for anemia (hemoglobin/hematocrit) and treat if necessary.
    • Vitamin A: Pregnant women in industrialized countries should limit to <5,000 IU/day.
    • Vitamin D: 200 to 1,200 IU (dose in standard prenatal vitamin) is recommended until more evidence is available to support different dose.
  • Routine screening for thyroid and vitamin D deficiency during pregnancy is not recommended.

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Citation

Stephens, Mark B., et al., editors. "Prenatal Care and Testing." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117641/all/Prenatal_Care_and_Testing.
Prenatal Care and Testing. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117641/all/Prenatal_Care_and_Testing. Accessed August 19, 2019.
Prenatal Care and Testing. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117641/all/Prenatal_Care_and_Testing
Prenatal Care and Testing [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 August 19]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117641/all/Prenatal_Care_and_Testing.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Prenatal Care and Testing ID - 117641 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117641/all/Prenatal_Care_and_Testing PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -