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Preconception Care
Reproductive Life Planning
sionals.html
http://www.cdc.gov/preconception/freematerials.ht
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http://www.beforeandbeyond.org/?page=cme-modu
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What are the components?
Preconception Care
CDC National Summit on Preconception Care (2006)
4 GOALS
1. Improve the knowledge and attitudes and behaviors of men
and women;
2. Ensure all women of childbearing age in the U.S. receive
preconception care services;
3. Reduce risks indicated by a previous adverse pregnancy
outcome during INTERCONCEPTION period to prevent or
minimize future health problems for mom and children
4. Reduce the disparities in adverse pregnancy outcomes.
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Interconception Care CA
http://www.everywomancalifornia.org/
Preconception Visit
The counseling priorities to optimize pregnancy
Sexual History.
Vaccinations:
Varicella
Influenza
Hepatitis
B
Assess for Travel Plans (immunization
review)
http://www.cdc.gov/vaccines/pubs/pregguide.htm
http://www.cdc.gov/vaccines/pubs/preg-guide.htm
infection.
prior to pregnancy
Review general screening protocols
http://www.cdc.gov/std/2010ebook.htm
Mantoux test with purified protein
derivative for TB
Medication Review
remedies
Medication Review and Teratogens
Identified
www.otispregnancy.org
FDA Risk Factor Category NEW (no longer A,B,C,D, X)
Genetic Diseases
Why Screen? Prevalence and Impact
Phenylketonuria (PKU)
family history.
level possible
Seizure Disorder
Monotherapy recommended and medications considered
less teratogenic (lamotrigine mono)
Folic Acid supplementation important in this population 4mg
per day at least one month prior to conception.
Preconception Care
TACE questions for Alcohol use assessment; non-
Smoking Cessation
Environmental Exposure
Evaluate exposure to infectious organisms and
NEW
Mental Health
Depression Screen and Treat
(upcoming lecture)
Preconception Nutrition
Obesity (BMI Measurements) control to reduce risks
Preconception Nutrition
Take a nutritionally oriented history (24 hour recall)
Encourage healthy eating habits and balanced diet
Evaluate eating disorders
Evaluate anemia status
Vegetarians: assess those without animal proteins
breastfeeding women?
New Guidelines for weight gain from IOM.
Cultural and International variablesASK.
Caffeine Intake Assessment.
My Pyramid Plan for Moms USDA (
http://www.mypyramid.gov/mypyramidmoms).
Nutrition
Exercise: Assess activities past and present.