Obstetrics Book

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Routine Obstetric VisitAka: Routine Obstetric Exam, Prenatal Visit

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  1. See Also
    1. Pregnancy Milestones
    2. First Obstetric Visit
    3. Nutrition in Pregnancy
  2. Prior to Pregnancy
    1. See Preconception Counseling
  3. Schedule of Clinic Visits
    1. Confirmation of intrauterine pregnancy
    2. First Obstetric Visit at 8 weeks gestation
    3. Routine Obstetric Visit
      1. Prenatal visit every 4 weeks to 28 weeks gestation
      2. Prenatal visit every 2 weeks to 36 weeks gestation
      3. Prenatal visit every 1 week until delivery
  4. Symptoms
    1. Pregnancy Induced Hypertension history (after 20 weeks)
      1. Headache
      2. Vision change
      3. Swelling of hands or face
      4. Epigastric Pain
    2. Fetal well being history (after 16-18 weeks)
      1. Fetal movement ("quickening")
      2. Fetal Kick Counts (after 36 weeks)
    3. Infection history
      1. Dysuria or urgency
      2. Increased or other change in Vaginal Discharge
    4. Vaginal Bleeding history
      1. See First Trimester Bleeding
      2. See Second Trimester Bleeding
      3. See Third Trimester Bleeding
  5. Signs
    1. Blood Pressure
    2. Weight
    3. Fetal Heart Activity by doptone (after 10-12 weeks)
    4. Fundal height (after 20 weeks)
    5. Abdominal palpation for Fetal Presentation >35 weeks
    6. Edema
      1. Lower extremity edema
      2. Face and hand edema (more suggestive of Preeclampsia)
  6. Labs: At each visit
    1. Urinalysis for Urine Glucose and Urine Protein
      1. Some guidelines have discontinued routine Urinalysis
  7. Labs: At Specific times after initial Prenatal Labs
    1. See Prenatal Labs for other lab testing
    2. Urine Culture at 12 weeks
    3. Triple Analyte Screen
      1. Requires education starting in first trimester
      2. Offered to patients at 16 to 18 weeks
      3. Consider first trimester screening of trisomy 16, 18
    4. Blood Type and Rh
      1. Indicated for maternal blood type Rh Negative
      2. Performed prior to RhoGAM administration at 28 weeks
    5. Glucose Challenge Test (GCT)
      1. Performed by 26 to 28 weeks
      2. Perform with initial Prenatal Labs if indicated
        1. See Glucose Challenge Test for indications
    6. Hemoglobin or Hematocrit
      1. Perform at 26-28 weeks
      2. Not necessary to repeat later in low risk pregnancy
        1. No Anemia at 26-28 weeks (physiologic nadir)
        2. Uncomplicated pregnancy
          1. No Hemoglobinopathy
          2. No Pregnancy Induced Hypertension
          3. Single gestation pregnancy
        3. Sherard (2001) Obstet Gynecol 98:1038
    7. Group B Streptococcus routine screening
      1. Culture vagina and rectum at 36 weeks
    8. Sexually Transmitted Disease screening
      1. Universal screening at First Obstetric Visit
      2. Labs repeated at 28 weeks if at exposure risk
      3. See Prenatal Labs for protocol
  8. Prevention
    1. Influenza Vaccine (after first trimester)
    2. Hepatitis B Vaccine if at risk of exposure
    3. See Vaccination in Pregnancy
  9. Education
    1. See First Trimester Education
    2. See Second Trimester Education
    3. See Third Trimester Education
    4. See Nutrition in Pregnancy

Prenatal visit (C1827763)

ConceptsHealth Care Activity (T058)
EnglishPrenatal visit
Spanishvisita prenatal
Parent ConceptsPrenatal care (C0033052)
SourcesSCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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