II. Symptoms

  1. Anticipated Discomforts
    1. Quickening
    2. Back pain
    3. Round ligament pain
    4. Constipation
    5. Gastroesophageal Reflux
  2. Symptoms prompting urgent evaluation
    1. Vaginal Bleeding
    2. Low abdominal cramps
    3. Fever
    4. Dysuria

III. Labs: Aneuploidy Screening and Neural Tube Defect Screening

IV. Labs: Testing at 24 to 28 weeks

  1. Urinalysis and Urine Culture
  2. Hemoglobin
  3. Consider Group B Streptococcus Culture (as indicated, e.g. Preterm Labor)
    1. Otherwise screen all women at 35-37 weeks gestation
  4. Cervical exam for baseline (in case of Preterm Labor)
  5. Glucose Challenge Test with 50g Glucola
    1. Followed by Glucose Tolerance Test if positive
    2. See Gestational Diabetes
  6. Maternal blood type Rh negative
    1. Antibody screen (Indirect Coombs test)
    2. RhoGAM 300 mcg IM

V. Management

  1. Discussion Points
    1. Breast Feeding
  2. Immunizations
    1. Influenza Vaccine if pregnant in Influenza season (wait until after first trimester)

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