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    Prenatal Care

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    Mikaela Carisse F. Balbon
    Group prenatal care models have been developed as an alternative to traditional one-on-one prenatal care. Group prenatal care allows for more time with providers to address clinical, behavioral, social, and psychological issues. Studies show group prenatal care results in similar outcomes as traditional care, though more research is needed to demonstrate improved outcomes in specific populations. The quality of care provided is important, as simply recording an elevated blood pressure without recommendations will not change outcomes. Prenatal care should ideally begin before pregnancy and continue after to promote optimal health over a woman's lifetime.

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    Prenatal Care

    Uploaded by

    Mikaela Carisse F. Balbon
    65 views2 pages
    Group prenatal care models have been developed as an alternative to traditional one-on-one prenatal care. Group prenatal care allows for more time with providers to address clinical, behavioral, social, and psychological issues. Studies show group prenatal care results in similar outcomes as traditional care, though more research is needed to demonstrate improved outcomes in specific populations. The quality of care provided is important, as simply recording an elevated blood pressure without recommendations will not change outcomes. Prenatal care should ideally begin before pregnancy and continue after to promote optimal health over a woman's lifetime.

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    Group prenatal care models have been developed as an alternative to traditional one-on-one prenatal care. Group prenatal care allows for more time with providers to address clinical, behavioral, social, and psychological issues. Studies show group prenatal care results in similar outcomes as traditional care, though more research is needed to demonstrate improved outcomes in specific populations. The quality of care provided is important, as simply recording an elevated blood pressure without recommendations will not change outcomes. Prenatal care should ideally begin before pregnancy and continue after to promote optimal health over a woman's lifetime.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    65 views2 pages

    Prenatal Care

    Uploaded by

    Mikaela Carisse F. Balbon
    Group prenatal care models have been developed as an alternative to traditional one-on-one prenatal care. Group prenatal care allows for more time with providers to address clinical, behavioral, social, and psychological issues. Studies show group prenatal care results in similar outcomes as traditional care, though more research is needed to demonstrate improved outcomes in specific populations. The quality of care provided is important, as simply recording an elevated blood pressure without recommendations will not change outcomes. Prenatal care should ideally begin before pregnancy and continue after to promote optimal health over a woman's lifetime.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Mark B.

    Landon MD, in Gabbe's Obstetrics: Normal and Problem Pregnancies, 2021


    Group Prenatal Care
    In the US, the most common prenatal clinical scenario is one provider to one patient, and was established in 1912 when the Children's Bureau recognized the importance
    of prenatal care in reducing infant and maternal deaths. This traditional model of care has been successful in improving mortality rates, but not equally across all racial
    and ethnic groups. Lack of access, transportation, social support, and social determinants of health are some reasons cited for late or no prenatal care, and differences in
    mortality. Hence, innovative prenatal care models have been developed as an alternative to traditional prenatal care. Alternative models include group prenatal care,
    initially described in the early 1990s and primarily limited to low-risk patients cared for by a midwife. Group prenatal care allows more time for provider-patient
    interaction to address not only clinical issues but behavioral, social, and psychological topics in a setting that allows for time for social support.97 Over the last decade,
    other formats of group prenatal care have evolved to supplement the care delivered outside of the prenatal care visit, including telephone calls, home visits, and text
    messaging.98Table 5.2 summarizes the various types of prenatal care programs. Although in some studies African American women participating in group prenatal care
    have demonstrated lower rates of PTB, most meta-analyses have shown similar rates of PTB, LBW, and NICU admission across the variety of prenatal care delivery
    models.98a,99 This suggests group prenatal care is at least equivalent to traditional prenatal care, and that more trials are needed to definitively demonstrate improved
    outcomes with specific populations.
    Efficacy of prenatal care also depends on the quality of care provided by the caretaker. If a blood pressure is recorded as “elevated,” and no therapeutic maneuvers are
    recommended, the outcome will remain unchanged. Recommendations must be made and carried out by the patient, whose compliance is essential to alter outcome.
    Using national survey data, Kogan and colleagues reported that women received only 56% of the procedures and 32% of the advice recommended as part of prenatal
    care content, whereas poor women and black women received even fewer of the recommended interventions. Site of care was also an important determinant, suggesting
    that infrastructure must be geared to address population-specific needs, and these differences likely contribute to health disparities.
    View chapter on ClinicalKey
    Prenatal Care
    M.C. Lu, J.S. Lu, in Encyclopedia of Infant and Early Childhood Development, 2008
    Prenatal care is healthcare provided to a woman during pregnancy. It consists of a series of clinical visits and ancillary services designed to promote the health and well-
    being of the mother, fetus, and family. Its major components include early and continuing risk assessment, health promotion, and medical and psychosocial
    interventions and follow-up. Risk assessment includes comprehensive evaluation of the woman’s or couple’s reproductive history, medical risks, medication use, family
    history and genetic risks, psychosocial factors, nutritional and behavioral risks, and laboratory testing. Health promotion includes alleviating unpleasant symptoms
    during pregnancy, providing lifestyle advice, promoting healthy nutrition, reducing environmental exposures, promoting family planning and breastfeeding. Medical and
    psychosocial interventions address identified medical and psychosocial risks. Ideally, prenatal care should begin before pregnancy (preconception care) and continue
    after (postpartum care) and between pregnancies (internatal care), as part of a longitudinally and contextually integrated strategy to promote optimal development of
    women’s reproductive health not only during pregnancy, but over the life course.
    View chapterPurchase book
    Antepartum Care
    Rick D. Kellerman MD, in Conn's Current Therapy 2021, 2021
    History

    1
    After pregnancy is confirmed, it is extraordinarily important to determine the duration of pregnancy and the estimated date of confinement (EDC). Further care is heavily
    predicated on this estimate. The history begins with ascertaining the first day of the last normal menstrual period and calculating the EDC by assuming duration of
    pregnancy averages 280 days (40 weeks). Because a first-trimester dating ultrasound (US) is accurate to within 5 days at confirmation or determination of an accurate
    EDC, its value cannot be overestimated.
    The documentation of prior obstetric history includes prior complications, route of delivery, and estimated birth weights. Maternal medical disorders are often
    exacerbated by pregnancy; cardiovascular, renal, and endocrine disorders require evaluation and counseling concerning possible treatments required. A history of
    previous gynecologic surgery, including cesarean delivery, is important to consider. A family history of twinning, diabetes mellitus, familial disorders, or hereditary
    disease is relevant.
    Current medications (prescription and nonprescription) are reviewed, along with any herbals or supplements. Certain prescription medications are known teratogens and
    should be discontinued. Examples include isotretinoin (Accutane), tetracycline (Sumycin), quinolone antibiotics (ciprofloxacin [Cipro], levofloxacin [Levaquin]),
    “statin” cholesterol-lowering medications such as atorvastatin (Lipitor) and rosuvastatin (Crestor) and warfarin (Coumadin). Angiotensin-converting enzyme (ACE)
    inhibitors and angiotensin receptor blockers (ARBs) should not be used in pregnancy because they can be associated with fetal renal agenesis.
    It is important to determine the pregnant patient’s risks for developing preeclampsia during the first trimester prenatal visit because starting low dose aspirin (81 mg)
    between 12 to 28 weeks (ideally before 16 weeks’ gestation) can prevent morbidity and mortality from preeclampsia. One or more of the following high-risk factors is
    an indication for beginning low dose aspirin after 12 weeks: a history of previous preeclampsia, multifetal gestation, renal disease, autoimmune disease, diabetes, and
    chronic hypertension. Consideration of low dose aspirin should be given for patients with more than one of moderate-risk factors for preeclampsia including obesity,
    advanced maternal age, history of low birth weight infants or adverse birth outcomes, and low socioeconomic status or African American race.
    Open discussion of substance abuse (alcohol, tobacco, and illicit drugs) is an integral part of the patient interview. Counseling patients about smoking cessation is vital
    in early pregnancy. Smoking increases the risk of fetal death or damage in utero. It is also associated with increased risk of placental abruption and placenta previa, each
    of which put both mother and child at risk, along with premature birth. The interest that pregnant women have in delivering a healthy infant can be a potent motivator for
    change at this point.
    View chapter on ClinicalKey
    Screening, Prenatal
    T.A. Lenzi, T.R.B. Johnson, in Encyclopedia of Infant and Early Childhood Development, 2008
    Introduction
    Prenatal care has existed for over 100 years as an approach to improve maternal and newborn outcomes. Traditionally, risk factors such as family history, social and
    behavioral factors, and the identification of existing risk factors (sexually transmitted disease, anemia, blood incompatibility) and intercurrent problems such as
    hypertension, fetal growth restriction, and pre-term labor have been the core of prenatal care. With advances in knowledge and tools of modern genetics, a major
    emphasis has become prenatal and recently preconception screening of hereditable diseases. The goal of prenatal screening is to counsel patients about their screening
    and diagnostic options, to provide reassurance to patients at low risk, and to identify high-risk patients who may benefit from diagnostic or therapeutic procedures.

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