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Healthy Pregnancy

Healthy Pregnancy. Monica Riccomini, RN, MSN Lisa Lottritz RN, BSN. Outline of Today’s Topics. Preconception Health Prenatal Health Fetal Infant Mortality Review Case Study Discussion Closing. Components of a Healthy Pregnancy. Preconception Health Prenatal Health

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Healthy Pregnancy

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  1. Healthy Pregnancy Monica Riccomini, RN, MSN Lisa Lottritz RN, BSN

  2. Outline of Today’s Topics • Preconception Health • Prenatal Health • Fetal Infant Mortality Review • Case Study • Discussion • Closing

  3. Components of a Healthy Pregnancy • Preconception Health • Prenatal Health • Interconception Health

  4. National Objective • Healthy People 2000 set a goal of 60% of primary care physicians will provide age-appropriate preconception care • Estimated 1 in 4 providers currently provide preconception care

  5. Preconception • Preconception Health • Defined as a women’s health status prior to becoming pregnant • Preconception Care • Interventions that aim to identify and modify risks to a women’s health or pregnancy outcome through prevention and management

  6. Preconception Risk Factors • Chronic Health Conditions • Obesity • Substance Use • Smoking • Sexual Transmitted Infections • Teratogenic Drugs • Vaccinations • Folic Acid

  7. Preconception Interventions • Smoking Cessation • Folic Acid Supplementation • Medication Adjustments • Pre-pregnancy Check Up • Obesity Control

  8. Prenatal Health • Prenatal Care • Healthy Behaviors • Community Resources

  9. National Objectives • Healthy People 2010 Objective • Increase the proportion of pregnant women who receive early and adequate prenatal care to 90% of live births

  10. Nevada Data, 2004

  11. Pregnancy Weight Gain • ..\Healthy Pregnancy\INSTITUTE OF MEDICINEappendix.doc

  12. Evaluating Interventions • Data • Pregnancy Risk Assessment Monitoring System (PRAMS) • Perinatal Periods of Risk (PPOR) • Fetal Infant Mortality Review (FIMR)

  13. National Objectives • Healthy People 2010 Objective • Less than 5 percent of the babies born will be low birth weight and less than 0.9 percent of the babies born will be VLBW

  14. Nevada Data, 2004

  15. National Objective • Healthy People 2010 Objective • Reduce fetal deaths to 4.1 per 1,000 live births plus fetal deaths • Reduce all infant deaths to 4.5 per 1,000 live births

  16. Nevada Data, 2004

  17. Fetal Infant Mortality Review • FIMR is a process that looks at community level factors related to individual cases of fetal and infant deaths • The objective of FIMR is to improve community resources and health delivery systems for women, infants, and families

  18. FIMR • Case Review Team • Medical Records • Death Certificate • Home Interview • Community Action Team

  19. Case Study • 19 year old African American female • Fetal demise at 27 weeks gestation • Second pregnancy, living child is 9 months old • Pre-pregnancy weight is 192#, height is 5 foot 4 inches • Quit smoking when she found out she was pregnant

  20. Case Study • Started prenatal care at 17 weeks • Has been taking multi-vitamin daily since she was 6 weeks pregnant • She had gestational diabetes with both pregnancies • She had 3 prenatal appointments

  21. Case Review • Additional information needed • Preconception risks • Prenatal risks • Recommendations

  22. Nevada Data, 2004

  23. Community Action Team • Interventions/Actions

  24. Health Care Costs • The IOM report estimates preterm birth cost the US more than $26.2 billion in 2005 • The average hospital charge for the most severe (premature) babies was $77,000 per stay, compared to $1,700 for an uncomplicated newborn stay

  25. Conclusion

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