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PRENATAL CARE Dr. Minoo Movahedi

PRENATAL CARE Dr. Minoo Movahedi. The goal of PNC. Birth healthy baby & minimal risk for the mother . GA High risk Health status decrease morbidity Patient education & communication. Serious morbidity & mortality are most occur at delivery. Care provider : Midwives 8-9 %

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PRENATAL CARE Dr. Minoo Movahedi

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  1. PRENATAL CARE Dr. Minoo Movahedi

  2. The goal of PNC

  3. Birth healthy baby & minimal risk for the mother . • GA • High risk • Health status • decrease morbidity • Patient education & communication

  4. Serious morbidity & mortality are most occur at delivery .

  5. Care provider : Midwives 8-9 % Family physicians 6-7% OB & Gyn __ The most

  6. Number of visit Care provider High risk : history & phexam deccrease IUGR 50 % Prevention eclampsia 70% Breech presentation 80% Physical exam : High risk BMI weight gain

  7. Lab test : -Rubella test postpartum vaccination -chlamydia test , Gonorrehea Age < 24 new & more one partner history STD Drug user - TSH

  8. HIV • 35-36 week • Absence of intervention __ 15-40% • Intervention < 2% • Avoidance Breast feeding

  9. Down syndrome screen : all patient

  10. Varicella : VZ IG : 1 vial/10 kg / 96h Vaccine __ post partum

  11. Work : • until the onset of labor except PROM & VB • Exercise

  12. Sexual activity Except : VB – PROM – No Effect on labor pain

  13. Antibiotics -Aminoglycoside : Ototoxicity - Nephrotoxicity -Doxycycline : Supresson of Bone growth Staining developing teeth • Fluoroquinolones : decrease developing cartilage

  14. Trimethoprim Folic acid antagonist Avoid first trimester

  15. Airline travel 35-36 weeks : no problem Flight attendant increase abortion ,Preterm labor Complicative pregnancy avoid airline travel

  16. Recommendations Hydration Move lower Extremities Wear seat belts HBS Oxygen : cardiac disease high flying

  17. Radiation in flying during pregnancy Harmful effect ( 2 rem ) Cumulative Radiation : 100 mrem

  18. High altitude flying : Increase 8000 feet Decrease cardiac out put Decrease birth weight Increase preterm labor Increase bleeding complication

  19. GDM screen in First trimester • Obesity • Persistant glucosuria • Macrosomia • History GDM

  20. Hair dye : Brain tumor • Avoid first trimester • Decrease time • Gloves • Rinse the hair • High light • Natural hair dye : Hena • Well – ventilated space

  21. Fish & Fish oil Docosahexaenoic acid ( DHA) • Iodine • Vitamin D • Selenium • Metylmercury

  22. Fish Benefits : Brain & eye development Third trimester & first two years of life Increase cognitive outcome Increase verbal IQ Increase prosocial behavior increase fine motor skills Increase social development Decrease hyperactivity Increase 3-5 point IQ Decrease peri partum depression Decrease preterm labor

  23. Minimata disease : BBB Methyl mercury : placenta Blindnes & deafness & CP Shark – swodrfish – tuna 95% absorption 70 days __ half life Decrease methyl mercury: whale meat sardin Salmon catfish

  24. The End

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