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Prenatal Assessment

Prenatal Assessment. Dr. John Dorsch Family Practice Via Christi Medical Center. Adjectives. Steady Gentle Thorough Efficient. Initial Prenatal Visit. Thorough medical history Thorough physical exam Discuss weight gain, activity level, diet, scheduling of appointments

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Prenatal Assessment

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  1. Prenatal Assessment Dr. John Dorsch Family Practice Via Christi Medical Center

  2. Adjectives • Steady • Gentle • Thorough • Efficient

  3. Initial Prenatal Visit • Thorough medical history • Thorough physical exam • Discuss weight gain, activity level, diet, scheduling of appointments • Discuss ‘milestone tests of the pregnancy’ • Labwork • CBC; UA; ABO Type; Rh type; Rubella Titer; Pap Smear; HBsAG; VDRL; Chlamydia; GC & Herpes Screen • Calculate EDC • Prescribe prenatal vitamins

  4. Checklist of Subsequent OB Visits • Weight, BP, temperature • Urine protein & glucose • Fundal height (size consistent w/gestational age) • Fetal heart tones • Edema • Nausea/vomiting • Pain contractions • Bleeding/discharge • Fetal movement • Recent illnesses or concerns

  5. Milestone Tests of Pregnancy • Ultrasound in uncomplicated pregnancy between 16–18 weeks gestation • Alpha Feto Protein (AFP) drawn between 17-21 weeks gestation(not required, but must be offered and documented) • 50 Gram Glucose Challenge at 24-28 weeks • Rhogam at 28-32 weeks if Rh negative • Repeat Hgb or Hct at 28 weeks • Beta Strep Screen at 28-32 weeks

  6. Miscellaneous Prenatal Care • Begin Lamaze at 32 weeks • Discuss when to go to hospital • Mucus Plug • Anesthesia & Analgesia • Circumcision

  7. Miscellaneous Prenatal Care • Conduct of labor: IV, monitor, exams, residents, episiotomy • Who will take care of baby? • Breast feeding vs. bottle feeding • Postpartum contraception • Tour of birthing center • Headaches

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