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Chapter 1 - Routine Prenatal Care

from Section 1 - Obstetric Aspects of Antenatal Care

Published online by Cambridge University Press:  23 February 2023

By
Megan Schneiderman  and
Amira El-Messidi
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow

Summary

A 27-year-old primigravida at 11+1 weeks’ gestation by menstrual dating presents for her first visit for routine prenatal care, accompanied by her husband. While discussing the comprehensive medical history with you before you meet the couple, your obstetric trainee mentions that the patient is allergic to penicillin.

Keywords

Antenatal careChemical exposureGestational ageImmunizationsIron-deficiency anemiaAnti-D immunoglobulinPhysical activityAir travelLyme diseaseGroup B Streptococcus bacteriaUmbilical cord blood bankingCervical lengthContraception
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 3 - 21
Publisher: Cambridge University Press
Print publication year: 2023

A 27-year-old primigravida at 11+1 weeks’ gestation by menstrual dating presents for her first visit for routine prenatal care, accompanied by her husband. While discussing the comprehensive medical history with you before you meet the couple, your obstetric trainee mentions that the patient is allergic to penicillin.

Learning Objectives

  1. 1. Take a comprehensive prenatal history, demonstrating the ability to appropriately assign a gestational age based on clinical and sonographic parameters

  2. 2. Appreciate defining features for a severe penicillin allergy and provide safe alternative intrapartum pharmacologic treatment where clinically indicated

  3. 3. Address common aspects of prenatal care for a low-risk patient, including, but not limited to, routine prenatal investigations and pharmacologic treatments, vaccinations, nutritional intake, chemical exposure, umbilical cord blood banking, and potential for air travel during pregnancy

  4. 4. Appreciate the importance of maintaining a low threshold for multidisciplinary collaboration where unexpected events occur among low-risk singleton pregnancies

  5. 5. Recognize important elements of the routine postpartum visit

References

Primary Sources

National Institute for Health and Care Excellence. Antenatal care; NICE guideline NG201, August 2021. Available at www.nice.org.uk/guidance/ng201. Accessed October 11, 2021.Google Scholar

Secondary Sources

Royal College of Obstetricians and Gynaecologists. Chemical exposures during pregnancy: dealing with potential but unproven risks to child health; Scientific Impact Paper No. 37. May 2013. Available at www.rcog.org.uk/en/guidelines-research-services/guidelines/sip37/. Accessed October 11, 2021.Google Scholar
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Qureshi, H, Massey, E, Kirwan, D, et al. BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn. Transfus Med. 2014;24(1):8–20.Google Scholar
Mottola, MF, Davenport, MH, Ruchat, SM, et al. No. 367 – 2019 Canadian guideline for physical activity throughout pregnancy. J Obstet Gynaecol Can. 2018;40(11):1528–1537. [Correction in J Obstet Gynaecol Can. 2019 Jul;41(7):1067]Google Scholar
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Antony, KM, Ehrenthal, D, Evensen, A, et al. Travel during pregnancy: considerations for the obstetric provider. Obstet Gynecol Surv. 2017;72(2):97–115.CrossRefGoogle ScholarPubMed
Royal College of Obstetricians and Gynaecologists. Air travel and pregnancy; Scientific Impact Paper No. 1. May 2013. Available at www.rcog.org.uk/en/guidelines-research-services/guidelines/sip1/. Accessed October 11, 2021.Google Scholar
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AIUM-ACR-ACOG-SMFM-SRU Practice parameter for the performance of standard diagnostic obstetrical ultrasound examinations. 2018. Available at https://onlinelibrary.wiley.com/doi/full/10.1002/jum.14831. Accessed October 14, 2021.Google Scholar
Butt, K, Crane, J, Hutcheon, J, et al. No. 374 – universal cervical length screening. J Obstet Gynaecol Can. 2019;41(3):363–374.CrossRefGoogle ScholarPubMed
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