Pre Pregnancy-101
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In this multimedia presentation Dr. Melissa Stoffel, D.O. provides valuable insight on preconception counseling, the practice of getting a woman as healthy as they can be prior to pregnancy, and describes what women should expect during pregnancy. Stoffel describes what to expect from preconception counseling, how to prepare for counseling sessions and how she manages special conditions like asthma management, diabetes management, smoking cessation and heart conditions before a pregnancy.
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Pre Pregnancy-101
- 1. Pre-pregnancy 101 Melissa Stoffel D.O. Marshfield Clinic OB/GYN May 26, 2009
Hinweis der Redaktion
- More important than prenatal care for prevention of congenital anomalies since 30% of women begin prenatal care in the second trimester (>14wks) after which organogenisis is complete. (3-10wks).
- Benefits of identifying and treating medical conditions before pregnancy occurs.
- Infertility, fetal aneupoloidy (chromosomal risks), GDM, preeclampsia, stillbirth Preeclampsia increases at extremes of ages
- Prior miscarriage, surgeries, pregnancy outcomes.
- Immunizations – live –attenuated viral vaccines not given in pregnancy Flu – ok after first trimester If recent vaccination – wait one month before conceiving
- NTDs, heart defects, cleft palate/lip, Downs Syndrome, cystic fibrosis, PKU, Hemophilia, kidney disease,
- Community support available – badger care, WIC, public health nurses
- Gestational HTN, preeclampsia, GDM, Preterm premature ROM, preterm/post-term delivery, macrosomia, operative vaginal delivery, congenital anomalies, c-section, stillbirth, increased childhood obesity and DM
- Toxo – avoid changing cat litter, don’t eat under cooked meat, wear gloves gardening, when preparing food – frequent hand washing Mercury – bottom feeder fish, once weekly Increased levels can lead to CNS damage, intellectual/motor/psychosocial impairement OSHA – organization that enforces work places to provide workplace free from recognized hazards, frequent audits
- Nutrasweet = aspartame Splenda = sucralose Sweet N Low = sucharin
- Oral disease increases preterm labor/delivery
- Glucose screen – hx macrosomic infant >9#), personal hx of GDM, overwt, family hx of DM CMV- work in child care area
- Increase glucose it the most important determinent of increase fetal risk in pregnancy. Decrease glucose levels decreases spont AB, congenital malformations. (heart/limbs.etc) BP meds = aldomet/methyldopa
- Medication list.
- Iron containing foods – liver, red meat, egg, dried beans, leafy green veggies, dried fruit, whole-grain bread
- Edema in legs is normal as pregnancy advances = venous compression by wt of uterus
- Increase fiber in diet. May take fiber supplement.
- Breastfeeding support class Childbirth preparation class Fathers in training Happiest baby on the block Infant care basics/infant safety Sibling celebration Early pregnancy fair Mommy mondays…move it, make it, manage it Mommy café Infant massage and nurturing touch