|
time
|
Frequency
|
Check for
|
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|
1st
|
every 4 w
|
· Between 11 and 14 weeks, US to confirm GA and check for nuchal translucency.
· CBC, Pap smear, and Chlamydia tests are done.
· Syphilis / HIV / Hep B
|
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|
2nd
|
every 4 w
|
· at 15-20: triple or quad test
· 24-28: check for Abs if RH ⊖ + Screen for GDM
|
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|
3rd
|
every 2 w ➡ every 1 weeks (@ 37 w)
|
· GBS
· 37 moving forward: check Cervix w/ every visit
|
|
⤴️ maternal serum alpha-fetoprotein
|
⤵️ maternal serum alpha-fetoprotein
|
|
Open neural tube defects (eg, anencephaly, open spina bifida)
Ventral wall defects (eg, omphalocele, gastroschisis)
Multiple gestation
|
Aneuploidies (eg, trisomy 18 & 21)
|
|
Initial prenatal visit
|
· CHECK THE BLOOD
· Rh (D) type, antibody screen
· Hemoglobin/hematocrit, MCV
· CHECK FOR BAD INFXN
· HIV, VDRL/RPR, HBsAg
· Rubella & varicella immunity
· Pap test (if screening indicated)
· Chlamydia PCR
· CHECK URINE
· Urine cx
· Urine protein
|
|
24-28 weeks
|
· Hemoglobin/hematocrit
· Antibody screen if Rh (D) negative
· 50-g 1-hour GCT (why? here where the hPL is secreted).
|
|
35-37 weeks
|
Group B Streptococcus culture
|
|
Causes of Rx Pregnancy Loss
|
|
|
Structural
|
· Uterine: fibroids, adhesions, polyps
· Cervical insufficiency
|
|
Chromosomal
|
· Aneuploidy
· Translocations/rearrangements
· Mosaicism
|
|
Hematologic
|
· Hypercoagulable disorders (antiphospholipid syndrome)
|
|
Endocrine
|
· Thyroid disease
· PCOS
· Hyperprolactinemia
· DM
|
|
Other
|
· Advancing maternal age
· Defective endometrial receptivity
· Celiac disease
|
Fast HY Review 