Podcast
Questions and Answers
What is the primary goal of preconception care?
Which chronic health condition is considered the primary cause of death among women?
What is recommended for every woman during the reproductive years?
During preconception care, why is folate supplementation important?
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Which is NOT a benefit of preconception care?
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How should conception counseling advise regarding the timing of intercourse?
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What should be assessed during preconception care regarding medications?
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Which infection is specifically mentioned as needing to be avoided during preconception?
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Study Notes
Preconception Care in Family Practice
- Preconception healthcare aims to decrease maternal and neonatal mortality through preventative and social change strategies.
Challenges/Barriers
- Lack of coverage
- Limited access to care
- Inadequate training of healthcare professionals
- Stigma surrounding pregnancy care only being needed during pregnancy.
Benefits & Evidence
- "Life course" perspective
- Importance of folate supplementation
- Vaccinations
- Treatment of STIs
- Controlling chronic disease
Health History
- Three generations of health data are pertinent
- Includes pregnancy outcomes, health outcomes, and psychosocial history
- See Jordan pg 52 Table 5.2 for details
Physical Exam & Labs
- Physical examinations and relevant labs are part of preconception care.
Mental Health
- Mental health screenings should be conducted for all women, especially during their reproductive years.
- Adverse effects on both mother and baby can result from untreated mental health issues
- Assessment of medications, and consideration of alternatives as needed
Substance Use/Abuse
- Assessment of tobacco use
- Assessment of marijuana use
- Assessment of prescription opioid use
- Assessment of alcohol use
- Assessment of illicit substance use
IPV
- Routine annual exams should be conducted
- First prenatal visit is important
- Prenatal checkups should be conducted on a trimester basis
- Postpartum checkups are crucial
Infections
- Screening of women and partners for infections to prevent transmission during pregnancy and TTC (trying to conceive)
- Focus on infections, such as toxoplasmosis, cytomegalovirus, and listeria.
- See Jordan text pg 66 table 5.3 for more information
Chronic Health Conditions
- Cardiovascular disease (CVD) and hypertension (HTN) are a primary cause of death in women
- Blood pressure should be monitored at every visit
Diabetes
- Increased risk of stillbirths, miscarriage, congenital malformations, and neonatal death.
- Risk for childhood diabetes is also increased
Thyroid Disorders
- Screen for hyperthyroidism or hypothyroidism for a positive maternal and neonatal outcome
- Normal thyroid function should be achieved before pregnancy.
- Medications should be safe to use during pregnancy
Conception Counseling
- Most fertile time is 6 days before ovulation
- Intercourse should occur every 1-2 days during this period
- If infertility is suspected after 12 months, a referral is warranted
Counseling: Nutrition, Vitamins, Weight, Activity
- Consider patient beliefs regarding nutrition
- Frequent reviews of vitamin intake, specifically folic acid (see Jordan pg. 73)
- Encourage a healthy BMI
- Recommend regular exercise for better pregnancy outcomes
Genetic Screening
- Preconception is the ideal time for genetic screenings
- Carrier testing is becoming more affordable
- Referrals to genetic counselors (GC) may be needed
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Description
This quiz explores the importance of preconception healthcare in family practice, highlighting the benefits and challenges involved. It covers key areas such as health history, physical exams, and mental health screenings necessary for optimal maternal and neonatal outcomes.