preconception/ Conception Flashcards
what is preconception considered?
Primary Care
what age women should receive preconception care?
All women ages 15-44
what should you counsel women who have had bariatric surgery?
avoid pregnancy for 12 months
Oral contraceptives absorption may be affected by bariatric surgery-> risk of vitamin deficiency. These patients should take two multivitamins daily
how do mood disorders affect preconception counseling?
Anticonvulsants and medications for bipolar disorder pose risk to fetus in first trimester
Depression is a/w preterm birth
nutritional deficiencies associated with conception/ preconception
Vitamins A, C, B, & E.
Calcium, iron, zinc, magnesium, and folic acid
FOLIC ACID- some contraceptive have added folic acid, however increase risk of blood clots in first year of use
how does being overweight/ obese cause conception difficulty
insulin resistance and oligomenorrhea cause conception difficulty
what problems can occur with pregnancy in an underweight mom?
preterm birth and low birth weight. Nutrient deficiencies, osteoporosis, amenorrhea, infertility, arrhythmias. Gastroschisis.
what problems can occur with pregnancy in a diabetic mom?
increased risk of miscarriage, congenital fetal abnormalities, perinatal death
what problems can occur with pregnancy in a mom with thyroid disease
Hypothyroidism in first trimester a/w cognitive impairment. Hyperthyroidism can result in maternal and neonatal morbidity
Increased risk of preterm birth, low birth weight, placental abruption, and fetal death
Thyroid replacement therapy should be increased during pregnancy
what problems can occur with pregnancy in a mom with asthma
symptoms worsen during pregnancy if poorly controlled
Risk to fetus: neonatal hypoxia, IUGR, preterm birth, low birth weight, and death
what problems can occur with pregnancy in a mom with thrombophilia
can you take coumadin while pregnant?
increased risk of clots during pregnancy; at risk for preeclampsia
Placental infarct, IUGR, placental abruption, recurrent miscarriage, fetal stroke, and fetal death
COUMADIN is teratogenic
can a pregnant woman w/ thrombophilia take coumadin?
NO= teratogenic
what problems can occur with pregnancy in a mom with seizure disorder
may have more frequent sz during pregnancy. A/w miscarriage, low birth weight, developmental disabilities, microcephaly, and hemorhagic disease of newborn.
what can occur in mom to be taking seizure medication? what to recommend?
Increased rates of neural tube defects with antiepileptic drugs
→ increase folic acid supplementation to 4mg daily at least one month prior to conception and continue through first trimester
how does zika virus affect fetus?
Passed to fetus→ causes microcephaly and brain development problems
Often asymptomatic
Sx includes mild illness, rash, fever, joint pain, or red eyes. Lasts one week
things to help prevent infirtility in men?
Obesity, smoking, T1D, radiation, mumps, hormone replacement, maintain healthy weight
what do males need to remember if exposed to zika virus
wait 3 months from initial symptoms or diagnosis -> if no sx wait 3 months regardless
use condoms with sex
what do females need to remember if exposed to zika virus
wait 2 months after initial symptoms or diagnosis - if no sx wait 2 months
use a condom with sex
In preconception how much folid acid supplementation should a woman take? why?
400mcg daily → reduce risk of neural tube defects
What to counsel women with DM before getting pregnant?
importance of glycemic control before conception to reduce risk of congenital abnormalities
what can toxoplasmosis cause?
fetal blindness and brain damage
what to counsel men before conceiving?
Avoid hot tubs, tight clothing, bike riding, immunizations, mental health, lifestyle
when is HCg test usually postive?
one week after missed perioid
when can FHT be ausculatated?
10-12 weeks
