Prenatal care

 Prenatal care

1. What complications a clinician should consider at each visit, assuming prenatal care begins at ten weeks gestation.

Throughout pregnancy, many women suffer from health issues. The health of the mother, the fetus, or both can be affected by these issues. Complications occur even in healthy women before becoming pregnant (Parobek,2021). Due to these issues, the pregnancy may be classified as high-risk. During the antenatal clinics, physicians should check on complications such as gestational hypertension. Hypertension makes it difficult for blood to penetrate the placenta, which supplies oxygen and other nutrients to the fetus throughout pregnancy (Parobek,2021). Reduced blood supply can stifle the fetus's development and put the mother at risk for premature labor and preeclampsia. The second complication is gestational diabetes. It occurs when a woman with no diabetes history acquires it during the pregnancy. The best method to decrease or prevent issues linked with hyperglycemia during pregnancy is to manage gestational diabetes by executing a treatment plan recommended by a physician.

The third complication is infections. Some of the disorders include sexually transmitted diseases. Such conditions led to difficulties for the fetus, the pregnant mother, and the baby after delivery. Most of these infections can be eliminated or managed through proper pre-pregnancy, prenatal, and postpartum care. However, if not treated, the conditions lead to miscarriage, congenital disabilities, stillbirths, and ectopic pregnancy (Parobek,2021). The fourth complication is preeclampsia. Preeclampsia is a dangerous medical problem resulting in premature birth and death. Although the cause is uncertain, some women are more susceptible than others.

2. What anticipatory guidance should the clinician provide the woman at each visit?

Pregnant women are advised to follow a healthy diet and exercise regularly. They are also educated on the importance of attending antenatal clinics. They’re told to avoid potentially dangerous things like lead and radiation. It promotes fetal growth and well-being while lowering the risk of complications during pregnancy (Parobek,2021). Controlling current illnesses, such as diabetes and hypertension is also encouraged to avoid significant complications and consequences (Parobek,2021). They are also recommended to avoid smoking and drinking alcohol while pregnant. It increases the risk of sudden infant death syndrome. Atypical facial traits, a tiny head, poor coordination, memory loss, intellectual impairment, and heart, renal, and musculoskeletal problems are linked to alcohol consumption.

3. What lab tests or surveillance tests should be considered? 

During pregnancy, lab testing is part of the standard healthcare coverage. A blood sample is used in a few other tests, whereas others utilize a urine test or tissue from the vaginal, cervix, or rectum (Parobek,2021). Even before the laboratory test is complete during pregnancy, the pregnant woman must be told why the testing is being done, the implications of a positive or negative result, the risk of infection transfer to the fetus, and how the results will be conveyed (Parobek,2021). These tests, known as prenatal tests, are intended to assist the health care practitioner to determine how the mother and baby are doing throughout pregnancy. Lab tests performed during the first antenatal screening include; Blood group, antibody screen, and Complete blood count: rubella antibodies level, serological tests, Hepatitis B serology, and HIV serology.

4. What do each of the lab test results mean?

 Each lab test done during the pregnancy journey is essential. A complete blood count can reveal several blood parameters, but the hemoglobin, platelet, and white blood cell counts are the most important in pregnancy. Hemoglobin levels that are either low or too high are linked to a higher risk of miscarriage. Hemoglobin levels fall during subsequent pregnancies to hemodilution produced by increased plasma volume (Parobek,2021). The most common hematological problem during pregnancy is iron deficiency anemia, characterized by low hemoglobin and mean cell volume. Platelet counts fluctuate a lot throughout pregnancy. Platelet count reductions are more prevalent than increases. Platelets often drop as a product of hemodilution. It is necessary to know a pregnant woman's ABO blood type and rhesus D status to minimize hemolytic sickness of the infant in future pregnancies with red cell antigens. Antibodies against rubella should be tested in every pregnant woman. Rubella has a substantial risk of harming the fetus if it is contracted during pregnancy (Parobek,2021). The purpose of screening is to identify women who hadn't been fully immunized or whose immunity has been impaired and are at risk of transmitting rubella so that they'll be inoculated in the postpartum period to avoid risky pregnancies.

All pregnant women should go for testing. Long-term morbidity can occur in syphilis-infected mothers, and pregnancy problems can be severe. Therefore, all pregnant women should undergo HIV testing  (Parobek,2021). In addition, HIV-positive women can receive therapy to lower the risk of HIV transmission to their children.

5. How do the results of these routine screening tests change the way this woman's prenatal care is managed?

Prenatal screening tests identify whether a baby is at low or high risk of suffering various congenital disabilities, most of which are genetic disorders. (Parobek,2021). Anxiety is reduced by routine screen testing. When pregnant mothers are educated about their baby's health in advance, they feel more at ease. Prenatal testing has improved, allowing for more precise results. If the baby is healthy, the mother can continue her pregnancy fearlessly. If the infant is at risk of a genetic condition, counseling can be obtained to make informed decisions. Prenatal testing is required to monitor the health of the unborn child. Mothers are frequently concerned about their babies' health throughout pregnancy, fearing that they will develop difficulties.

References

Parobek, C. M., Russo, M. L., & Lewkowitz, A. K. (2021). Privacy Risks in Prenatal Aneuploidy and Carrier Screening: What Obstetricians and Their Patients Need to Know. Obstetrics and gynecology, 137(6), 1074–1079. https://doi.org/10.1097/AOG.0000000000004387