Onm-13: Prenatal Care in High-Risk Pregnancies
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Abstract:
Prenatal care is more than just health care in pregnancy. For the vast majority of women, pregnancy follows a routine course. Some women, however, have medical difficulties related to their health or the health of their baby. These women experience what is called a high-risk pregnancy. A pregnancy may be considered high-risk for a variety of reasons. Some of these include: diabetes, preeclampsia, miscarriage, problems in the developing baby, premature labor, multiple pregnancy (twins or more), gestational diabetes and pregnancy related issues. Often a pregnancy is classified as high risk becauseof issues that arise from the pregnancy itself and that have little to do with the mother's health. These include: • Premature labor • Multiple births • Placenta previa • Fetal problems Genetic counseling is offered to patients who are considering prenatal screening. A screening test is not a definitive test; it is meant to measure the risk for Down syndrome or trisomy 18 so that women with a high risk can be offered amniocentesis. First trimester screening, performed between 11.5 and 13.5 weeks of pregnancy involves two parts; a specialized ultrasound scan (a nuchal translucency scan) and a blood test. The MSAFP blood test is called the Expanded AFP screen, is performed at 15 to 20 weeks and measures three substances; AFP, hCG, and estriol. Ultrasound is used before and during amniocentesis and CVS to assist the doctor in performing those. Physical birth defects such as neural tube defects (spina bifida), heart defects, and cleft lip and club feet can be diagnosed by ultrasound; however, chromosome abnormalities may be suspected and only diagnosed by CVS or amniocentesis.
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volume 5 issue Supplement Issue
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publication date 2011-09-01
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