![]() ![]() ![]() Guiding the timing of prenatal screening and fetal monitoring.Determination of gestational age and estimated date of delivery is important for:.Gestational age and estimated date of delivery In high-risk pregnancies or if there is concern for fetal well-being, consider:.Assess growth via physical examinations and ultrasound (US).Monitoring fetal growth and wellbeing General principles ![]() High-risk pregnancies generally warrant more than the usual number of follow-up visits for maternal and/or fetal surveillance. Weekly: from 36 weeks' gestation until delivery (see also “ Postterm pregnancy ”).Every 2 weeks: from 28 to 36 weeks' gestation.Every 4 weeks: from initial visit to 28 weeks' gestation.Initial visit: usually in the first trimester.Typical timing of routine prenatal visits for an uncomplicated pregnancy:.Visit frequency should be tailored to maternal needs and pregnancy risk factors.See also “ Principles of medical law and ethics.”.In accordance with EMTALA, patients in active labor cannot be turned away.Regardless of state law, EMTALA allows for provision of emergency abortion to stabilize a patient.Follow state laws pertaining to induced abortion and mandatory reporting (e.g., of maternal substance use).Encourage voluntary, informed decisionsīecause pregnancy outcomes are unpredictable, pregnant individuals should be informed about the potential need for obstetric interventions (e.g., cesarean delivery) and encouraged to discuss any concerns ahead of time.Ensure a safe environment for asking questions and addressing concerns.Use shared-decision making when discussing treatment options with patients in order to:.Patients may refuse recommended screening or procedures.Healthcare providers have an ethical obligation to obtain informed consent from patients for prenatal care.This article covers the general principles of prenatal care, including recommended screening studies, elective prenatal genetic screening, fetal surveillance, and patient education.įor other aspects of peripartum care, see also “ Preconception counseling,” “ Normal labor and delivery,” “ Abnormal labor and delivery,” and “ Postpartum visit.” General principlesĭiagnosis of pregnancy is covered in “ Pregnancy.” Ethics of prenatal care More frequent assessment may be indicated in pregnancies deemed high-risk for the fetus or pregnant individual. Components of prenatal visits include evaluation of the medical history, physical and gynecological examinations, laboratory testing, and ultrasonography. After an initial visit (usually in the first trimester), follow-up prenatal visits generally occur once monthly until 28 weeks' gestation, twice monthly between 28 and 36 weeks, and weekly after 36 weeks. Prenatal visits allow high-risk pregnancies to be identified and are used to monitor maternal health and fetal development. Prenatal care is the health care provided throughout a pregnancy it is aimed at optimizing maternal and fetal outcomes. ![]()
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