Prenatal Information: Difference between revisions

From Guide to YKHC Medical Practices

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===Fetal Monitoring===
===Fetal Monitoring===
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|+ style="caption-side:bottom; text-align:left;"| ''written by: Dr. David Compton''
|+ style="caption-side:bottom; text-align:left;"| ''Resource: Dr. David Compton''
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! scope="col"| Diagnosis/Indication
! scope="col"| Diagnosis/Indication

Revision as of 00:42, 8 October 2020

Prenatal Care During COVID-19

OB Case Managers are the primary resource for the prenatal paperwork. We have a large number of pregnant patients, many who are high risk due to chronic HTN or preeclampsia. Please, at the top of each HPI for a pregnant women, put a summary sentence like this example.

Pt is a 32 yr old G5P3 AB1 with an EDC of 12/25/17 at 22 weeks gestation with a history of Cholestasis of Pregnancy and Kell Antibodies.

To document prenatal visits use "OP PC Prenatal Visit Note."

There are several auto-text that should be used when documenting a prenatal or 1st prenatal visit. These all start with "..ob" (case sensitive). The "..ob1stpnhpi" is particularly important to include for 1st Prenatal visits.

At the first prenatal visit you will also need to complete the 1st Prenatal Visit ad hoc form and copy the textual rendition of this form to your HPI.

  • You should only open one 1st Prenatal Visit ad hoc form for each pregnancy.
  • If you need to add or modify information, you should go to the Form Browser, find the 1st Prenatal Visit ad hoc form for the current pregnancy, right click and select Modify.

Prenatal Appointment Schedule if Uncomplicated

Q4 week: Appts until 32 weeks
Q2 week: Until be-in-Bethel Date
Q1 week: Appts in Bethel and/or Anchorage

Prenatal Labs/Sono Needed

1st prenatal(If in SRC do labs): CBC, HepBxAg, RPR, CCUA and urine culture, GC/CT, Rubella, PPD (see PowerPlan). Make Bethel appt. for 1st trimester sono. We want a sono as early as possible on everyone.
11-13 weeks: If Advanced Maternal Age, 35 or older, first trimester screening for Down’s. Contact Ann Glasheen for particulars.
15-21 weeks: Do Quad screen
18-24 weeks: Make a 2nd Sono appt. in Bethel for Anatomy screen
24-28 weeks: Prenatal with CBC/GST. If the GST is over 140, will need a GTT ASAP.
36 weeks: Into Bethel and/or Anchorage, CBC, GC/CT, and GBS culture

Fetal Monitoring

Resource: Dr. David Compton
Diagnosis/Indication Gestational age to begin weekly Testing Test Stay in Bethel
Intrahepatic Cholestatis of Pregnancy (IHCP) 32 weeks or diagnosis BPP 32 weeks or diagnosis
Gestational Pruritus Kick Counts not indicated
Pregestational DM 32 weeks BPP 32 weeks
Gestational Diabetes (GDMA2) 32 weeks or diagnosis BPP 32 weeks or diagnosis
Chronic Hypertension in Pregnancy 32 weeks BPP 32 weeks
Pre-ecclampsia (see Gestational Hypertension diagnosis BPP diagnosis
Chronic Kidney Disease 32 weeks BPP 32 weeks
Intrauterine Growth Restriction (IUGR) diagnosis BPP with dopplers 32 weeks or diagnosis
SLE 32 weeks BPP 32 weeks or diagnosis
Fetal Arrhythmia diagnosis BPP then kick counts not indicated
Mono/Di twins 32 weeks per Anchorage 30 weeks to Anchorage
Di/DI twins if indicated 32 weeks to Anchorage
Obesity 32 weeks Kick Counts not indicated
Oligohydramnios diagnosis BPP diagnosis
Polyhydramnios diagnosis BPP 32 weeks or diagnosis
Prior stillbirth 32 weeks BPP 32 weeks or 1 week before stillbirth
Single umbilical artery Kick Counts not indicated

Category:Women's Health