Screening and treatment for iron deficiency anemia can reduce the risks of preterm labor, intrauterine growth retardation, and perinatal depression.
Early studies have shown a sensitivity for Down syndrome of 100% and a specificity of 99.3%.31 Currently, cost is high and insurance coverage variable, but this may represent an emerging step in sequential genetic testing.Other genetic screening should be based on the family histories of the patient and her partner.Genetic risk considerations include cystic fibrosis in whites; Tay-Sachs disease in Ashkenazi Jews, Cajuns, and French Canadians; Canavan disease in Ashkenazi Jews; sickle cell disease in Africans; and thalassemias in Africans, East Indians, Hispanics, Mediterraneans, Middle Easterners, and Southeast Asians.611Neural tube defects affect 1.5 per 1,000 pregnancies and can be detected by testing maternal serum α-fetoprotein levels (sensitivity = 85.7%, specificity = 97.6%).6 Folic acid supplementation should be recommended early, preferably before conception.616 Folic acid, 400 mcg daily, started before pregnancy and continued until six to 12 weeks' gestation reduces the rate of neural tube defects by nearly 75%.6 Women taking folic acid antagonists or who have a history of carrying a fetus with a neural tube defect should take 4 mg of folic acid daily.16Thyroid-stimulating hormone levels should be measured in women with a history of thyroid disease or symptoms of disease in pregnancy, although there is no evidence that universal testing during pregnancy improves outcomes.32 There is concern that subclinical hypothyroidism in pregnant women may increase the risk of neurodevelopmental delays in infants, but the effectiveness of levothyroxine therapy has not been demonstrated.33 A large randomized trial comparing thyroid-stimulating hormone measurement before 16 weeks' gestation and after birth found no differences in children's IQ scores at three years of age.34 If the thyroid-stimulating hormone level is abnormal, a free thyroxine test may be useful. Copyright © 2014 by the American Academy of Family Physicians. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.Many elements of routine prenatal care are based on tradition and lack a firm evidence base; however, some elements are supported by more rigorous studies.Correct dating of the pregnancy is critical to prevent unnecessary inductions and to allow for accurate treatment of preterm labor.
The Centers for Disease Control and Prevention provides information for pregnant travelers at fetal effects are not associated with radiography that is in a normal diagnostic range (less than 50 m Gy) and that avoids direct abdominal views; ultrasonography; or use of microwaves, computers, or cell phones The Centers for Disease Control and Prevention provides information for pregnant travelers at fetal effects are not associated with radiography that is in a normal diagnostic range (less than 50 m Gy) and that avoids direct abdominal views; ultrasonography; or use of microwaves, computers, or cell phones9 Estimated date of confinement is based on the first day of the last menstrual period plus 280 days.