Prenatal care as we know it today is a relatively new development in medicine. It originated in Boston in the first decade of this century. Before that time, the patient who thought she was pregnant may have visited a physician for confirmation but did not visit again until delivery was imminent.
The nurses of the Instructive Nursing Association in Boston, thinking they might contribute to the health of pregnant mothers, began making house calls on all mothers registered for delivery at the Boston Lying-In Hospital.
[...] The prenatal history should include important social aspects such as the number of sexual partners, the history of sexually transmitted diseases, and possible contact with intravenous drug users. HIV testing should be offered to all patients. D. SURGICAL HISTORY Of special importance is a history of previous gynecologic surgery. Prior uterine surgery may necessitate cesarean delivery. A history of multiple induced abortions or midtrimester losses may suggest an incompetent cervix. Patients with previous cesarean deliveries may be candidates for vaginal delivery if they are adequately counseled and meet established guidelines. [...]
[...] Final Discussion Prenatal care as we know it today is a relatively new development in medicine. It originated in Boston in the first decade of this century. Before that time, the patient who thought she was pregnant may have visited a physician for confirmation but did not visit again until delivery was imminent. Williams - Obstetrics 21st Ed. Manual of Obstetrics 7th.Ed 2007. The 5-Minute Consult Clinical Companion to Women's Health. J.S.Berek - Novak's Gynecology. 13th edition. Glass Layers Prenatal Care Prenatal care as we know it today is a relatively new development in medicine. [...]
[...] Prenatal care should have as a principal aim the identification and special treatment of the high-risk patient—the one whose pregnancy, because of some factor in her medical history or an issue that develops during pregnancy, is likely to have a poor outcome. The purpose of prenatal care is to ensure, as much as possible, an uncomplicated pregnancy and the delivery of a live healthy infant. There is evidence that mothers and offspring who receive prenatal care have a lower risk of complications. [...]
[...] If the bacteria count is over 105/mL on a voided sample or if bacteria are noted on a catheterized specimen, perform antibiotic sensitivity testing. Testing for urinary protein, glucose, and ketones should be done at each prenatal visit. Proteinuria of more than 300 mg/24 h on standard dipstick testing) may indicate renal dysfunction or, if associated with relative hypertension, the onset or progression of preeclampsia-eclampsia. The presence of glucosuria signifies that the delivery of glucose to the kidneys exceeds renal resorptive capacity. This is not important if blood levels are normal, but elevated blood levels indicate carbohydrate intolerance. [...]
[...] Common reasons why pregnant women may not receive adequate prenatal care are inability to pay for health care, fear of or lack of confidence in health care professionals, lack of self-esteem, delays in suspecting pregnancy or in reporting pregnancy to others, different individual or cultural perceptions of the importance of prenatal care, adverse initial feelings about being pregnant, and religious or cultural prohibitions. These factors should be screened for and addressed. INITIAL OFFICE VISIT The purpose of the first visit to the physician is to identify all risk factors involving the mother and fetus. [...]
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