When Offered, Issues for Well Women, Common Conditions, Common Illnessess

When should Pre-conception care be offered

Since so few pregnancies are planned, preconception care issues must be addressed at all encounters with reproductive aged individuals, and should be offered:

  • As part of a routine health maintenance care
  • At a defined preconception visit
  • For women with chronic illness

Preconception Issues for Well Women

Family Planning

A short pregnancy interval may be associated with birth of an SGA infant in a subsequent pregnancy, (Lieberman 1989, Zhu 1999; and preterm birth in a subsequent pregnancy (Basso1998, Zhu 1999) Family Planning and pregnancy spacing assessment should include the following:

  • Family history
  • History of depression and the potential for PP depression
  • Maternal health risk
  • Genetic History (both maternal and paternal)
  • Medical, surgical, pulmonary and neurologic history
  • Current medication (prescriptions and nonprescription);
  • Social history, including alcohol, tobacco, and illicit drug use
  • Domestic abuse and violence
  • Physical and emotional stress
  • Nutritional status
  • Environmental and occupational exposures
  • Immunity and immunization status
  • Risk factors for sexually transmitted diseases
  • Obstetric history
  • Potential fetal health risks
  • Gynecologic history
  • General physical examination

Common Conditions Amenable to Preconception Care include, but not limited to:

  • Diabetes
  • Hypertension
  • Seizure disorder
  • Sickle Cell Trait /Disease
  • Thyroid disorders
  • Thrombo-embolic disease
  • Hemoglobin disorders
  • STDs
  • Repetitive pregnancy losses
  • Eating disorders
  • Alcohol, tobacco and other drug use and abuse
  • Domestic violence
  • Poor nutrition

Common In-apparent Illnesses Amenable to Preconception Care Include:

  • Hypertension
  • Diabetes
  • Renal conditions
  • Rheumatic heart disease
  • Substance abuse
  • Thyroid abnormalities
  • Chronic hepatitis
  • HIV infection
  • Depression