II. Risk Factors: Child Abuse Associations

  1. Substantial increase in risk of maltreatment
  2. Risk of change in primary Caregiver before age 2 years
  3. Breast Feeding exposure to illicit substance
  4. Deliberate Poisoning with illicit substance
  5. Passive inhalation of illicit substance
  6. Accidental Ingestion of illicit substance
  7. Physical or Sexual abuse
  8. Household or neighborhood Violence

III. Complications: General

  1. Lack of Prenatal Care and other health care
  2. Fetal Growth Restriction
  3. Placental Abruption
  4. Preterm Labor
  5. Preterm Death
  6. High Risk Behavior (e.g. prostitution)

IV. Management: Preterm Recommendations for Obstetric Visits

  1. Every 2 weeks until 30 weeks
  2. Every week until delivery after 30 weeks

V. Labs: Sexually Transmitted Disease screening

VI. Imaging: Obstetric Ultrasound

  1. Baseline: late first or early second trimester
  2. Serial Ultrasound for Intrauterine Growth Retardation

VII. Monitoring

  1. Random Urine Drug Screening (obtain permit)
  2. Obstetric Ultrasound as above
  3. Nonstress Test
    1. Every two weeks from 30 to 35 weeks
    2. Weekly after 35 weeks
  4. Meconium Drug Screen from fetus after delivery

VIII. Management

  1. Child Protective Services reporting is required by most states in U.S.

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