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First Trimester Education
Aka: First Trimester Education, Pregnancy Education in the First Trimester, Prenatal Patient Education, Antepartum Counseling
- See Also
- Second Trimester Education
- Third Trimester Education
- Postpartum Education
- First Obstetric Visit
- Prenatal Visit
- Nutrition in Pregnancy
- Travel in Pregnancy
- Exercise in Pregnancy
- Medications in Pregnancy
- Approach
- See Pregnancy Risk Assessment
- See Preconception Counseling
- History: Habits
- See Nutrition in Pregnancy
- See Exercise in Pregnancy (includes Lifting Restrictions in Pregnancy)
- See Medications in Pregnancy
- Wear Seat Belts (three point Seat Belt)
- Sexuality
- Regardless of frequency or timing, sexual intercourse is safe and does not impact maternal or fetal outcomes
- Kong (2019) J Obstet Gynaecol 39(4): 455-60 [PubMed]
- Reduce adverse health risks
- Tobacco Cessation
- Tobacco associated with 4600 U.S. perinatal deaths per year
- Alcohol Abstention
- See Fetal Alcohol Syndrome
- Marijuana
- Associated with low birth weight and NICU admission
- Heavy use is associated with Cannabinoid hyperemesis and Preterm Labor
- Avoid in pregnancy
- Metz (2018) Obstet Gynecol 132(5): 1198-1210 +PMID:30234728 [PubMed]
- Bailey (2020) Perinatol 40(10):1477-82 +PMID:32139807 [PubMed]
- See Substance Abuse in Pregnancy
- Illicit Drug use Cessation
- Intimate Partner Violence
- Obesity (see Nutrition in Pregnancy)
- Relaxation Positions
- Incline
- Lie back with head and back against incline chair
- Pillow under hips and behind head and neck
- Semi-prone
- Prone or slightly on side propped up
- Pillows under one hip and head
- One knee flexed to assist in propping
- Activities to avoid
- Avoid hot tubs and saunas (increased Miscarriages and Neural Tube Defects)
- Avoid hair treatments with hair dye or hair straightening products (unknown effect)
- May be associated with childhood Acute Leukemia
- Couto (2013) Chem Biol Interact 205(1): 46-52 [PubMed]
- Symptoms
- Discomforts to expect
- Fatigue
- Nausea or Vomiting
- Symptoms prompting urgent evaluation
- Vaginal Bleeding
- Abdominal Cramping
- Labs
- Weeks 8 to 18
- Obstetric Ultrasound for dating and surveillance
- Aneuploidy Screening and Neural Tube Defect Screening
- See Aneuploidy Screening
- Requires education starting in first trimester
- First trimester screening (Nuchal Translucency, Free bHCG, PAPPA) at 9-11 weeks
- Second trimester screening (AFP, uE3, HCG, Inhibin) at 15-19 weeks
- Advanced Testing for women for over 35 years (or abnormal screening results)
- Chorionic Villus Sampling at 9 to 13 weeks
- Amniocentesis at 16 to 18 weeks
- Prevention: Neural Tube and other congenital defects
- See Nutrition in Pregnancy
- Prenatal Vitamins with Folic Acid 400 mcg (600 Dietary Folate Equivalents or DFE) per day
- Reduce risk of Neural Tube Defect
- Limit Vitamin A intake to under 8000 IU qd
- Over 15000 IU/day Vitamin A associated with defects
- Prevention: Infectious agents to avoid (and to notify provider if exposure occurs)
- See Toxoplasmosis Prevention
- Listeria (see Nutrition in Pregnancy)
- Varicella Zoster Virus (see VZV for Post-exposure Prophylaxis)
- Parvovirus B19
- References
- Caro (2020) Am Fam Physician 102(7):420-6 [PubMed]
- Zolotor (2014) Am Fam Physician 89(3): 199-208 [PubMed]