Pre-conception and pregnancy care guide

1. Health education and guidance: (1) Knowledge about childbirth (symptoms of labor, guidance on delivery methods, labor analgesia). (2) Guidance on immunization of newborns. (3) Instruction on puerperium. (4) Intrauterine monitoring of fetal condition. (5)Hospitalization and induction of labor at ≥41 weeks of gestation. (2) Routine health care: (1)Ask about fetal movement, contractions, redness, etc. (2) Physical examination is the same as prenatal examination at 30-32 weeks of gestation; cervical examination and Bishop score are performed. (1)Ultrasound examination: assess fetal size, amniotic fluid volume, placental maturity, fetal position and the ratio of peak systolic and end diastolic flow velocity of umbilical artery (S/D ratio), etc. (2) NST examination (1 time per week). 4.Ready items: None. The contents of routine examination are not recommended during pregnancy 1. extra-pelvic measurement: there is sufficient evidence that extra-pelvic measurement does not predict cephalopelvic disproportion at delivery. Therefore, it is not necessary to routinely check external pelvic measurements during pregnancy. For pregnant women with vaginal delivery, the pelvic outlet diameter can be measured in late pregnancy. 2. Serological screening for Toxoplasma gondii, cytomegalovirus and herpes simplex virus: At present, there are no mature screening methods for these three pathogens, and serological specific antibody tests for pregnant women cannot confirm when a pregnant woman is infected, whether the fetus is involved and whether there are any long-term sequelae, nor can the serological screening results of pregnant women be used to decide whether a pregnancy should be terminated. It is recommended that preconception screening or targeted screening during pregnancy should not be conducted for all pregnant women to avoid psychological fear and unnecessary interventions. 3.BV screening: the incidence of BV during pregnancy is 10% to 20%, which is related to the occurrence of preterm delivery. Pregnant women at high risk of preterm delivery can be screened for BV, but routine BV screening should not be performed for all pregnant women. 4. cervicovaginal discharge test for fFN and ultrasonographic assessment of the cervix: in pregnant women at high risk of preterm labor, the value of these two screening tests is that negative results suggest no possibility of preterm labor in the near future, thus reducing unnecessary interventions. However, there is insufficient evidence to support cervicovaginal secretion fFN testing and ultrasound cervical assessment in all pregnant women. 5.Checking urine protein and blood routine at each antenatal visit: urine protein and blood routine tests are not required at each antenatal visit, but repeated urine protein and blood routine tests may be performed in pregnant women with gestational hypertensive disease and gestational anemia. 6. Thyroid function screening: Hypothyroidism in pregnant women affects the development of neurointelligence in children, and some experts recommend screening thyroid function [free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH)] in all pregnant women, but there is not enough evidence to support screening of thyroid function in all pregnant women, and adequate iodine intake should be ensured during pregnancy. . 7. Tuberculosis screening: At present, there is insufficient evidence to support screening for tuberculosis (including PPD tests and chest X-rays) in all pregnant women. High-risk pregnant women (high TB prevalence areas, poor housing conditions, HIV infection, drug addicts) can be screened for TB at any time of pregnancy.