In medicine we don’t often affect the care
of more than one patient at a time. With prenatal care we have two patients: the mother and
the fetus. Prenatal care includes a series of office visits spanning the pregnancy to
postpartum. Also performed are investigations throughout. The goal of this care is to minimize morbidity
and mortality for both mother and fetus and maximize chance of a safe delivery. Understanding
your patient’s medical history is very important as medical conditions can affect health of
the pregnant woman and fetus. Conversely, pregnancy can affect the course of medical
conditions. Each medication, prescription or over-the-counter, needs to be reviewed,
as many are not considered safe in pregnancy. No medication should be taken unless necessary.
Blood tests during pregnancy screen for common conditions, such as anemia and diabetes. Ultrasounds tell how many fetuses are present
and uncover genetic conditions, congenital anomalies, and problems with the placenta.
Knowing your patient’s gestational age and estimated due date is key in timing of tests.
If her last menstrual period is known, a simple rule is to add 7 days and subtract 3 months
for the due date. Early ultrasound measurement of the fetus can aid in dating the pregnancy.
After pregnancy, one last visit covers how the patient is recovering from delivery and
time for contraceptive counselling. Close care of the pregnant woman makes for a safer
pregnancy and delivery for both the mother and baby.