1.13 screening in pregnancy

hepatitis b

HIV: Screening (HIV test) should be offered to every woman who gets pregnant. If positive, Zidovudine prophylaxis should be started during the latter half of pregnancy. IV zidovudimne must be given during labor and the newborn must be given Zidovudine for 6 weeks.

hep c

syphilis

Gestational Diabetes screening : Glucose Tolerance Test - 26th -28th week
Three percent of pregnant women will get gestational diabetes. Symptoms are minimal. Treatment is necessary to prevent macrosomia (big baby), congenital defects and SIDS. All pregnant women should be screened using a random glucose test. 15 percent of women have high glucose levels on this screening test, but only a small percentage of these women will actually have gestational diabetes when further testing is done.

htn

Group B Streptococci (GBS) Test - between 35 and 37 weeks
Nearly 30% of women have this colonizer bacterium in the GIT. Vaginal and rectal swabs are taken for Group B Streptococci. GBS can cause meningitis or other serious infections in neonates. If positive for GBS, the mother is given Ampicillin IV during labor. Also IV Ampicillin should be offered to mothers whose membranes rupture before they can be tested, those whose membranes rupture occured 18 or more hours before delivery or temp >100.4F during labor. The antibiotic should be given as soon as labor starts. Use Clinda IV in PCN allergic.

Asymptomatic bacteruria: Screening is done in the first trimester. If positive, treat with Amox/Nitrofurantoin/Oral Cephalosporin. Then check every visit.

wt gain

proteinuria

fetal heart sound