Our objective was to provide the clinician with easy-to-use evidence-based guidelines, based on the best available literature, for offering effective preconception care, aimed at decreasing maternal and fetal/neonatal morbidity and mortality. We searched the Cochrane Library, MEDLINE, and PUBMED from 1966 until January 2009. We used the search terms "preconception," "preconception care," "prepregnancy," and "inter-pregnancy." We focused on level I publications, randomized studies, and meta-analyses of these studies in particular. We included non-English publications, if pertinent. We searched the reference lists of manuscripts identified, and selected those we judged relevant. Preconception care has been defined as a set of interventions that aim to identify and modify risks to a woman's health or pregnancy outcome through prevention and management. It should occur any time any healthcare provider sees a reproductive age woman. Personal and family history, physical exam, laboratory screening, reproductive plan, nutrition, supplements, weight, exercise, vaccinations, and injury prevention should be reviewed in all women. Folic acid 400 mcg per day, as well as proper diet and exercise should be encouraged. Women should receive the influenza vaccine if planning pregnancy during flu season; the rubella and varicella vaccines if there's no evidence of immunity to these viruses; and tetanus/diphtheria/pertussis if lacking adult vaccination. Specific interventions to reduce morbidity and mortality for both the woman and her baby should be offered to those identified with chronic diseases, or exposed to teratogens or illicit substances. There are several interventions that have been proven to effectively improve pregnancy outcome when provided as preconception care. These should be consistently provided to reproductive-age women. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEANING OBJECTIVES: After completion of this educational activity, the participant should be better able to assess potential benefits for women and their offspring that result from preconception care, translate specific evidence-based preconception strategies into clinical practice, and select resources for practitioners and patients that are print media or online related to preconception health.
"These differences should be kept in mind when developing implementation guidelines. Furthermore, there are initiatives to be taken by the entire healthcare to promote PCC, there is an urgent need for political support and it is necessary to develop an efficient reimbursement system (Berghella et al., 2010). "
[Show abstract][Hide abstract] ABSTRACT: Objective: To review the current knowledge and implementation of preconceptional care (PCC) in the Western world, focusing both on health care workers and the general population, and to analyze pathways to disseminate the influence of preconceptional care on pregnancy outcome.
A systematic literature study was performed using OvidSP and Pubmed, searching for articles about PCC and its implementation, published between 1966 and October 2012. Only randomized controlled trials and systematic reviews dealing with PCC in the Western world were retained.
Forty-six articles were identified for review. PCC might result in better pregnancy outcomes, including e.g. a reduction of congenital abnormalities. There are no proven disadvantages of PCC. Health care workers are in favor of the implementation of PCC, but claim that they don't have enough knowledge to do so. The general population shows interest in receiving PCC. The implementation of PCC should be improved by e.g. the development of guidelines and checklists.
As PCC might improve pregnancy outcomes and is considered important by health care workers and the general population, its implementation should be improved, e.g. by the development of guidelines and checklists.
[Show abstract][Hide abstract] ABSTRACT: The preconception care has been defined as reporting high-risk situations for future pregnancy, and management of those situations. Personal and family history, physical exam, laboratory screening, vaccination, nutrition supplements, and injury prevention should be reviewed in all women.
[Show abstract][Hide abstract] ABSTRACT: Assessment of structural birth defects (SBDs) in animal models usually entails conducting detailed necropsy for anatomical defects followed by histological analysis for tissue defects. Recent advances in new imaging technologies have provided the means for rapid phenotyping of SBDs, such as using ultra-high frequency ultrasound biomicroscopy, optical coherence tomography, micro-CT, and micro-MRI. These imaging modalities allow the detailed assessment of organ/tissue structure, and with ultrasound biomicroscopy, structure and function of the cardiovascular system also can be assessed noninvasively, allowing the longitudinal tracking of the fetus in utero. In this review, we briefly discuss the application of these state-of-the-art imaging technologies for phenotyping of SBDs in rodent embryos and fetuses, showing how these imaging modalities may be used for the detection of a wide variety of SBDs.
Birth Defects Research Part C Embryo Today Reviews 09/2010; 90(3):176-84. DOI:10.1002/bdrc.20187 · 2.63 Impact Factor
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