Preconceptional care (PCC) (The Critical role of Primary Care Physician). Introduction to Primary Care a course of the Center of Post Graduate Studies i n FM. PO Box 27121 – Riyadh 11417 Tel: 4912326 – Fax: 4970847. Content of this session. Overview Rational of PCC. Objectives of PCC.
Preconceptional care (PCC)(The Critical role of Primary Care Physician)
Introduction to Primary Care
a course of the Center of Post Graduate Studies in FM
PO Box 27121 – Riyadh 11417
Tel: 4912326 – Fax: 4970847
Rational of PCC.
Objectives of PCC.
PCC implementation at PHC centers.
Physicians' role - delivering PCC.
Obstacles of PCC.
13.82 births/1000 population
28.55 births/1000 population
country comparison to the world 52
21.70 births/1000 population
16.02 births/1000 population
7.64 births/1000 population
7 deaths/1000 live births.
11.7 deaths / 1000 live births
12.70 deaths / 1000 live births
27.26 deaths / 1000 live births
2.4 deaths / 1000 live births
Central Intelligence Agency, The WORLD FACTBOOK
Potentially all related to
Maternal Health Prior to Pregnancy
Rational of PCC
Objectives of PCC
Screening tool for physicians to assess women’s health
In one sense, PCC can be compared to:
Will Baby Clinic visit
a baby is screened for Normal health, Normal Development to identify emerging unnoticed problems in an infant.
Objectives of PCC
For a Woman: PCC assess Normal health of a child-bearing woman, to identify: -
Existing or emerging illness or disease which may have gone undetected before.
Existing risks for the woman who may become pregnant.
Existing risks which may affect a fetus if the woman does become pregnant.
PCC at PHC centers
PCC can be provided most effectively as part of
ongoing primary care.
Components of PCC
What is involved in PCC?
Assess & screen for:
UTI & Renal problems.
Cardiac / pulmonary problems.
Examples Genetic counseling
Check : EIP complete? women <18 yrs.
EIP = Expanded Immunization Program)
Sexually Transmitted Infection (STI = STD)
STI : PCC is a good opportunity to screen for genital infections such as Chlamydia, gonorrhea, syphilis and HIV.
Medications : therapeutic regimens for chronic illnesses are best modified, if possible, in PC period to include the drugs that have been used the longest & have been determined to pose the lowest risk.
Antihypertensives: Diuretics & angiotensin-converting enzyme should be avoided
drug of choice: methyldopa- proven maternal & fetal safety.
Warfarin ContraIndidated Switch to heparin
Switch to insulin before pregnancy.
Worldwide: women entry to workforce.
Most women are in reproductive age
Is increasingly recognized as a major public health issue.
It crosses all racial, religious & educational boundaries.
Physical abuse during pregnancy :
significant Risk Factor low birth wt & maternal complications.
Physicians should assess the victims
& refer to local community resources.
Obstacles of PPC
PCC in Saudi Arabia
تم بحمد الله
a) Maternal health problems.
c) Age >20 or < 40
d) Late entry into prenatal care.