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.
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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
Maternal Health Prior to Pregnancy
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.
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 can be provided most effectively as part of
ongoing primary care.
UTI & Renal problems.
Cardiac / pulmonary problems.
Check : EIP complete? women <18 yrs.
EIP = Expanded Immunization Program)
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.
a) Maternal health problems.
c) Age >20 or < 40
d) Late entry into prenatal care.