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Brief Summary

GUIDELINE TITLE

Routine prenatal and postnatal care.

BIBLIOGRAPHIC SOURCE(S)

  • Michigan Quality Improvement Consortium. Routine prenatal and postnatal care. Southfield (MI): Michigan Quality Improvement Consortium; 2006 Jul. 1 p.

GUIDELINE STATUS

This is the current release of the guideline.

BRIEF SUMMARY CONTENT

 RECOMMENDATIONS
 EVIDENCE SUPPORTING THE RECOMMENDATIONS
 IDENTIFYING INFORMATION AND AVAILABILITY
 DISCLAIMER

 Go to the Complete Summary

RECOMMENDATIONS

MAJOR RECOMMENDATIONS

The level of evidence grades (A-D) are provided for the most significant recommendations and are defined at the end of the "Major Recommendations" field.

Routine Prenatal and Postnatal Care

Recommendation 6-8 weeks 14-16 weeks 24-28 weeks 32 weeks 36 weeks 38 weeks 39 weeks 40 weeks 41 weeks Post partum 4-6 weeks after delivery
Social and medical history (update at each visit) X X X X X X X X X X
Assessment (dental and nutritional health, weight, physical and sexual activity, alcohol and drug abuse, tobacco use [A], domestic violence, environment, genetic risk factors, medications, transportation, seatbelt use [B], infant car seat use [A], childbirth education, adequate social support, coping skills, financial resources, knowledge of available resources, mental health, ability to comprehend information or care provided) (update at each visit) X X X X X X X X X X
Education and counseling (need for early [first trimester] and consistent prenatal care; prevention of unintended pregnancy; benefits and methods of breastfeeding; assessment and referrals for ongoing parenting education and early childhood care) X       X         X1
General physical exam X                 X
Pelvic exam X         X X X X X
Blood pressure [B], weight, body mass index (BMI) X X X X X X X X X X
Fundal height, weeks gestation X X X X X X X X X  
Routine urinalysis, culture [A]   X                
Urine for glucose and albumin X X X X X X X X X  
Fetal position, fetal heart tones   X X X X X X X X  
D (Rh) type, blood type, antibody screen [A] X                  
Pap smear [A] (if not performed in past 12 months) X                  
Human immunodeficiency virus (HIV) counseling/testing [A]

*Repeat at 36 weeks if previous negative test in prenatal care or women who have never been tested		 X       X          
Sexually transmitted diseases (STD) screening (gonorrhea [GC], chlamydia, Venereal Disease Research Laboratory [VDRL] [A]) for high-risk patients (e.g., new or multiple sexual partners, history of sexually transmitted diseases, not using condoms consistently or correctly)

*Rescreen in third trimester if at continued risk. 		X   X
(28-36 weeks+) 		             
Hepatitis B [A] and rubella screening [B] X                  
Hemoglobin and hematocrit [B] X   X   X          
Maternal serum alpha fetoprotein/multiple marker screening [B]   X
(16-20 weeks) 		               
Screening for gestational diabetes (test earlier if previous history gestational diabetes)     X             X2
Influenza vaccine (second or third trimester during flu season)   X X              
Group B strep cultures (vaginal and rectal)         X
(35-37 weeks) 		         
Folic acid (0.4 to 0.8 mg one month prior to conception through 1st trimester) [A] X X                

1 Education and counseling for prevention of unintended pregnancy

2 Arrange follow-up to screen for non-gestational diabetes six weeks after delivery and annually thereafter

Definitions:

Levels of Evidence for the Most Significant Recommendation

  1. Randomized controlled trials
  2. Controlled trials, no randomization
  3. Observational studies
  4. Opinion of expert panel

CLINICAL ALGORITHM(S)

None provided

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EVIDENCE SUPPORTING THE RECOMMENDATIONS

TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

The type of evidence is provided for the most significant recommendations (see "Major Recommendations" field).

This guideline is based on several sources, including: Routine Prenatal Care, Institute for Clinical Systems Improvement, 2005 (www.icsi.org).

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IDENTIFYING INFORMATION AND AVAILABILITY

BIBLIOGRAPHIC SOURCE(S)

  • Michigan Quality Improvement Consortium. Routine prenatal and postnatal care. Southfield (MI): Michigan Quality Improvement Consortium; 2006 Jul. 1 p.

ADAPTATION

This guideline is based on the Routine Prenatal Care, Institute for Clinical Systems Improvement, 2005 (www.icsi.org).

DATE RELEASED

2006 Jul

GUIDELINE DEVELOPER(S)

Michigan Quality Improvement Consortium - Professional Association

SOURCE(S) OF FUNDING

Michigan Quality Improvement Consortium

GUIDELINE COMMITTEE

Michigan Quality Improvement Consortium Medical Director's Committee

COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

Physician representatives from participating Michigan Quality Improvement Consortium health plans, Michigan State Medical Society, Michigan Osteopathic Association, Michigan Association of Health Plans, Michigan Department of Community Health and Michigan Peer Review Organization

FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

Not stated

GUIDELINE STATUS

This is the current release of the guideline.

GUIDELINE AVAILABILITY

Electronic copies: Available in Portable Document Format (PDF) from the Michigan Quality Improvement Consortium Web site.

AVAILABILITY OF COMPANION DOCUMENTS

None available

PATIENT RESOURCES

None available

NGC STATUS

This NGC summary was completed by ECRI on October 16, 2006. The information was verified by the guideline developer on November 3, 2006.

COPYRIGHT STATEMENT

This NGC summary is based on the original guideline, which may be reproduced with the citation developed by the Michigan Quality Improvement Consortium.

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DISCLAIMER

NGC DISCLAIMER

The National Guideline Clearinghouse™ (NGC) does not develop, produce, approve, or endorse the guidelines represented on this site.

All guidelines summarized by NGC and hosted on our site are produced under the auspices of medical specialty societies, relevant professional associations, public or private organizations, other government agencies, health care organizations or plans, and similar entities.

Guidelines represented on the NGC Web site are submitted by guideline developers, and are screened solely to determine that they meet the NGC Inclusion Criteria which may be found at http://www.guideline.gov/about/inclusion.aspx .

NGC, AHRQ, and its contractor ECRI Institute make no warranties concerning the content or clinical efficacy or effectiveness of the clinical practice guidelines and related materials represented on this site. Moreover, the views and opinions of developers or authors of guidelines represented on this site do not necessarily state or reflect those of NGC, AHRQ, or its contractor ECRI Institute, and inclusion or hosting of guidelines in NGC may not be used for advertising or commercial endorsement purposes.

Readers with questions regarding guideline content are directed to contact the guideline developer.
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