Bradford VTS Online Resources:
path: WOMEN’S HEALTH
path: WOMEN’S HEALTH
When some tells you they are newly pregnant...
- Discuss smoking cessation, alcohol intake, weight management, exercise
- Discuss nutritional advice – care with dairy produced, tinned meats etc
- Prescribe folic acid intake: usual dose for most women trying to get pregnant and during the first 12 weeks of pregnancy is 400 micrograms, taken once a day.
- Remember higher dose Folic acid 5mg od if
- BMI >30,
- if diabetic,
- family history or past history of NTD,
- if taking anti-epileptic medication
- in multiple pregnancies.
- Medication review
- Mental health and emotional wellbeing review
Optimising Perinatal Care
- ALWAYS ask women before and after birth about their mental wellbeing and consider their mental health history. Past history is important in identifying women at high risk of mental illness and should be considered for referral.
- Fluoxetine is the safest SSRI in pregnancy.
- Sertraline is the safest during breastfeeding a full term, healthy baby.
- Psychotropic medication should not be stopped because of pregnancy but it is important to consider risks/benefits and seek advice.
The Importance of Aspirin in Pregnancy
- Aspirin taken from the first trimester can improve placental blood flow and therefore fetal growth.
- It reduces stillbirth risk, prevents pre-eclampsia and associated preterm delivery.
- See the Bradford Royal Infirmary risk assessment for deciding who to give aspirin to throughout pregnancy:
- Midwives will use the risk assessment tool when deciding if aspirin is required, please continue prescriptions when requested.
- More placentas are now being sent for histology. If there is evidence of placental dysfunction or insufficiency, then aspirin will be recommended for future pregnancies. Look for recommendations in the snowdrop (pregnancy loss) clinic letters.
- Have a look at The Leicester Guidance (2019) – in particular, appendix 1 based on NICE guidelines (2019) and Saving Babies Lives (2019)