Psych iatric Cha p. 61, p. 11 75 Depression: Screen for symptoms of depression. Counsel on risks of treatment and disorders of untreated illness and the high risk of exacerbation during pregnancy and the puerperium.
Neurological Chap. 60, p. 11l59 Seizure disorder: Optimize seizure control using monotherapy if possible. disorders Dermatological Chap. 12, p. 245 Discuss isotretinoin and etretinate teratogenicity and effective contraception disease during their use; switch agents before conception.
Cancer Chap. 63, p. 11l92 Counsel on fertility preservation options before cancer therapy and on decreased fertility following certain agents. Discuss appropriateness of pregnancy balanced with need for ongoing cancer therapy and prognosis of the disease state.
Infectious Chap. 64, p. 1209 Influenza: Vaccinate all women who will be pregnant during flu season. Vaccinate diseases high-risk women prior to flu season.
Malaria: Counsel to avoid travel to endemic areas during conception. If unable, offer effective contraception during travel or provide chemoprophylaxis for those planning pregnancy.
Zika virus: See travel restrictions by CDC.
Rubella: Screen for rubella immunity. If nonimmune, vaccinate and counsel on the need for effective contraception during the subsequent month.
Tdap: tetanus, diphtheria, pertussis: Update vaccination in all reproductive-aged women.
Varicella: Question regarding immunity. If nonimmune, STDs Chap.l65,lp.l1235 Gonorrhea, syphilis, chlamydial infection: Screen high-risk women and treat as indicated.
HIV: Screen at-risk women. Counsel afected women on risks during pregnancy and on perinatal transmission. Discuss initiation of treatment before pregnancy to decrease transmission risk. Offer effective contraception to those not desiring conception.
HPV' Provide Pap smear screening per guidelines (Chap. 63, p. 1193). Vaccinate candidate patients.
HSV: Provide serological screening to asymptomatic women with affected partners. Counsel affected women on risks of perinatal transmission and on preventative measures during the third trimester and labor.
ACE = angiotensin-converting enzyme; ACOG = American College of Obstetricians and Gynecologists; ARB = angiotensinreceptor blocker; BMI = body mass index; CDC = Centers for Disease Control and Prevention; HIV = human immunodeficiency virus; HPV = human papillomavirus; HSV = herpes simplex virus; HTN = hypertension; NSAID = nonsteroidal antiinflammatory drug; RA = rheumatoid arthritis; SLE = systemic lupus erythematosus; STD = sexually transmitted disease. Data from Jack BW, Atrash H, Coonrod DV, et al: The clinical content of preconception care: an and preparation of this supplement, Am J Obstet Gynecol. 2008 Dec;199(6 Suppl 2):5266-S279.
Aghajanian P, Gupta M: Helping your epileptic patient. Contemp OB/GYN 60:10,s2015
Aguglia U, Barboni G, Battino 0, et al: Italian consensus conference on epilepsy and pregnancy, labor and puerperium. Epilepsia 50:7, 2009
Amant F, Vandenbroucke T, Verheecke M, et a1: Pediatric outcome after maternal cancer diagnosed during pregnancy. N Engl J Med 3(19): 1824, 2015 American Academy of Pediatrics: Maternal phenylketonuria. Pediatrics 122: 445, 2008