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Community & FamilyHealthFlogram Perinatal& Paediatric Services




lf LNMP unknown, orderan "urgent" trimester first U/S for dating lf ultrasound available the NorlhShore,consider not on optionsin VCH

Prenatal Screening EarlyPregnancy Loss Prenatal Biochemistry Laboratory Requisition Private Clinics
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FR OM 6- s W E E K S OI{WARDS 1 O_ 13 W E E K S

. All Rh negative patients require Rhogam pv bleeding for . Nuchalrranslucency Test (optional) for women40 and overat BC women's free r Private options available screening various for at locations . Selum Integrated Prenatal ScreenPart I available womenof all for OF F IC IAL S P R E N A T AL 1 t VIS IT- S TA R TP R E N A TA L E C OR D R physical ' Complete . PA P . Cervical swabsfor Chlamydia and N. Gonorrhea . HlV, Hep B, syphilis, rubella antibody titre(CDClab requisition) . Bloodtype (CBS lab requisition) o C BC . Urinalysis, c&s for asymptomatic (if bacteruria positive, of pretermlabour rlsk treatas per C&S). NOTE: Lab will only do if ordering physician clearly writes "screen for asymptomaticbacteruria" a Cornplete TWEAKScore a Startmonthlv prenatal visits . SerumIntegrated ScreenPart2 . Quad l,/laternal SerumScreenif SIPS Part 1 not done ,'lowlying',, RoutinePN ultrasound for fetaldetail(if placenta needto repear ATTENTION:once U/s report is back and blood work recorded on prenatal history . Fax copy of completed prenatal history Labour Delivery LGH {604-9g3to & at 6045) . Givepatient if travelolans (50 diabetes gm) plus repeatcanadian ' RepeatcBC and screenfor gestational (CBS)iab work BloodServices . lf screenpositive fullglucose do tolerance test . Referral Obstetrician previrtus to (to if c-section bookC/S or VBAC
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1 2 WE E K S

Baby'sBestChance Prenatal Class Schedule

15 - 20 WEEKS
1 8- 2 0 W E E K S 2 1 WE E K S

2 4 - 28 W E E K S

Breastfeeding Pamphlets

2 8 WE E K S

Rhogamshot if Rh negative (300micrograms) Start q2 week prenatalvisits Administer Edinburgh Postnatal Depression Scale inq FetalMovements

r FetalMovement Count Pamphlet . Perinatal Depression Support lnformation

32-36WEEKS 35 - 37 WEEKS

. Commence NSTsfor insulin dependant insulin or required pregnancies twice/week swabfor groupB strep | . Vaginallanal o Start weekly prenatalvisits copy of Prenatal Historv Record Labor& Deliverv to : Sgld original LGH U/S for fluidlevel. lmmediate induction indicated AFI < 5 cm and DVp < 2 if BegintwiceweeklyNSTsat localhospital ReviewFetalMovement Counts Reviewaccuracy EDC of at ' Discussand book induction 41 + 3 weeks I Minimum babyvisitsto physician 'l , 3 and 6 weekspostpartum at a communityHealth Nursewillcontact patient within24 hoursafterdischaroe o lf mastitispresent; treat with appropriate antibiotics 7-.,| days for 0 a Avoidcodeine in the breastfeedino mother
(As per societyof obstetricians and Gynecologists canada currentquidelines) of
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4 1 WE E K S

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. Mastitis Protocols Tx Coroners Report ' (Codeine)

Standardof Care determined LGH perinatat by Carc C