Preconception Care Flashcards

Vocabulary flashcards covering key definitions, risk factors, screening protocols, and medical management guidelines for preconception care based on chapter 23.

Preconception Care

Wide-ranging information, advice, screening, and care provision for birthing people and their partners before conception that focuses on optimising maternal and neonatal health and subsequent lifelong health for the baby.

Organogenesis Period

The critical period of early fetal development occurring $17$ to $56\text{ days}$ after conception when the early cell mass becomes organized into three germ layers (ectoderm, mesoderm, and endoderm) and the potential for fetal abnormality is highest.

Preconception Care Objectives

A set of five core clinical and public health goals: maximising parental and fetal health, reducing maternal and perinatal mortality and morbidity, enabling informed lifestyle and care choices, identifying risk factors and evaluating genetic potential, and advising on contraception discontinuation to plan conception.

Folic Acid Preconception Dosing

A standard daily supplement of $0.4\text{ mg}$ taken $2$ to $3\text{ months}$ before conception through the first trimester to prevent neural tube defects, or a higher daily dose of $4\text{ mg}$ for individuals with higher risk factors such as epilepsy, smoking, or alcohol use.

Preconception Target Body Mass Index (BMI)

A recommended body mass index between $21$ and $29$ that prospective parents are advised to achieve before conception to establish optimal nutritional stores and lower risks associated with being underweight ($\le 20$) or obese ($\ge 30$).

Varicella Zoster (VZ) Preconception Care

Screening birthing people for VZ antibodies and providing varicella zoster immunoglobulin if non-immune, while advising strict avoidance of pregnancy for $3\text{ months}$ post-vaccination due to a $1:3$ rate of spontaneous abortion following infection.

Cytomegalovirus (CMV)

A virus living within salivary glands transmitted through close contact with bodily fluids like saliva and urine; gamete donors must undergo CMV screening, and risk reduction centers on diligent hand washing after changing nappies and before meal preparation.

Erythema Infectiosum (Slapped Cheek Disease)

A communicable parvovirus infection transmitted airborne that is infectious $1\text{ week}$ prior to symptom onset and can lead to hydrops fetalis or intrauterine death if contracted during pregnancy.

Group B Streptococcus (GBS)

A bacterium present vaginally in $25\%$ of childbearing people without symptoms, associated with maternal infection, late miscarriage, stillbirth, preterm delivery, and neonatal meningitis, requiring intrapartum antibiotic prophylaxis.

Sperm Washing

An assisted conception technique available in select UK units where sperm is cleansed free of HIV prior to artificial insemination to reduce transmission risk compared to unprotected intercourse.

Listeriosis (Listeria monocytogenes)

A food-borne bacterial pathogen found in soil, water, unpasteurised milk, and soft cheeses that multiplies in refrigerators at $6^{\circ}\text{C}$ or above, taking up to $8\text{ weeks}$ for illness to emerge; prevention requires reheating food to steaming point.

Toxoplasmosis (Toxoplasma gondii)

A parasitic infection found in soil, cat litter, and raw or cured meats that can cause fetal neurological damage; precautions include wearing gloves when cleaning cat litter, hand washing after gardening, and thorough cooking of meat.

Target HbA1c in Preconception Diabetes Care

A target glycosylated haemoglobin level of $48\text{ mmol/mol}$ ($6.5\%$) prior to conception, whereas levels exceeding $59\text{ mmol/mol}$ ($7.5\%$) significantly elevate risks of hypoglycaemia, miscarriage, congenital malformations, and stillbirth.

Sodium Valproate Avoidance in Epilepsy

The preconception evaluation and discontinuation of sodium valproate due to severe teratogenic risks, adjusting antiepileptic drug (AED) regimens to the lowest effective dose before pregnancy.

Phenylketonuria (PKU) Preconception Management

A monogenic autosomal recessive metabolic disorder requiring a low-phenylalanine diet prior to conception and through the first trimester to keep blood phenylalanine levels strictly between $120$ and $360\text{ mmol/L}$.

Heparin Substitution in Cardiac Disease

The preconception replacement of warfarin with heparin for individuals requiring anticoagulation therapy, as warfarin is known to cause embryonic abnormalities.

Teratogenic Autoimmune Medications

Prescription drugs such as methotrexate and leflunomide used for rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) that must be reviewed and stopped pre-pregnancy due to teratogenic risks.

Preconception Care

Wide-ranging information, advice, screening, and care provision for birthing people and their partners before conception that focuses on optimising maternal and neonatal health and subsequent lifelong health for the baby.

Organogenesis Period

The critical period of early fetal development occurring $17\text{ to }56\text{ days}$ after conception when the early cell mass becomes organized into three germ layers (ectoderm, mesoderm, and endoderm) and the potential for fetal abnormality is highest.

Preconception Care Objectives

A set of five core clinical and public health goals: maximising parental and fetal health, reducing maternal and perinatal mortality and morbidity, enabling informed lifestyle and care choices, identifying risk factors and evaluating genetic potential, and advising on contraception discontinuation to plan conception.

Folic Acid Preconception Dosing

A standard daily supplement of $0.4\text{ mg}$ taken $2\text{ to }3\text{ months}$ before conception through the first trimester to prevent neural tube defects, or a higher daily dose of $4\text{ mg}$ for individuals with higher risk factors such as epilepsy, smoking, or alcohol use.

Preconception Target Body Mass Index (BMI)

A recommended body mass index between $21$ and $29$ that prospective parents are advised to achieve before conception to establish optimal nutritional stores and lower risks associated with being underweight ($\\le 20$) or obese ($\\ge 30$).

Varicella Zoster (VZ) Preconception Care

Screening birthing people for VZ antibodies and providing varicella zoster immunoglobulin if non-immune, while advising strict avoidance of pregnancy for $3\text{ months}$ post-vaccination due to a $1:3$ rate of spontaneous abortion following infection.

Cytomegalovirus (CMV)

A virus living within salivary glands transmitted through close contact with bodily fluids like saliva and urine; gamete donors must undergo CMV screening, and risk reduction centers on diligent hand washing after changing nappies and before meal preparation.

Erythema Infectiosum (Slapped Cheek Disease)

A communicable parvovirus infection transmitted airborne that is infectious $1\text{ week}$ prior to symptom onset and can lead to hydrops fetalis or intrauterine death if contracted during pregnancy.

Group B Streptococcus (GBS)

A bacterium present vaginally in $25\%$ of childbearing people without symptoms, associated with maternal infection, late miscarriage, stillbirth, preterm delivery, and neonatal meningitis, requiring intrapartum antibiotic prophylaxis.

Sperm Washing

An assisted conception technique available in select UK units where sperm is cleansed free of HIV prior to artificial insemination to reduce transmission risk compared to unprotected intercourse.

Listeriosis (Listeria monocytogenes)

A food-borne bacterial pathogen found in soil, water, unpasteurised milk, and soft cheeses that multiplies in refrigerators at $6^{\circ}\text{C}$ or above, taking up to $8\text{ weeks}$ for illness to emerge; prevention requires reheating food to steaming point.

Toxoplasmosis (Toxoplasma gondii)

A parasitic infection found in soil, cat litter, and raw or cured meats that can cause fetal neurological damage; precautions include wearing gloves when cleaning cat litter, hand washing after gardening, and thorough cooking of meat.

Target HbA1c in Preconception Diabetes Care

A target glycosylated haemoglobin level of $48\text{ mmol/mol}$ ($6.5\%$) prior to conception, whereas levels exceeding $59\text{ mmol/mol}$ ($7.5\%$) significantly elevate risks of hypoglycaemia, miscarriage, congenital malformations, and stillbirth.

Sodium Valproate Avoidance in Epilepsy

The preconception evaluation and discontinuation of sodium valproate due to severe teratogenic risks, adjusting antiepileptic drug (AED) regimens to the lowest effective dose before pregnancy.

Phenylketonuria (PKU) Preconception Management

A monogenic autosomal recessive metabolic disorder requiring a low-phenylalanine diet prior to conception and through the first trimester to keep blood phenylalanine levels strictly between $120$ and $360\text{ mmol/L}$.

Heparin Substitution in Cardiac Disease

The preconception replacement of warfarin with heparin for individuals requiring anticoagulation therapy, as warfarin is known to cause embryonic abnormalities.

Teratogenic Autoimmune Medications

Prescription drugs such as methotrexate and leflunomide used for rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) that must be reviewed and stopped pre-pregnancy due to teratogenic risks.

Preconception Smoking Cessation Timeline

The recommendation that both prospective parents quit smoking at least $4\text{ months}$ prior to conception to eliminate toxins like carbon monoxide and nicotine that reduce fetal oxygen supply and cause placental arteriole vasoconstriction.

Paternal Alcohol Effects on Fertility

The testicular toxic effects of alcohol consumption in prospective fathers, which decrease sperm count, reduce motility, cause sperm malformation, and lead to potential subfertility or impotence.

Preconception Rubella Vaccination Protocol

Determining antibody status before conception and administering the vaccine if non-immune, while advising individuals to delay pregnancy for $1\text{ month}$ post-vaccination to prevent high fetal risks associated with first-trimester infection.

Caffeine Preconception Limits

A substance whose excessive intake prospective parents are advised to limit, as consumption can reduce implantation and lower rates of conception by $27\%$.

High-Dose Vitamin A Teratogenicity

The recommendation to avoid supplements or foods rich in retinoids (such as liver and fish liver oil) prior to and during early pregnancy due to the risk of fetal malformations during the first trimester.

Preconception Dental Hygiene Rationale

The practice of completing dental treatments and maintaining oral hygiene before conception to lower the risk of preterm birth and avoid excessive surgical gum bleeding caused by increased pregnancy blood volume.

Preconception Asthma Management

The clinical recommendation for birthing people to continue safe asthma medications prior to and during pregnancy to maintain disease control and reduce maternal mortality.

CD4 Count in HIV Preconception Care

A key laboratory indicator measuring CD4 T-lymphocyte cells in blood to evaluate immune function; maintaining a high count and steady low viral load before conception reduces the risk of fetal and newborn HIV transmission.

Fertility Preservation in Cancer Care

The process of offering sperm and ova storage options to prospective parents before initiating chemotherapy or cancer treatments that could damage spermatogenesis or oogenesis.

Preconception Hypertension Screening

Baseline evaluations including retinopathy and renal function screening performed before conception to manage pre-existing high blood pressure and mitigate risks of superimposed pre-eclampsia or fetal growth restriction.

Thyroid Dysfunction Pregnancy Risks

Endocrine imbalance risks where untreated low thyroxine levels (hypothyroidism) can cause dwarfism and intellectual impairment, whereas high levels (hyperthyroidism) increase risks of miscarriage, preterm birth, and pre-eclampsia.

Occupational Chemical Toxins in Preconception

Environmental hazards such as pesticides, lead, mercury, phthalates, and arsenic found in agriculture or industrial work that increase risks of miscarriage, preterm birth, birth defects, and learning disabilities.