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planned parenthood; preconception planning; preconception risk assessment

While Planned Parenthood is the name of an organization that provides a variety of women's health services [2], the term is used here literally, that is planning of parenthood, including preconception planning & preconception risk assessment. Assessment: - desire for pregnancy - number & timing of pregnancies - understanding of reproductive fitness - exposures to environmental hazzards & toxins - radiation, lead, mercury - nutrition - folic acid (+) - mercury-containing fish (-) - family history (genetic disease) - substance abuse - alcohol, tobacco, illicit drugs - medical history - seizures - diabetes mellitus - hypertension - thyroid disease, - asthma - HIV1 infection - lupus - obstetric history - pregnancy-induced hypertension, pre-eclampsia - gestational diabetes - medications - over the counter medications - prescription medications - potential teratogens* - immunizations - varicella, rubella, pertussis, tetanus, hepatitis B - psychosocial stress - depression - interpersonal or family stress - risk for domestic violence * teratogens commonly prescribed by internists - ACE inhibitors - androgens & testosterone analogs - carbamazepine - folate antagonists - lithium carbonate & other lithium saltss - phenytoin - primodone - statins - tetracyclines, including doxcylcine - valproic acid - vitamin A analogs - isotretinoin, retinoids, etretinate - warfarin Laboratory: - carrier screening for - cystic fibrosis - cystic fibrosis genotyping - spinal muscular atrophy [4] - childhood spinal muscular atrophy genotyping - complete blood count to quantify the risks for thalassemias & hemoglobinopathies [4] - consider screening for - fragile X syndrome - Fragile X syndrome genotyping - Tay-Sachs disease - PSAP genotyping, HEXA gene mutation, HEXA gene deletion Notes: - also see prenatal care - in 2017 Republicans in congress planned to ban Planned Parenthood from access to Medicaid reimbursements & federal family-planning funds - the Republican plan would prohibit Planned Parenthood from billing the federal government for contraception & other reproductive health care services, tests for STDs, & primary care [3]

Related

prenatal care

General

health care

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018.
  2. Callegari LS, Ma EW, Schwarz EB. Preconception care and reproductive planning in primary care. Med Clin North Am. 2015 May;99(3):663-82. Review. PMID: 25841606
  3. Ciccariello C Defunding Planned Parenthood - The Stakes for America's Women. JAMA Internal Medicine. Feb 3, 2017 PMID: 28158330 http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2600545
  4. American Congress of Obstetrics & Gynecologists Carrier Screening in the Age of Genomic Medicine. Committee Opinion Number 690, March 2017 http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Genetics/Carrier-Screening-in-the-Age-of-Genomic-Medicine - American Congress of Obstetrics & Gynecologists Carrier Screening for Genetic Conditions. Committee Opinion Number 691, March 2017 http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Genetics/Carrier-Screening-for-Genetic-Conditions
  5. Planned Parenthood https://www.plannedparenthood.org