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Screening and treatment for iron deficiency anemia can reduce the risks of preterm labor, intrauterine growth retardation, and perinatal depression.Testing for aneuploidy and neural tube defects should be offered to all pregnant women with a discussion of the risks and benefits.Routine pelvimetry is not useful.11 Papanicolaou smears should be offered during prenatal care at recommended intervals based on age and Papanicolaou smear history, but do not need to be repeated during pregnancy.12 Although promotion of breastfeeding is critical, there is no clear evidence to support clinical breast examinations.However, breast examinations may help to proactively address breastfeeding concerns or problems.13 Although assessment of fundal height and fetal heart tones at every visit is recommended in multiple guidelines, the effect on outcomes is not clear.610Early body mass index measurement, using prepregnancy height and weight, is important to guide further nutritional counseling and to address the risks of obesity and diabetes.14 Measurement of blood pressure at each prenatal visit will identify chronic hypertension and hypertensive disorders that may develop during pregnancy, such as preeclampsia and gestational hypertension.6 These disorders are often asymptomatic.Physicians should recommend folic acid supplementation to all women as early as possible, preferably before conception, to reduce the risk of neural tube defects.Administration of Rh(D) immune globulin markedly decreases the risk of alloimmunization in an Rh D-negative woman carrying an Rh D-positive fetus.Ultrasonography can accurately date the pregnancy, evaluate for multiple gestation, and reduce the likelihood of unnecessary labor induction for postterm pregnancy.2021 Pregnancy dating should be confirmed with auscultation of fetal heart tones between 10 and 12 weeks, and with fetal quickening between 16 and 18 weeks in women who have been pregnant before or between 18 and 19 weeks in first pregnancies. communities to offer a single ultrasound examination at 18 to 20 weeks' gestation, even if dating confirmation is not needed.11 This is the optimal time for fetal anatomic screening,23 although the sensitivity of ultrasonography for structural anomalies is poor (overall sensitivity from 11 studies = 24.1%, range = 13.5% to 85.7%).6(D) immune globulin should also be administered if the risk of fetal-to-maternal transfusion is increased (e.g., with chorionic villus sampling, amniocentesis, external cephalic version, abdominal trauma, or bleeding in the second or third trimester).A randomized trial comparing routine screening ultrasonography (between 15 and 22 weeks and again at 31 to 35 weeks) performed only for medical indications showed no difference in perinatal outcomes (e.g., fetal or neonatal death, neonatal morbidity).22 A recent Cochrane review, however, showed that ultrasonography before 24 weeks reduces missed multiple gestation and inductions for postterm pregnancies.21 There is no other scientific support for routine ultrasonography in uncomplicated pregnancies. Although alloimmunization is uncommon before 12 weeks' gestation, women with a threatened early spontaneous abortion may be offered Rh Iron deficiency anemia is associated with an increased risk of preterm labor, intrauterine growth retardation, and perinatal depression.26 All pregnant women should be screened for anemia early in pregnancy and treated with supplemental iron if indicated.626The U. Preventive Services Task Force has found insufficient evidence to recommend for or against routine iron supplementation.27 Multivitamins alone have demonstrated no benefit over iron and folate supplementation.28 Pregnant women with anemia other than iron deficiency or who do not respond to iron supplementation within four to six weeks should be evaluated for other conditions, including malabsorption, ongoing blood loss, thalassemia, or other chronic diseases.

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For information about the SORT evidence rating system, go to Standard elements of prenatal care include a routine physical examination (including pelvic examination) at the initial visit, maternal weight and blood pressure at all visits, fetal heart rate auscultation after 10 to 12 weeks with a Doppler monitor or after 20 weeks with a fetoscope, fundal height after 20 weeks, and fetal lie by 36 weeks.8A pelvic examination at the initial visit is useful in detecting reproductive tract abnormalities and to screen for sexually transmitted infections.Many elements of routine prenatal care are based on tradition and lack a firm evidence base; however, some elements are supported by more rigorous studies.Correct dating of the pregnancy is critical to prevent unnecessary inductions and to allow for accurate treatment of preterm labor.Most laboratories can report the risk of trisomy 18 syndrome using serum testing.Protocols for the detection of other trisomies can detect a large portion of these anomalies.

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There’s nothing wrong with going under the knife – it isn’t a crime to want to make yourself look better and feel more confident. Here are 13 celebrities who look different then and now – some more drastically than the others. Before: Taiping princess (read: flat chested) After: Hot bikini babe showing a generous amount of cleavage Controversy: Peh started tongues wagging when she appeared in a Channel 8 cooking show in a low-cut halter neck dress, revealing a shocking D-cup. Before: Small eyes with an unflattering haircut After: Bigger eyes and definitely one hot mama Plastic surgery? Before: Single eyelids which made him look sleepy After: Well-defined double eyelids with deep folds Plastic surgery? How it might have helped his career: Lee managed to clinch his first Top 10 Most Popular Male Artistes award this year.

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