Pregnancy & Prenatal Care

  • Discuss key pre-conception considerations in healthy women of childbearing age (e.g. folic acid supplementation, smoking, rubella immunity, etc.).
  • Perform an adequate first prenatal visit including taking a history and performing an appropriate focused physical exam with the assistance of available antenatal tracking tools.
  • Screen for and identify pregnancies at risk (e.g. domestic violence, multiple gestation, maternal age, substance use, etc.)
  • Conduct a basic prenatal visit, including BP measurement, weight, fetal heart rate (starting at 12 weeks), symphysis-fundal height (20 weeks and beyond), screening for concerns and complications.
  • Identify potential serious complications in the first trimester and their initial work-up, including ectopic pregnancy and miscarriage.

Core Resources

Preconception Health Care Tool

Centre for Effective Practice in collaboration with the Ontario College of Family Physicians.  Preconception Health Care Tool.  Centre for Effective Practice.  Revised November 2015.

Ontario Perinatal Record

Ontario Ministry of Health and Long-Term Care. 2017 Ontario Perinatal Record. 2017. Available at: http://www.pcmch.on.ca/

Common Prenatal Problems Clinical Card-2011

Bach TV O’Beirne M Keegan DA.  Common Prenatal Problems.  Canadian Family Medicine Clinical Card.  2011.  Available at: https://sites.google.com/site/sharcfm/

First Trimester Bleeding

Deutchman M, Tubay AT, Turok D. First trimester bleeding. Am Fam Physician. 2009;79(11):985-994.

Diagnosis and Management of Ectopic Pregnancy

Barash JH, Buchanan EM, Hillson C. Diagnosis and management of ectopic pregnancy. Am Fam Physician. 2014;90(1):34-40. doi: d10859 [pii].

Antenatal emodule

Akhtar S, Law M, Mardimae A et al.  Antenatal Primary Care: Family and Community Medicine Clerkship Core Curriculum Module.  University of Toronto.

Postpartum Care: An Approach to the Fourth Trimester

Paladine H, Blenning C, and Strangas Y. Postpartum Care: An Approach to the Fourth Trimester. Am Fam Physician. 2019;100(8):485-491.

Supplemental Resources

Update on Prenatal Care.pdf

Zolotor AJ, Carlough MC. Update on prenatal care. Am Fam Physician. 2014;89(3):199-208. doi: d10490 [pii].

Sunnybrook DFCM Prenatal checklist

Domb S.  Sunnybrook DFCM Routine Prenatal Checklist.  Sunnybrook Health Sciences Centre.  Revised Nov 2018. Dr. N. Gelber, Dr. S. Domb, Dr. M. Shuman.

An Approach to the Postpartum Office Visit.pdf

Blenning CE, Paladine H. An approach to the postpartum office visit. Am Fam Physician. 2005;72(12):2491-2496.

HYPERTENSION_IN_PREGNANCY_CLINICAL_CARD.pdf

Ressel B, O’Beirne M. HTN in Pregnancy. Canadian Family Medicine Clinical Card. 2015. Available at: https://sites.google.com/site/sharcfm/

First Trimester Bleeding: Evaluation and Management

Hendricks E, MacNaughton H, MacKenzie M. First Trimester Bleeding: Evaluation and Management. Am Fam Physciain. 2019; 99(3):166-174