wcs117我们可以结婚吗.pdf

Can we get married? Pre-marital, pre-pregnancy and prenatal counselling Should we have children? •  chance of having a healthy child •  chance of having adverse pregnancy e • Current prenatal screening and diagnostic tests Objective of premarital, pre-pregnancy and prenatal counselling - to protect the health of the women - to reduce adverse pregnancy e - to promote the birth of healthy children Outline 1 Reproductive risks - maternal, fetal 2 Risk identification 3 Options for at-risk couples 4 Counselling concerns 1 Reproductive risks - maternal • pre-existing medical disease • pregnancy related complications • operative risk • psycho-social problems Pre-existing medical disease • gestational DM, thyroid disorders • hypertension, renal disease • valvular or congenital heart disease • autoimmune disease Reproductive risks - fetal • growth problems • congenital anomalies • infection • birth trauma Fetal growth problems Problem Maternal cause Fetal cause Growth Hypertension Syndromal restriction (early onset) Infection Macrosomia Gestational DM (suboptimal control) Syndromal Congenital anomalies • Chromosomal / g ic • Structural • Functional 2 Risk identification • History • Physical examination • Screening tests History • Age - hypertension, GDM; aneuploidy • Race - specific g ic disorders • Consanguinity - fetal loss, g ic disorders • Family history of g