Other health maintenance items are updated at the initial visit, such as the Hepatitis B vaccine for women at risk and the tetanus vaccine. The prenatal intake should include a thorough history and physical to identify potential risks and to assist in referral to appropriate services. Once a woman has a confirmed pregnancy, she should be scheduled for the first prenatal visit that includes a full review of the pertinent history. The quantitative HCG is usually done in conjunction with examination and ultrasound to confirm a normal versus abnormal pregnancy, to correlate gestational age with the last normal menstrual period, or to guide in the management of a potential miscarriage. Most providers in the emergency, ambulatory, or episodic care environments use the urine HCG tests for the initial screen. The gold standard for pregnancy testing is the quantitative beta HCG radioimmunoassay. Women with a functioning reproductive system must have a pregnancy test to rule out pregnancy. Many women will come in for interim visits with complaints of abdominal pain, abnormal uterine bleeding, and irregular menses. The key determinants to a healthy pregnancy and reproductive life are preventing, identifying, and addressing preconception health issues, pregnancy readiness, early prenatal care, and minimizing risks during the perinatal and interconception period. This is a grade A recommendation by the United States Preventive Task Force (USPTF) and The American College of Obstetrics and Gynecology (ACOG) since most women present after the critical part of organogenesis. All women of reproductive age should receive folate at 400 mcg to 800 mcg to prevent neural tube defects. Taking these opportunities for a pregnancy test can play a major role in getting women to early prenatal care. Opportunities for diagnosing pregnancy and preventing unwanted and unplanned pregnancies exist during routine visits, sports exams, well-woman exams, emergencies, and during acute visits. Of the 40% of unintended pregnancies, early prenatal care is important to prevent poor perinatal outcomes and complications. Every couple must have the opportunity to plan for pregnancy and choose when they are ready for pregnancy. Of these pregnancies, more than 40% are unintended. Globally, there are more than 200 million pregnancies each year. The key determinants to a healthy pregnancy and reproductive life are the interprofessional team preventing, identifying, and addressing preconception health issues, pregnancy readiness, early prenatal care, and minimizing risks during the perinatal and interconception period. Of the 40 percent of unintended pregnancies, early prenatal care is important to prevent poor perinatal outcomes and complications.
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