Editing Maternal and Newborn Nursing (section)

=== Visit schedule and routine screening ===

A common schedule for an uncomplicated pregnancy is every 4 weeks until 28 weeks, every 2 weeks from 28 to 36 weeks, then weekly until birth. Each visit includes weight, blood pressure, urine dipstick for protein and glucose, fundal height, fetal heart rate, fetal movement, and a review of danger signs.

Initial labs typically include blood type and Rh with antibody screen, CBC, rubella and varicella immunity, hepatitis B surface antigen, HIV, syphilis screening, gonorrhea and chlamydia testing, urine culture, and cervical cancer screening as indicated.

* '''Gestational diabetes screening at 24 to 28 weeks''', usually a 50 g 1-hour glucose challenge followed by a 100 g 3-hour oral glucose tolerance test if the screen is elevated.
* '''Group B ''Streptococcus'' (GBS) rectovaginal culture at 36 0/7 to 37 6/7 weeks.''' A positive culture, GBS bacteriuria in this pregnancy, or a previous infant with GBS disease means '''intrapartum''' IV antibiotic prophylaxis, typically penicillin G, ideally at least 4 hours before birth. Treating GBS antepartum does not prevent neonatal disease; the antibiotic must be given in labor.
* '''Rh-negative patients''' receive '''Rho(D) immune globulin at about 28 weeks''' and again '''within 72 hours after birth if the newborn is Rh positive'''. It is also indicated after miscarriage, ectopic pregnancy, elective termination, amniocentesis, chorionic villus sampling, external cephalic version, and abdominal trauma. Rho(D) immune globulin prevents maternal ''sensitization''; it does nothing once antibodies already exist, which is why the antibody screen matters.