Antepartum Care Guidelines

Essential Components of Antepartum Care

Routine antenatal and postnatal care is considered essential and should continue for all pregnant women, with modifications as needed based on individual risk factors, as recommended by the British Medical Journal 1
Health professionals should inquire about mental health during every consultation and connect women to relevant resources, according to the British Medical Journal and other guidelines 1, 3
After 28 weeks of gestation, social distancing should be observed more stringently for pregnant women, especially during pandemic situations, as suggested by the British Medical Journal 1, 2

Low-dose aspirin (81 mg daily) is recommended for women at high risk of preeclampsia, starting between 12 and 28 weeks of gestation, optimally before 16 weeks, as recommended by the American College of Obstetricians and Gynecologists 4

Detailed fetal anatomy ultrasound should be performed in the second trimester, as recommended by the American College of Obstetricians and Gynecologists 4, 5
Fetal echocardiogram is recommended for women with pregestational diabetes in the second trimester, according to the American College of Obstetricians and Gynecologists 4, 5
Antepartum fetal surveillance starting at 32 to 34 weeks of gestation is recommended for high-risk pregnancies, as suggested by the American College of Obstetricians and Gynecologists 4, 5
Ultrasound for fetal growth assessment should be conducted, especially for women with risk factors, as recommended by the American College of Obstetricians and Gynecologists 4, 5

Risk assessment for Venous Thromboembolism (VTE) should be performed for all pregnant women, according to Blood Advances 6, 7
For pregnant women with hereditary thrombophilia and family history of VTE, antepartum antithrombotic prophylaxis is suggested, as recommended by Blood Advances 6, 7
Postpartum antithrombotic prophylaxis is recommended for women with certain thrombophilias regardless of family history, according to Blood Advances 6, 7
The American College of Obstetricians and Gynecologists recommends strict glycemic control, screening for comorbidities, diagnostic testing, preeclampsia prophylaxis, fetal surveillance, and individualized planning regarding timing and mode of delivery for women with pregestational diabetes 4, 8
Women with obesity (BMI ≥30 kg/m²) should receive counseling about pregnancy risks including gestational diabetes, hypertension, miscarriage, and stillbirth, as recommended by the Obesity Reviews 9, 10

Pregnant women with COVID-19 should receive essential antenatal and postnatal care with appropriate precautions, according to the British Medical Journal 1, 2
Consider differential diagnoses such as pulmonary embolism and sepsis when evaluating pregnant women with COVID-19 symptoms, as suggested by the British Medical Journal 1, 2
For confirmed cases of COVID-19, refer women for fetal growth surveillance via ultrasound 14 days after symptom resolution, as recommended by the British Medical Journal 1, 2
Continuous electronic fetal monitoring is recommended during labor for all cases of suspected or confirmed COVID-19, according to the British Medical Journal 1, 2

Delivery timing should be individualized based on maternal and fetal conditions, as recommended by the American College of Obstetricians and Gynecologists 4, 5
For women with good glycemic control and no vascular complications, delivery at 39 0/7 to 39 6/7 weeks of gestation is recommended, according to the American College of Obstetricians and Gynecologists 4, 5
For women with poor glycemic control, vascular complications, or prior stillbirth, delivery at 36 0/7 weeks to 38 6/7 weeks may be appropriate, as suggested by the American College of Obstetricians and Gynecologists 4, 5