Pre-Conception Counseling: Obtaining a Medical History and Determining Risk Factors before Prescribing

Credit

Handouts/Brochure

Speaker

Marry Vuong, PharmD, BCPPS Related seminars and products

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Marry Vuong, PharmD, BCPPS, is a Board Certified Pediatric Clinical Pharmacist and head of staff at Perfecting Peds. She completed her bachelor’s degree in nutrition and Doctorate in pharmacy from the University of Florida. She then completed her PGY-1 Pediatric Pharmacy Residency at Nicklaus Children’s Hospital where she worked for almost six years as a Neurology/Neurosurgery/General Pediatrics Clinical Pharmacy Specialist.

 

Speaker Disclosures:
Financial: Marry Vuong has employment relationships with Solidcore, LLC., Perfecting Peds LLC. and Lucy Tran Collection, LLC. She receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Marry Vuong is a peer reviewer for ACCP BCPPS Recertification, the Seizure Journal, the American Academy of Pediatrics, and the Journal of Pediatric Pharmacology and Therapeutics.

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Objectives

1. Assess the patient's medical history and potential risks during pregnancy.
2. Provide guidance on the appropriate use of medications, including the identification of teratogenic medications.
3. Determine risk factors associated with infections in pregnancy. 
4. Determine age-related risks during preconception and pregnancy. 
5. Analyze various risk factors (genetics and family history) that should be considered during preconception and pregnancy. 
6. Analyze laboratory findings in pregnancy women.
7. Assess a patient’s past pregnancy history as it relates to risk.

Outline

Part 1: Obtaining a Medical History

• Components of Pre-Conceptual Medical History
  • Menstrual and Reproductive History 
    • Pre-Existing Chronic Medical Conditions
    • Hypertension
    • Epilepsy
    • Thyroid Disease – hyper and hypo
    • Rheumatoid Arthritis/Lupus – Anti-inflammatories, biologics
    • Hepatitis/HIV
    • STIs – G/C, Chlamydia, HSV, Syphilis
  • Pregestational Diabetes Mellitus
  • Fetal/Neonatal and Maternal Risks
• Psychiatric/Mental Health
  • Anxiety/Depression - SSRI’s/TCSs
  • Bipolar – Lithium
  • Schizophrenia – Antipsychotics
• Risks/Classes of Medication
• Supplements/OTC
• Other medications
• Immunizations

Part 2: Determining Risk Factors

• Age related risk
  • Education and effect of age on fertility
  • Women > 35 years
  • Women >40 years
• Genetic Factors/Family History
  • Carrier Screening
  • CF/Spinal Muscular Atrophy
  • Others
  • Red Flags
• Labs
  • Standard Panel
  • Selective Panel
• Past pregnancies/miscarriages

Target Audience

• Nurse Practitioners
• Advanced Practice Nurses
• Clinical Nurse Specialists
• Physician Assistants
• Pharmacists
• Physicians
• Nurses 
• Midwives
• Doulas