Preconception Counseling

Uncontrolled diabetes in mother is associated with following defects in neonate except

A. Hyperbilirubinemia
B. Visual problems
C. Congenital heart defects
D. Miscarriage

To avoid Congenital heart defects in the fetus, HbA1c must be maintained below

A. 6
B. 6.5
C. 5.6
D. 5.8

Recommended waiting period for rubella-containing vaccine before pregnancy

A. 36 days
B. 28 days
C. 45 days
D. 90 days

Increased thyroid hormone secretion in pregnancy is due to all except

A. Thyroid stimulation starts as early as the first trimester by β-HCG hormone
B. Estrogen-mediated increase in circulating levels of thyroid-binding globulin (TBG)
C. Decreased hepatic degradation of TBG
D. Estrogen mediated sialylation of TBG that increases the half-life from 15 min to 3 days

Not true of women exposed to HIV desiring pregnancy

A. Viral load should be undetectable before pregnancy
B. Antiretroviral therapy should be started before pregnancy
C. Artificial insemination is the safest way for an HIV-infected couple to become pregnant
D. Preexposure prophylaxis should continue throughout pregnancy

All are true regarding Tdap vaccine for pregnant women except

A. Adult women whose Tdap vaccination status is unknown should receive a single dose
B. Tdap vaccine should be given to all women during each pregnancy
C. If Tdap is administered earlier in pregnancy, it should be repeated between 27 and 36 weeks gestation
D. If Tdap is administered at a preconception visit, it should be administered again during pregnancy between 27 and 36 weeks gestation

In short

  • Optimal timing for Tdap vaccine is between 27 and 36 weeks gestation (preferably during the earlier part of this period) to maximize the maternal antibody response and passive antibody transfer to the infant.
  • Breastfeeding is not a contraindication for receiving Tdap and is, in fact, fully compatible with Tdap vaccination.
  • Zika virus is also transmitted from mother to fetus during pregnancy, as well as through sexual contact, transfusion of blood and blood products, and possibly through organ transplantation.
  • A pregnant woman should not get any doses of the HPV vaccine until her pregnancy is completed.
  • Pregnant people should get an injectable flu vaccine  and not the nasal spray flu vaccine.

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