TY - CHAP M1 - Book, Section TI - Chapter 39. Care of the Fetus A1 - Jobe, Alan H. A2 - Rudolph, Colin D. A2 - Rudolph, Abraham M. A2 - Lister, George E. A2 - First, Lewis R. A2 - Gershon, Anne A. Y1 - 2011 N1 - T2 - Rudolph's Pediatrics, 22e AB - The goals of prenatal care are to assess pregnancy and fetal risks and to monitor the pregnancy to optimize the chances for a good outcome. Ideally, a pregnancy is planned, and counseling and health assessments can begin before the fetus is conceived. There are risk assessment tools for evaluating the mother’s family and medical history, previous pregnancy history, and the progress of this pregnancy.1 Currently, most women receive a level 1 fetal ultrasound before 20 weeks’ gestation to assess gestational age, screen the fetus for anomalies, determine placental position, and identify multiple births. A level 1 ultrasound obtained prior to 20 weeks is more accurate than the date of the last menstrual period to determine gestational age. The early screening ultrasound is not intended to identify more subtle structural abnormalities. If anomalies are noted, the woman will be referred for a complete ultrasound evaluation of the fetus using more sensitive equipment and expert evaluations. In the United States it is now unusual for infants to deliver with major skeletal, cardiac, or other internal organ structural anomalies that have not been identified prior to delivery. Common chromosome anomalies such as trisomy 21 also have structural signatures that can be identified by early gestational ultrasound. The genetic abnormality then can be verified by amniocentesis. An accurate early assessment of gestational age is the cornerstone for subsequent monitoring of the pregnancy and decisions about the timing of delivery. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/29 UR - accesspediatrics.mhmedical.com/content.aspx?aid=6733926 ER -