Pregnant Women 21-64 Years of Age Quick Table: All Relevant Recommendations
Please note: In 2003, the CTF updated its Grades of Recommendations to include an "I Recommendation" for situations where insufficient evidence exists to allow a recommendation to be made. (Formerly, these situations were captured under a "C Recommendation".) This change is not retroactive, and all "C Recommendations" made prior to 2003 have not been reevaluated in light of the new "I" recommendation grade. For a discussion of these recommendation grades, please link to the 2003 article in the Canadian Medical Association Journal here.
Quick Table of All Recommendations Specific and Relevant to Pregnant Women 21-64 Years of Age
| "A" Recommendations | ||
| Bacteriuria in pregnancy | Urine culture | Pregnant women |
| D (Rh) Sensitization | D (Rh) antibody screening and immunoglobin (D Ig) administration after delivery of D positive infant | Pregnant women |
| Dental caries | Community fluoridation, fluoride toothpaste or supplement | General population |
| Dental caries, periodontal disease | Brushing and flossing teeth to apply toothpaste (A) and prevent gingivitis (B) but not cariostatic (C) | General population |
| Gastrointestinal and respiratory infection in the newborn | Counselling on breast feeding; peripartum interventions to increase frequency of breast feeding | Pregnant women (or peripartum period) |
| Hearing impairment | Noise control and hearing protection | General population |
| Household and recreational injury | Public education/ Legislation on poison control | General population |
| Influenza | Influenza vaccination | General population |
| Influenza | Neuraminidase inhibitor prophylaxis | General population |
| Lack
of initiation and early cessation of breastfeeding |
Education programs
and postpartum support to promote breastfeeding; Rooming-in
and early maternal contact to promote breastfeeding |
Pregnant women |
| Low birth weight/cognitive ability of child | Smoking cessation interventions | Pregnant women |
| MVA injury | Legislation, restraint use and control of drinking and driving | General population |
| Periodontal disease | Flossing teeth | Adult population |
| Progressive renal disease | Urine dipstick | Adults with IDDM |
| Tobacco-caused disease | Counselling, smoking cessation or offer nicotine replacement therapy | Smokers |
| "B" Recommendations | ||
| All-cause mortality and morbidity | Moderate physical activity | General population |
| Chlamydial infection | Smear, culture or analysis | Pregnant women |
| Congenital rubella syndrome | Screen, counsel and vaccinate post-partum if indicated | Pregnant women |
| D (Rh) Sensitization | Repeat blood test, D (Rh) antibody screening and immunoglobin (D Ig) administration | Pregnant women who are antibody negative and women undergoing induced abortion or amniocentesis |
| Diet-related illness | Counselling on adverse nutritional habits | Adult population |
| Domestic violence | Referral to post-shelter advocacy counseling | Pregnant and non-pregnant women |
| Down syndrome | Genetic screening and counselling | High-risk pregnant women |
| Down syndrome | Triple screening and counselling | Pregnant women <35 yrs |
| Fetal alcohol syndrome | Screening and Counselling, alcohol consumption | Pregnant women |
| Gingivitis | Brushing teeth | General population |
| Gonorrhea | Counselling, Educational materials | General population |
| Group B Streptococcal | Universal screening for GBS colonization and selective intrapartum chemoprophylaxis to colonized women with risk factors | Pregnant women |
| Group B Streptococcal | Universal screening for GBS colonization and intrapartum chemoprophylaxis to all colonized women | Pregnant women |
| Hemoglobinopathies | 1) Screen for carrier status (complete blood count, hemoglobin and electrophoresis) | High-risk pregnant women |
| Household and recreational injury | Legislation, window and stair guards, smoke detectors | General population |
| Household and recreational injury | Public education/ Legislation, fire burn and water (tub and swimming) safety | General population |
| Household and recreational injury | Legislation, avoidance of alcohol with water recreation | General population |
| Iron deficiency anemia in infants | Counselling, breast feeding | Pregnant women (or peripartum period) |
| Lack
of initiation and early cessation of breastfeeding |
Peer
counseling to promote breastfeeding |
Pregnant women |
| Lung cancer | Dietary advice on green leafy vegetables and fruit | Smokers |
| MVA Injury | Counselling on restraint use and avoidance of drinking and driving | General population |
| Neural tube defects | Maternal serum aplha-fetoprotein/ ultrasound, amniocentesis | Pregnant women |
| Perinatal morbidity and mortality | Single prenatal ultrasound, second trimester | Pregnant women |
| Periodontal disease | Tooth scaling and prophylaxis | General population |
| Preeclampsia | Blood pressure measurement | Pregnant women |
| Problem drinking | Case finding and counselling | General population |
| Skin cancer | Counselling, sun exposure, clothing | General population |
| Tobacco-caused disease | Referral to validated cessation program | Smokers |
| Vehicle-related injury | Legislation, bicycle motorcycle or all terrain vehicle helmet | General population |
| "C" Recommendations | ||
| Adverse consequences, children of alcoholics | Routine evaluation; some screening options | General population |
| All-cause mortality and morbidity | Counselling, physical activity; prevent obesity | General population |
| Child maltreatment | Sexual abuse, abduction prevention programs | General population |
| Coronary heart disease | Diet/drug treatment | Individuals with elevated cholesterol or LDL-C except males 30-59 yrs |
| Coronary heart disease | Measurement of blood total cholesterol level | General population with case-finding for males 30-59 years |
| Coronary heart disease | General dietary advice on fat and cholesterol | General population except males 30-69 years |
| Dental caries | Counselling, diet or baby bottle | General and high-risk population |
| Domestic violence | Batterer/couples interventions | General population |
| Fetal alcohol syndrome | History, questionnaire, interview, clinical judgement/alcohol consumption | Pregnant women |
| Gestational diabetes mellitus | Blood glucose, fasting/random or glucose challenge test | Pregnant women |
| Gestational diabetes mellitus | History, risk factors; if positive glucose tolerance test | Pregnant women |
| Group B Streptococcal | Intrapartum chemoprophylaxis based on risk factors only | Pregnant women |
| Hemoglobinopathies | Screening for carrier status and counselling | Adult population |
| HIV/AIDS | History, sexual and drug use counselling | General population |
| HIV/AIDS | Voluntary HIV antibody screening | General population including pregnant women |
| HIV/AIDS | Voluntary HIV antibody screening | Pregnant women |
| Household and recreational injury | Public education/ Legislation, gun control and use of Heimlich maneuver | General population |
| Household and recreational injury | Counselling, household and recreational injury (except some home hazards) | Adult population |
| Influenza | Immunization, annual | General population <65 years |
| Iron deficiency anemia | Routine hemoglobin | General population |
| Low birth weight | Iron supplementation | Pregnant women |
| Low birth weight/preterm birth | Diet supplementation | Pregnant women at high risk of undernutrition |
| Low birth weight/preterm birth | Multicomponent programs | Pregnant women |
| MVA injury | Counselling, helmet, alcohol use | General population |
| MVA injury | Monitor medical impairment | General population |
| Neonatal herpes simplex | Cesarean section | Symptomatic pregnant women |
| Neonatal morbidity and mortality | Electronic fetal monitoring, intrapartum | High-risk pregnancies |
| Oral cancer | Physical exam, oral cavity | General population |
| Perinatal morbidity and mortality | Ultrasound, prenatal, serial | Pregnant women |
| Phenylketonuria | Phenylalanine test | Pregnant women |
| Preeclampsia | Aspirin prophylaxis, low dose | Pregnant women |
| Preterm birth | Home uterine activity monitoring | High-risk pregnancies |
| Protein/calorie malnutrition | Protein/calorie malnutrition screening | Adult population |
| Skin cancer | Counselling, Skin self-examination | General population |
| Skin cancer | Counselling, Sun block | General population |
| Skin cancer | Physical examination, skin | General population |
| Suicide | Suicide risk evaluation | General population |
| Thyroid cancer | Neck Palpation | Adult population |
| Tuberculosis | INH Prophylaxis | General population aged >35 years |
| "D" Recommendations | ||
| Bladder cancer | Urine dipstick or cytology | General population |
| Carotid disease/Stroke | Neck auscultation or carotid endarterectomy | General population |
| Child maltreatment | Screen for risk of maltreating children | General population |
| Chlamydial infection | Smear, culture or analysis | General population |
| Cystic fibrosis | DNA analysis for carrier status | General population |
| Cystic fibrosis | Sweat test, immunoreactive trypsin and "BM meconium" test | General population |
| Depression | General Health Questionnaire or Zung Self-rating depression scale | General population |
| Diabetes mellitus | Blood glucose, fasting | Non-pregnant general population |
| Gonorrhea | Gram stain/culture of cervical or urethral smear | General population |
| Lack
of initiation and early cessation of breastfeeding |
Provision of written materials to new mothers to promote breastfeeding |
Pregnant women |
| Low birth weight/Preterm birth | Programs of only social support | High risk pregnant women |
| Lung cancer | Chest radiography | General population |
| Neonatal morbidity and mortality | Electronic fetal monitoring, intrapartum | Low risk pregnancies |
| Pancreatic cancer | Abdominal palpation, ultrasound or serologic tumor markers | General population |
| Periodontal disease | Brushing with electric toothbrush | General population |
| Preterm birth | Home uterine activity monitoring | Low risk pregnancies |
| Progressive renal disease | Urine dipstick | General population |
| Recurrent herpes simplex type II (progenitalis) infection | Cervical smear, culture; weekly screening | Pregnant women with history, active disease, or partner with proven infection |
|
"E" Recommendations |
||
| Lack
of initiation and early cessation of breastfeeding |
Provision of commercial discharge
packages to new mothers |
Pregnant women |
| Lung cancer | Sputum cytology | General population |
| Tuberculosis | Mantoux tuberculin skin test | General population |
| "I" Recommendations | ||
| Domestic violence | Screening | Pregnant or non-pregnant women |
| Domestic violence | Primary care counseling | Pregnant or non-pregnant women |
| Domestic violence | Referral to shelters | Pregnant or non-pregnant women |
| Domestic violence | Referral to personal and vocational counseling | Pregnant or non-pregnant women |
| Lack
of initiation and early cessation of breastfeeding |
Primary caregiver advice to expectant or new mothers to promote breastfeeding | Pregnant women |