title: Antenatal care for the normal patient.
abstract: Screening protocols for low-risk obstetric patients are used to identify those at risk for adverse perinatal outcome. Gestational diabetes screening is best performed by administering 50 g of glucose in the nonfasting state, with plasma glucose values above 140 mg/dL at 1 hour considered abnormal. Assay of maternal serum alpha-fetoprotein is primarily used to identify pregnancies at risk for neural tube defects and other structural anomalies. However, an elevated value may also identify patients at increased risk for a number of abnormal pregnancy outcomes, even when the fetus is free from defects. Patients who have previously had a cesarean section are now strongly encouraged to undergo a trial of labor and to attempt a vaginal birth. Such a course is not without risk, and catastrophic complications can develop. Careful patient selection, appropriate counseling, and close management are necessary in this situation.
mesh_terms: D016640:Diabetes, Gestational / Q000175:diagnosis; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D009436:Neural Tube Defects / Q000097:blood / Q000175:diagnosis; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D011296:Prenatal Diagnosis; D016064:Vaginal Birth after Cesarean; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins