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Pregnancy

Screening on First visit

Blood pressure.
Hemoglobin/hematocrit.
Hepatitis B surface antigen (HBsAg).
RPR/VDRL.
Chlamydia screen (<25 yr).
Rubella serology or vaccination history.

D(Rh) typing, antibody screen.

Offer hemoglobinopathy screening.
Assess for problem of alcohol or illicit drug use.
Offer HIV screening. Universal screening is recommended for areas (states, counties, or cities) with increased HIV prevalence among pregnant women. In low-prevalence areas, the choice between universal and targeted screening may depend on other considerations.
Offer CVS (<13 wk) or amniocentesis (15-18 wk) to women

> 35 yr with access to counseling and follow-up services, reliable standardized laboratories, skilled high-resolution ultrasound, and amniocentesis capabilities.

Offer multiple marker testing (15-18 wk) and serum a-feto-protein testing (16-18 wk) to all women with access to counseling and follow-up services, reliable standardized laboratories, skilled high-resolution ultrasound, and amniocentesis capabilities.

Screening on Follow-up visits

Blood pressure.
Urine culture (12-16 wk).

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