From the Guidelines
A positive pregnancy test requires immediate estimation of gestational age and counseling to ensure appropriate prenatal care and to identify potential complications early on. According to the recommendations of the CDC and the U.S. Office of Population Affairs 1, if a woman is uncertain about the date of her last normal menstrual period, a pelvic examination might be needed to help assess gestational age. The client should receive information about the normal signs and symptoms of early pregnancy, and should be instructed to report any concerns to a provider for further evaluation. Some key points to consider after a positive pregnancy test include:
- Estimating gestational age to provide appropriate counseling and care
- Informing the client about normal signs and symptoms of early pregnancy, such as missed periods, breast tenderness, nausea, fatigue, and increased urination
- Instructing the client to report any concerns, such as severe abdominal pain or vaginal bleeding, to a provider for further evaluation
- Referring the client to appropriate providers of follow-up care, as needed, and assessing the client’s social support and referring her to appropriate counseling or other supportive services, as needed
- Providing initial prenatal counseling, including reviewing current medications, encouraging the client to take a daily prenatal vitamin with folic acid, and advising her to avoid smoking, alcohol, and other drugs 1.
From the Research
Positive Pregnancy Test
- A positive pregnancy test indicates that a woman is pregnant, and it is essential to initiate prenatal care as early as possible to ensure a healthy pregnancy outcome 2.
- Prenatal care should include screening for various health conditions, such as asymptomatic bacteriuria, sexually transmitted infections, and immunity against rubella and varicella, as well as vaccination against tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap), influenza, and COVID-19 2.
- Folic acid supplementation is crucial during pregnancy to prevent neural tube defects, and the recommended daily dose is 400-800 mcg 2, 3.
- Women with a history of pregnancy complications, such as neural tube defects, or those with certain medical conditions, such as diabetes or obesity, may require higher doses of folic acid 3.
- A well-balanced diet that includes essential nutrients, such as iron, calcium, and omega-3 fatty acids, is also vital for a healthy pregnancy outcome 4.
- However, many pregnant women do not consume adequate amounts of these nutrients through their diet alone, and dietary supplements may be necessary to fill the gap 4.
Prenatal Care and Nutrition
- Prenatal care should be initiated at 10 weeks or earlier to improve pregnancy outcomes 2.
- A prepregnancy body mass index (BMI) greater than 25 kg/m2 is associated with an increased risk of gestational diabetes, hypertension, and other pregnancy complications 2.
- Advanced maternal and paternal age (35 years or older) is also associated with an increased risk of pregnancy complications, such as gestational diabetes, hypertension, and birth defects 2.
- Rho(D) immune globulin should be administered to RhD-negative women to decrease the risk of alloimmunization 2.
- Iron deficiency anemia should be treated to decrease the risk of preterm delivery, intrauterine growth restriction, and perinatal depression 2.
Folic Acid Supplementation
- Folic acid supplementation has been shown to reduce the risk of neural tube defects 5, 3.
- The optimal dosage of folic acid for pregnant women is 400-800 mcg per day 2, 3.
- Women with a history of neural tube defects or certain medical conditions may require higher doses of folic acid 3.
- Folic acid supplementation should be started before conception and continued throughout the first trimester 3.