In practice - Pregnant

Provide information about the importance of good oral care because of a higher risk of gum problems. Ask if the pregnant woman has nausea and vomiting. Explain that it is better not to brush the teeth immediately after vomiting, but only to rinse the mouth first. When the woman immediately brushes, she spreads the stomach acid more about the teeth and that strengthens the erosion.

In practice - Pregnant
Provide information about the importance of good oral care because of a higher risk of gum problems. Ask if the pregnant woman has nausea and vomiting. Explain that it is better not to brush the teeth immediately after vomiting, but only to rinse the mouth first. When the woman immediately brushes, she spreads the stomach acid more about the teeth and that strengthens the erosion.

In practice

 

In the dental practice

Oral care

Provide information about the importance of good oral care because of a higher risk of gum problems. Ask if the pregnant woman has nausea and vomiting. Explain that it is better not to brush the teeth immediately after vomiting, but only to rinse the mouth first. When the woman immediately brushes, she spreads the stomach acid more about the teeth and that strengthens the erosion.

 

Explain that care for the baby dentures starts as soon as the first tooth comes through. Tell the pregnant woman that you will return to this next time and that you want to discuss how to brush the teeth of young children.

 

X-rays

Explain that it is local radiation that does not reach the baby. In principle, the dentist will prefer to postpone the photos until after the birth. But if it is necessary to make them now, that does not pose any danger.

 

Local anaesthesia

Explain that the substances from the local anesthetic do not reach the baby. But here also applies: only if the procedure can not be done without anesthesia and can not be postponed until after delivery, it is now carried out. Fortunately, that is possible without danger.

 

In the general practice 

Preconception care

Practice assistants are involved in preconception care. In some practices, this task is limited to giving folic acid advice and possibly referring to the preconception consultation. There is an opportunity to discuss everything about children's wishes and healthy pregnancy. Inform the woman that she can complete a questionnaire in advance, digitally (www.zwangerwijzer.nl) or on paper (www.nhg.org/pcz). Optionally offer low-literate patients to help with the completion.

 

In other practices, the practical assistant carries out the preconception consultation himself.

 

Care for pregnant patients

When you perform a pregnancy test, you try to assess whether the woman will be happy with a positive result or not. With a positive pregnancy test and a desired pregnancy, congratulate her. You explain that it is important to contact the midwife in the short term in connection with the first trimester ultrasound. Make a note of the pregnancy in the file. If the pregnancy is undesirable or unexpected, ask the woman to make an appointment with the GP.

 

Bear in mind (anxiety about) the pregnancy when the woman calls for an appointment or advice during the course of the pregnancy.

 

In the pharmacy

For a prescription drug, follow the pharmacy protocol or the following steps:

  • Check whether the woman has informed her doctor that she is pregnant, unless the prescription shows that this is the case, for example a prescription for antirhesus (D) immunoglobulins.
  • Check whether the product can be used in pregnancy.
  • Consult with the pharmacist for details.

 

Sometimes pharmacist assistants find it difficult for a woman to use medicines during her pregnancy (see next box). Table shows a counter discussion in the pharmacy about medication during pregnancy.

 

Example of the counter discussion in the pharmacy about medication during pregnancy

A woman of childbearing age comes into the pharmacy
With a recipe      With a question for a self-care product
The woman tells that she is pregnant You see a report of pregnancy in the computer There is no mention of pregnancy  
You can congratulate the woman and ask her if she likes it to be entered into the computer to check if medicines can be used during pregnancy.

Check that the message is correct. You can say, "Our computer indicates that you are pregnant. Is that right? Or is there a mistake in our data? "

 

In case of incorrect notification: correct the data

You always ask: 'Is the recipe for yourself?'

 

Ask for pregnancy, for example: 'Are you pregnant? I ask because it is important for medication use '

 

If the woman confirms that she is pregnant, ask her if she agrees to enter it in the computer to check if medicines can be used during pregnancy.

Ask for pregnancy (unless that is obvious), for example: 'Are you pregnant? I ask because it is important for medication use '

 

If the woman confirms that she is pregnant, tell them that it is best for the baby to use as little medicine as possible. You can ask if she has considered other solutions. Of course you say that you will check which medicines can be used. Please refer to the self-care guide in case of pregnancy

Check whether the prescribed medication can be used in Lareb's information system
Only give the medicine if Lareb indicates that it may be used. In all other cases, you consult with the pharmacist. He can contact the prescribing doctor, often with a proposal for an alternative
Provide information about the product and use as usual. Tell them whether the product can be used safely or advise, after consultation with the pharmacist or according to protocol, another remedy

Ask if you can discuss vitamin and calcium usage


"If you have already been to the midwife or gynecologist, you may have told them about the importance of vitamins. Do you want to know something about it or can I explain something about that to you? '


- Folic acid (0.4 or 0.5 milligrams (mg) / day) to 10 weeks of pregnancy reduces the risk of an open spine


- Vitamin D (10 micrograms / day) during pregnancy promotes the growth of the baby and its defense against infections
depending on the procol of cooperation agreements with midwives and gynecologists:


- Calcium supplement for women who receive less than 1 gram of calcium through the diet. This reduces the risk of preeclampsia

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