Clinical and Communication Skills Elicit a history from a woman with a high risk pregnancy; complete a risk assessment for the pregnancy Calculate the estimated delivery date Examination of a patient who is pregnant including blood pressure measurement, weight and height Identify risk factors present at the start of this pregnancy, and list complications that may arise as a result of these risk factors Interpret routine and relevant additional antenatal investigations, such as ultrasound and early diabetes testing Management of high risk pregnancy based on the risk assessment and knowledge of complications that may arise as a result of the risks identified, both maternal and fetal: pharmacological (e.g. low dose aspirin, calcium, methyldopa) and non-pharmacological (lifestyle, diet and exercise,optimal gestational weight gain) Management of pre-existing and gestational hypertension in pregnancy Prescribing for pregnant women and women of child-bearing potential Optimising maternal health pre-pregnancy Role of periconceptual folic acid in preventing neural tube defect
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Personal and Professional Skills Lifestyle changes Ascertaining woman's feelings towards pregnancy Counselling on high risk factors in pregnancy, prenatal screening, appropriate lead maternity carer (LMC) according to pregnancy risk Ethical aspects of prescribing; recognise limits of competence and ask for help when needed; responsibility to update knowledge Understanding the role of the midwife and obstetrician in a high risk pregnancy Supporting normality during pregnancy
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Population Health Models of antenatal care in New Zealand Epidemiology of hypertension and pre-eclampsia/eclampsia in pregnancy The role of pre-conceptual counselling in all women of reproductive age; folic acid, weight loss, smoke-free counselling, avoiding alcohol and drugs, early booking with lead maternity carer (LMC) The role of high risk pregnancy clinics Epidemiology of obesity; how to modify the risk of adverse outcomes
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