Lesson 1Urine and point-of-care tests: urine dipstick interpretation (protein, glucose, ketones), when to send cultures or urine microscopyExplores urine dipstick technique and interpretation for protein, glucose, and ketones, and clarifies when to obtain urine culture or microscopy to evaluate infection, renal disease, dehydration, and metabolic concerns in early pregnancy.
Preparing patient and clean-catch urine collectionDipstick timing, reading, and documentationInterpreting proteinuria and preeclampsia riskGlucosuria, diabetes screening, and follow-upKetones, dehydration, and hyperemesis concernsIndications for culture and urine microscopyLesson 2Medical and surgical history: chronic conditions, medications, allergies, vaccinations, infectionsReviews how to obtain a targeted medical and surgical history, including chronic diseases, medications, allergies, vaccinations, and prior infections, and how to identify conditions needing adjustment or referral to optimize maternal and fetal outcomes.
Chronic conditions impacting pregnancy riskMedication reconciliation and teratogenicityAllergy history and anaphylaxis precautionsVaccination status and needed updatesPast surgeries and obstetric implicationsSignificant infections and exposure risksLesson 3Current pregnancy review: symptoms (nausea, vomiting, pain), vaginal discharge or bleeding, fetal movement expectationsAddresses systematic review of current pregnancy symptoms, including nausea, vomiting, pain, vaginal bleeding or discharge, and early fetal movement expectations, distinguishing normal discomforts from warning signs requiring urgent evaluation.
Characterizing nausea, vomiting, and triggersAbdominal and pelvic pain red-flag featuresVaginal bleeding patterns and triageNormal versus concerning vaginal dischargeUrinary symptoms and infection suspicionFetal movement education by gestational ageLesson 4Gynecologic and sexual history: STIs, contraception history, menstrual pattern, abnormal bleedingDetails how to obtain a respectful gynecologic and sexual history, including menstrual patterns, contraception, prior STIs, abnormal bleeding, and cervical procedures, while maintaining privacy, trauma-informed care, and culturally sensitive communication.
Establishing privacy and trauma-informed rapportDocumenting menarche, cycle length, and flowContraception history and fertility intentionsScreening for current and past STIsAbnormal bleeding, pain, and red-flag symptomsPrior gynecologic procedures and implicationsLesson 5Focused physical exam: vitals interpretation, weight and BMI calculation, abdominal and pelvic exam indicationsOutlines components of the focused physical exam at the first prenatal visit, including vital signs, weight, BMI, and indications for abdominal and pelvic exams, emphasizing infection control, chaperone use, and respectful patient communication.
Accurate blood pressure and pulse techniqueWeight, BMI, and counseling on gain goalsGeneral inspection and thyroid assessmentCardiac, respiratory, and edema evaluationAbdominal exam and uterine size by weeksPelvic exam indications and chaperone useLesson 6Psychosocial assessment: mental health screening (anxiety, depression), social support, domestic safety, substance use screeningFocuses on psychosocial assessment during the first prenatal visit, including screening for depression, anxiety, substance use, intimate partner violence, and evaluating social support, housing, and financial stressors that may affect pregnancy outcomes.
Using validated perinatal mood screenersAssessing anxiety, stress, and coping skillsScreening for alcohol, tobacco, and drug useIdentifying intimate partner violence and safetyEvaluating social support and caregiving rolesConnecting patients to mental health resourcesLesson 7Reproductive planning and counseling needs: pregnancy intentions, partner involvement, cultural and language considerationsExplores reproductive life planning and counseling at the first visit, including pregnancy intentions, partner involvement, cultural and language needs, and shared decision-making about prenatal care, spacing, and future contraception options.
Assessing pregnancy intention and ambivalenceDiscussing partner involvement and supportAddressing cultural beliefs about pregnancyUsing interpreters and language access toolsPlanning birth spacing and contraceptionShared decision-making in prenatal careLesson 8Obstetric history: GTPAL, last menstrual period, previous pregnancy outcomes, dating and uncertaintyCovers structured obstetric history using GTPAL, clarifying last menstrual period, prior pregnancy outcomes, complications, and dating uncertainty, and explains how this information guides risk assessment, counseling, and early pregnancy management.
Using GTPAL to summarize pregnancy historyClarifying LMP, cycle regularity, and recallReviewing prior pregnancy complicationsEctopic, miscarriage, and termination historyEstimating due date and dating discrepanciesWhen to order early ultrasound for dating
