Hanlin Robert B
Greenville Hospital System, 877 W. Faris Rd., Greenville, SC 29605, USA.
J S C Med Assoc. 2002 Oct;98(6):277-80.
Given the risks of congenital infections, the frequent occurrence of unintended pregnancy, and the lack of prenatal care in the first trimester, physicians should seek opportunities to discuss immunizations and disease prevention with women of childbearing age. Discussions of the following topics would be beneficial: 1. Encourage women to seek medical care at the first missed period. 2. Discuss safe sex and abstinence for prevention of sexually transmitted diseases. (See "Clinical Prevention Guidelines" in the CDC's 1998 Guidelines for Treatment of Sexually Transmitted Diseases.) 3. Encourage early medical care for vaginal discharge, pelvic pain, or possible exposure to sexually transmitted diseases. 4. Encourage good handwashing, especially before and after handling food or changing diapers. 5. Encourage the use of universal precautions when exposed to body fluids or blood. 6. Educate the patient on the importance of cooking food thoroughly and avoiding raw meat and unpasteurized dairy products. 7. Ensure vaccination against hepatitis B, rubella, and varicella.
鉴于先天性感染的风险、意外怀孕的频繁发生以及孕早期缺乏产前护理的情况，医生应寻找机会与育龄女性讨论免疫接种和疾病预防问题。讨论以下主题将有所帮助：1. 鼓励女性在月经推迟时就寻求医疗护理。2. 讨论安全性行为和禁欲以预防性传播疾病。（见美国疾病控制与预防中心1998年性传播疾病治疗指南中的“临床预防指南”。）3. 鼓励对白带异常、盆腔疼痛或可能接触性传播疾病的情况尽早进行医疗护理。4. 鼓励勤洗手，尤其是在处理食物前后或更换尿布前后。5. 鼓励在接触体液或血液时采取通用防护措施。6. 告知患者将食物彻底煮熟并避免食用生肉和未经巴氏消毒的乳制品的重要性。7. 确保接种乙肝、风疹和水痘疫苗。
