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45-Med-Counsel-Alcohol Excess in Pregnancy
45-Med-Counsel-Alcohol Excess in Pregnancy
O+G Hx.: menarche age 14, regular periods, 28 days, 3-4 days, P0G1, no PIDs or STDs,
contraception with condoms, never been on pill, steady partner for 12 years, regular pap
smears (normal).
PHx. + FHx.: unremarkable
SHx: married, part time book keeper, no obvious problems, no medication, NKA.
MANAGEMENT:
There is no doubt that cessation of alcohol and smoking improves the outcome of the
pregnancy! The main stay intervention is psychosocial management. Understanding this
and admitting it is the problem and the resulting concerns about the possible damage to
the baby are strong motivators!
Help manuals or videos can be powerful allies.
The ideal way is to stop both or to establish clear and realistic goals.
Withdrawals can occur and the GP can support the patient or sometimes the referral to a
specialist service is necessary.
Ideally the family or partners should be involved because if the partner continuous to
smoke the prospect is not good. Other factors to be considered are coping skills and
coexisting emotional and psychological/psychiatric problems. Help can be provided with
counseling, AA or other support groups.
Stress has to be addresses with healthy living, like exercising, meditation, and other
relaxation techniques.
Nicotine patches are controversial because of possible toxic effects on fetus!