Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study.

Purpose: Interconception care (ICC) is recommended to improve birth outcomes by targeting maternal risk factors, but little is known about its implementation. We evaluated the frequency and nature of ICC delivered to mothers at well-child visits and maternal receptivity to these practices.

Methods: We surveyed a convenience sample of mothers accompanying their child to well-child visits at family medicine academic practices in the IMPLICIT (Interventions to Minimize Preterm and Low Birth Weight Infants Through Continuous Improvement Techniques) Network.

Diagnosis and management of ectopic pregnancy.

Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination, and imaging with transvaginal ultrasonography can usually confirm the diagnosis.

Adult vaccination.

Immunization has effectively decreased the burden of disease on society. Nevertheless, over 50,000 deaths occur annually in the United States from vaccine-preventable disease, and nearly all of these occur in adults. It is essential for primary care physicians to be knowledgeable about the unique immunization-related needs of adults and to be aware of the factors that determine the need for vaccination.

The future of cancer screening.

Lung and ovarian cancers are two of the most common and deadly cancers affecting men and women in the United States. The potential impact of an effective screening modality for early detection of these cancers is enormous. Yet, to date, no screening tool has been proven to reduce mortality in asymptomatic individuals, and no major organization endorses current modalities for screening for these cancers.

Preconception and prenatal care.

Advances in preconception and prenatal care have been successful in reducing risk in a number of areas. Folic acid supplementation, abstinence from alcohol, tight glycemic control in pre-gestational diabetics, and the administration of rhogham all have been successful in reducing individual risks. Unfortunately, overall perinatal morbidity and mortality has not decreased in the past two decades.