A Modernized Approach to Prenatal Care in Low Risk Women
A Modernized Approach to Prenatal Care in Low Risk Women
The investigators plan to identify 80 pregnant women at low risk for obstetrical
 complications and replace 4-5 routine third trimester visits with a structured program of
 home weight, blood pressure and urine protein monitoring along with regular structured phone
 interviews and a 28 week ultrasound. The investigators hypothesis is that this protocol is
 both safe and acceptable.
Inclusion Criteria:

 -  Age < 35

 -  Doesn't live alone

 -  Current phone number

 -  Previous pregnancy

 -  No prior second trimester miscarriage/fetal loss after 13 weeks

 -  Previous delivery

 -  If yes, all had uncomplicated antepartum course

 -  All Deliveries > 37 weeks

 -  All birth weight > 2700 grams

 -  Maternal BMI between 18.5 and 30

 -  No chronic medical problems

 -  No current substance abuse

 -  Spontaneous conception

 -  No family history of pre-eclampsia

 -  Agrees to first trimester aneuploidy screening

 Exclusion Criteria:

 -  Clinically significant abnormalities on routine physical exam or routine laboratory
 results

 -  Multiple pregnancy

 -  Fetal abnormalities detected on either the 11-14 week or the 18 week ultrasound
 including a nuchal translucency > 3 mm but not including second trimester markers for
 aneuploidy or a low lying placenta

 -  A risk of fetal aneuploidy on first trimester screening > 1:300 PAPP-A < 5 %ile or HCG
 < 1 %ile (abnormalities of these serum analytes routinely obtained as part of
 aneuploidy screening are associated with an increased risk of adverse outcome)

 -  Elevated blood pressure (> 140/90),

 -  Cervical length < 3 cm at the 18 week ultrasound (which is associated with an
 increased risk for preterm delivery).