Pregnancy screening and timeline calculation

Chief Complaint

Pregnancy screening and timeline calculation

Template

Empathia Pregnancy Screening & Timeline — Plain-Language Template (Clinician Build Guide v6) Purpose: This template helps clinicians enter basic pregnancy information and automatically calculate: - Estimated Due Date (EDD) - Gestational Age (GA) today - Maternal Age at Delivery - A full prenatal screening timeline All dates display as DD-MMM-YYYY (e.g., 07-Aug-2025). Bold all headers and test names. ------------------------------------------------------------ 1. Inputs - Ethnicity (optional) - Date of Birth (required) - Cycle Length (days, required): default 28; range 21–45 - Last Menstrual Period (LMP) — optional - Ultrasound Date — optional - Ultrasound GA — optional; both weeks and days (0–6) required ------------------------------------------------------------ 2. Logic Summary Dating rules: - If ultrasound date + GA entered → Effective LMP = ultrasound date − (GA weeks × 7 + days). → Source = “Ultrasound.” Lock LMP; set cycle = 28. - If only LMP entered → Effective LMP = LMP + (cycle length − 28). → Source = “LMP (cycle-adjusted).” - If neither → error: “Enter LMP or ultrasound data to calculate.” Core calculations: - EDD = Effective LMP + 280 days - GA Today = (Today − Effective LMP) ÷ 7 (1 decimal) - Maternal Age at Delivery = whole years at EDD ------------------------------------------------------------ 3. Validation - DOB, LMP, and US date must not be in the future. - Cycle length must be 21–45. - US GA days must be 0–6. - If both LMP and US present, use ultrasound. ------------------------------------------------------------ 4. Standard Prenatal Tests If a test is clinically indicated, mark with * and add “– CLINICALLY INDICATED.” Tests at First Visit: ABO Rh Rh Ab (if Rh−) CBC and platelets Rubella Hepatitis B HIV GC and Chlamydia Urine C&S VDRL RBG TSH Varicella * CMV * Parvovirus B19 * Toxoplasmosis * Listeria * Hepatitis C * ASHPLEX * (if Jewish) Hemoglobin electrophoresis * (if Black/Latinx/Middle East/SE Asian or MCV <70) Sickledex * (if Black or Latinx) "*if clinically indicated" ------------------------------------------------------------ 5. Test Schedule Use weeks × 7 = days from effective LMP. Example: 8 weeks = Effective LMP + (8 weeks x 7 days = 56 days) Format: (no bullet)8–10 weeks • Dating ultrasound • [Effective LMP + (8 weeks x 7 days = 56 days)](Open Date) to [Effective LMP + (10 weeks x 7 days = 70 days) ](Close Date) First Trimester 8–10 weeks • Dating ultrasound • [Open to Close] 8–12 weeks • Nuchal translucency (NT) ultrasound * • [Open to Close] 9–14 weeks • SIPS #1 • [Open to Close] 10 weeks • NIPT • [Open] Second Trimester 14–17 weeks • SIPS #2 • [Open to Close] 18–20 weeks • Detailed anatomy ultrasound • [Open to Close] 18–20 weeks • Amniocentesis * (if abnormal SIPS or 40+) • [Open to Close] Third Trimester 24–28 weeks • Gestational diabetes screen • [Open to Close] 24–28 weeks • Hb, Anti-D RhIG * (if Rh−) • [Open to Close] 28 weeks • Rhogam * (if Rh−) • [Open] 35–37 weeks • GBS vaginorectal screen • [Open to Close] >40 weeks • Consider Rhogam repeat * (if Rh−) • [Open] Nuchal Translucency Indications: • Age 35+ at EDD • Previous Trisomy 21, 18, or 13 pregnancy • ≥3 prior miscarriages (age ≥35) • Twins (any maternal age) • IVF conception • HIV positive ------------------------------------------------------------ 6. Display - Patient Block: Ethnicity, DOB, Cycle - Dating Block: LMP, Ultrasound, Effective LMP, EDD, GA Today, Maternal Age - Schedule Table: Test, GA window, Dates - Banner: “EDD and schedule based on ultrasound dating.” ------------------------------------------------------------ 7. Summary Example: “EDD 10-Oct-2025; GA 14.3 wks; Age@EDD 33 yrs; Source: Ultrasound.” ------------------------------------------------------------ 8. Quality Checks - Cycle shifts correctly adjust all test windows. - Ultrasound locks LMP and recomputes all dates. - GBS window (35–37 wks) = +245 to +259 days from effective LMP. ------------------------------------------------------------ Implementation Notes: - Use ISO date format internally (YYYY-MM-DD). - Convert weeks → days using ×7. - Apply cycle adjustment once. - Round GA today to 1 decimal. - Bold all headers and test names. - IF a test is specifically clinically indicated by history or exmination, THEN add " - CLINICALLY INDICATED" next to the test(s) ELSE keep * only, do not remove the *. - Do not remove the line: "*if clinically indicated"