Pregnancy Screening and Timeline Fixed

Chief Complaint

Pregnancy Screening and Timeline

Template

Empathia Pregnancy Screening & Timeline (Revised – [revision year] Guidelines) Purpose This template captures basic pregnancy data and automatically calculates: - Estimated Due Date (EDD) - Gestational Age (GA) today (weeks+days and 1-decimal) - Maternal Age at Delivery (at EDD; recompute if actual delivery entered) - A prenatal screening/timeline based on ultrasound > IVF > LMP precedence Dating Rules (Precedence) Order: Ultrasound (CRL ≤13+6) > IVF (fresh/frozen) > Ultrasound (biometry ≥14 w, if no prior CRL/IVF) > LMP (cycle-adjusted) If Ultrasound Date + GA (CRL-based, GA ≤13+6): Effective LMP = US Date − (GAweeks×7 + GAdays) Source = “Ultrasound (CRL)” Lock LMP; set Cycle Length = 28 for downstream logic Else if IVF: IVF Fresh: Effective LMP = Egg Retrieval − 14 days IVF Frozen: Effective LMP = Embryo Transfer − (14 − EmbryoAgeDays) Source = “IVF” Lock LMP; set Cycle Length = 28 Else if first qualifying Ultrasound is ≥14 w (no CRL ≤13+6, no IVF): Date pregnancy by average GA of ≥3 biometry parameters (HC, AC, FL). Effective LMP = US Date − (GAweeks×7 + GAdays) Source = “Ultrasound (2nd-trimester biometry)” Else if LMP present (no qualifying US/IVF): Effective LMP = LMP + (CycleLength − 28) Source = “LMP (cycle-adjusted)” Else: Error → “Enter LMP or ultrasound (or IVF) data to calculate.” Core Calculations EDD = Effective LMP + 280 days (calendar-true add) GA Today (decimal) = (Today − Effective LMP)/7 → 1 decimal GA Today (display) = weeks+days Validation - DOB, LMP, Ultrasound Date, IVF dates ≤ Today - Cycle Length: 21–45 - Ultrasound GA (CRL branch): weeks 7–13; days 0–6 - If both LMP and qualifying Ultrasound exist → use Ultrasound; ignore cycle shift - Range guard: if GA Today < 0 or > 43+0 → “Check dates/inputs.” - Use leap-year-safe arithmetic Quality Checks - Cycle shift applies once only when LMP is source; US/IVF locks LMP and sets cycle to 28 - All windows recompute instantly if source switches (US/IVF/LMP) - GBS window resolves to +252 to +263 d (36 0/7–37 6/7 w) - Anatomy window resolves to +126 to +154 d (19–21 w preferred) - NT window resolves to +77 to +97 d (11+0–13+6 w) Inputs - Ethnicity [Optional:] - Date of Birth / DOB - Cycle Length, days (default 28; range 21–45) - Last Menstrual Period / LMP [Optional:] - Ultrasound Date [Optional:] - Ultrasound GA [Optional:]; both weeks and days 0–6 required - IVF [Optional:] - IVF Fresh: Egg Retrieval Date - IVF Frozen: Embryo Transfer Date + Embryo Age at Transfer (days) Summary Example: Effective LMP [Effective LMP]; EDD [EDD date]; GA [GA display] ([GA decimal]); Age@EDD [maternal age] yrs; Source: [source] Standard Prenatal Tests At First Visit: ABO Rh Rh Antibody (if Rh−) CBC and platelets Rubella Hepatitis B HIV GC and Chlamydia Urine C&S Syphilis serology (treponemal ± nontreponemal) Random plasma glucose (or local pathway: FPG/HbA1c) TSH Varicella * CMV * Parvovirus B19 * Toxoplasmosis * Listeria * Hepatitis C * Ashkenazi carrier panel * (if appropriate ancestry) Hemoglobin electrophoresis * (if Black/Latinx/Middle East/SE Asian or MCV <70) (always render this line: *if clinically indicated) Test Schedule (weeks from Effective LMP) (Formating example for below: 24–28 weeks: • Gestational diabetes screen • 22 January to 19 February 2026 ) First Trimester: 7–10 w • Dating ultrasound • [Effective LMP +49 to +70 d] 11–13+6 w • Nuchal translucency (NT)* • [Effective LMP +77 to +97 d] 9–14 w • SIPS #1 • [Effective LMP +63 to +98 d] ≥10+0 w • NIPT • [Effective LMP +70 d onward] Second Trimester: 14–20 w • SIPS #2 • [Effective LMP +98 to +140 d] 18–22 w • Detailed anatomy ultrasound • [Effective LMP +126 to +154 d] (prefer 19–21 w) 15–20 w • Amniocentesis * • [Effective LMP +105 to +140 d] Third Trimester: 24–28 w • Gestational diabetes screen • [Effective LMP +168 to +196 d] 24–28 w • CBC/Hb • [Effective LMP +168 to +196 d] 28 w • Antibody screen (Rh−) • [Effective LMP +196 d] 28 w • RhIG (Rh−) • [Effective LMP +196 d] 36–37+6 w • GBS vagino-rectal screen • [Effective LMP +252 to +263 d] >40 w • Consider RhIG repeat (Rh−) • [Effective LMP +280 d] *NT Indications - Age ≥35 at EDD - Prior trisomy 21/18/13 pregnancy - ≥3 prior miscarriages - Twins (any maternal age) - IVF conception - HIV positive - (Consider) parental balanced translocation; prior increased NT Display - Patient Block: Ethnicity, DOB, Cycle - Dating Block: LMP (entered/derived), Ultrasound (if any), IVF (if any), Effective LMP, EDD, GA Today, Maternal Age @EDD, Source - Schedule Table: Test • GA window • Date(s) - Banner (dynamic): - “EDD and schedule based on Ultrasound dating.” OR - “…based on IVF parameters.” OR - “…based on LMP (cycle-adjusted).”ne