For a time, the comprehensive nature of our work as family physicians was described as our “basket of services,” evoking handbaskets, egg collecting, or Little Red Riding Hood, among other mental images. Fortunately, this term has fallen out of favor in recent years, but along with continuity, patient-centeredness, and community focus, comprehensiveness remains one of the foundations of primary care.1 Comprehensiveness can be assessed in many ways. As family physicians we provide care in a variety of settings. We also provide a tremendous breadth of clinical services, from procedures to cognitive behavioral therapy to ambulatory chronic condition management.
Approximately 1 in 6 family physicians provides obstetric care, according to information from the American Academy of Family Physicians (AAFP).2 Although not all of these family doctors are providing intrapartum care, many will be providing prenatal care, and the management of common prenatal conditions is the focus of this edition of FP Essentials.
In Section One, you’ll find information about management of vaginal bleeding in the first trimester of pregnancy. Section Two covers the diagnosis and management of gestational diabetes. Section Three reviews fetal growth restriction and its causes and complications, while Section Four addresses the indications and mechanisms for antepartum fetal surveillance.
Some complications of pregnancy are relevant after delivery. This edition discusses the postpregnancy implications of gestational diabetes, including follow-up screening recommendations. Likewise, the management of recurrent pregnancy loss has implications for future pregnancy plans, which family physicians who do not offer prenatal care still may include among their services.
I hope you find this edition of FP Essentials useful as you care for your patients.
Kate Rowland, MD, FAAFP, Associate Medical Editor
Vice Chair of Education and Associate Professor,
Department of Family Medicine
Rush University, Chicago, Illinois