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is a period of rapid change in the lives of boys and girls during which the reproductive systems mature and become capable of reproduction. |
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begins when the secondary sex characteristics appear |
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ends when mature sperm are formed or when regular menstrual cycles occur |
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changes normally begin between 10 and 16 years of age |
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levels are constant, not cyclical like female hormones, although levels may decrease with age to 50% of peak levels by age 80 years |
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The first outward change of puberty in females is |
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development of the breasts |
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The first menstrual period (menarche) occurs |
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2-2 ½ years later (age 11-15 years) |
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cheese-like sebaceous substance that collects under the foreskin and is easily removed with basic hygiene |
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Under the direction of the hypothalamus |
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, the anterior pituitary gland secretes FSH and LH. FSH and LH initiate the production of testosterone in the Leydig cells of the testes |
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combination of seminal plasma and sperm |
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Pelvic weakness or painful intercourse (dyspareunia) |
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may result if tissue does not heal properly |
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The marked stretching of the vagina during delivery is made possible by the |
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transverse ridges of the mucous membrane lining |
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Is self-cleansing and during the reproductive years maintains a normal acidic pH of 4 to 5 |
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consists of a cervical canal with an internal opening near the uterine corpus (the internal os) and an opening into the vagina (the external os). |
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the classic female pelvis, with rounded anterior and posterior segments. This type is most favorable for vaginal birth. |
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has a shortened anteroposterior diameter and a flat, transverse oval shape. This type is unfavorable for vaginal birth |
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measured between the symphysis pubis and the sacrum and is the shortest inlet diameter. It’s measurement of the outlet is the distance between the lower border of the symphysis pubis and the tip of the sacrum |
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stored briefly in widened areas of the ducts, called ampullae or lactiferous sinuses |
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the vaginal secretions increase noticeably |
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Approximately 2 days before ovulation |
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the corpus luteum degenerates if fertilization has not occurred, and progesterone levels and estrogen levels decrease |
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Approximately 12 days after ovulation |
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a period of years during which the women’s ability to reproduce gradually decreases |
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woman’s last menstrual period |
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made up of 22 pairs (autosomes), and 1 pair of sex chromosomes that determine the sex of the fetus |
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Biological development is influenced by |
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the external environment, such as maternal drug use (teratogens that cause damage to growing cells include some prescribed medications), maternal under nutrition, or smoking by the mother, and it is now known that sounds such as music are heard by the fetus and are recognized by the newborn |
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46 chromosomes in a body cell are called |
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the diploid number of chromosomes |
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The process of mitosis in the sperm |
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During meiosis the number of chromosomes in each cell is reduced by half |
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to 23 chromosomes per cell, each including only one sex cell chromosome, this is called the haploid number of chromosomes |
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At the moment of fertilization the 23 chromosomes |
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pair with the partners 23 chromosomes making now the diploid (46) chromosomes, creating a new fetus. |
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The formation of gametes by cell division |
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The sex of the offspring is determined at |
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The ovum always carries an |
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the sperm may have either an |
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if the sperm carries an X chromosome (making an XX, from both the ovum and sperm) the sex would be |
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If the sperm carries the Y chromosome and unites with the X of the ovum, it creates a |
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inner layer is a solid mass of cells, which develops into the embryo and the embryonic membrane. |
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The endometrium later becomes the |
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the area under the blastocyst is called the |
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decidua basalis and gives rise to the maternal part of the placenta |
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The chorion develops from the |
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trophoblast (outer layer of embryonic cells) and envelops the amnion, embryo, and yolk sac |
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It is the think membrane with fingerlike projections (villi) on its outermost surface which allows implantation to the uterus wall |
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it is a thin structure that envelops and protects the embryo |
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The chorion and the amnion develop the |
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amount of fluid is about 1000mL at 37 weeks |
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On the 9th day after fertilization a cavity called the |
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yolk sac forms in the blastocyte |
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The umbilical cord than encompasses the |
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yolk sac and the yolk sac degenerates |
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Three basic stages characterize prenatal development |
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zygote, embryo, and fetus |
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Four hormones are produced by the placenta |
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progesterone, estrogen, hCG, and hPL |
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corpus luteum that conception has occurred |
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more glucose available to the baby |
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Circulation to the fetus is well maintained by |
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identical, each has its own amnion but have a common chorion and placenta |
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fraternal, always have two amnions, two chorions, two placentas |
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The three stages of pregnancy |
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antepartum (before birth), intrapartum (during pregnancy), and postpartum (after birth) |
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The focus of nursing care during pregnancy is to |
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teach the mother how to maintain good health or, in the case of a mother with a condition that places her or her fetus at risk, to improve her health as much as possible. |
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An adequate folic acid intake before conception |
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can reduce the incidence of congenital abnormalities. |
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A complete history will help identify problems and should include |
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obstetric history, menstrual history (LNMP), contraceptive history, medical and surgical history, family history of the woman and her partner, health history of the woman and her partner, and psychosocial history of the woman and her partner. |
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The U.S. Preventive Services Task Force has updated its recommendations concerning obtaining urine cultures at |
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12-16 weeks of gestation to screen for asymptomatic bacteria |
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The recommended schedule for prenatal visits |
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Conception-28 weeks=every 4 weeks, 29-36 weeks=every 2-3 weeks, 37 weeks-birth=weekly. |
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pregnant for the first time |
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pregnant before, regardless of the duration |
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past age of viability, regardless of baby being alive or dead |
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given birth to two or more children |
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prenatal age of developing fetus, approximately two weeks less that gestational age |
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T=number of terms,P=preterm, A=abortions, L=living, M=multiple births |
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Determine EDD, count back 3 months, add 7 days |
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Presumptive Signs of Pregnancy |
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those from which a definite diagnosis of pregnancy cannot be made |
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Probable Signs of Pregnancy |
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provide stronger evidence of pregnancy |
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softening of the cervix and vagina |
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purplish or bluish discoloration of the cervix, vagina, and vulva |
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softening of the lower uterine segment |
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easy reflex of the body of the uterus against the cervix |
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a maneuver by which the fetal part is displaced by a light tap of the examining finger on the cervix and then rebounds quickly |
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may be identified by palpation after the 24th week |
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A highly reliable pregnancy test |
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The fetal heart rate at term ranges between a low of |
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110-120 bpm and a high of 150-160 bpm. |
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soft blowing sound heard over the uterus during auscultation |
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soft swishing sound heard as the blood passes through the umbilical cord vessels |
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At term the uterus reaches the woman’s xiphoid process and weighs about |
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2.2lbs, it’s capacity is about 5000mL. |
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Vaginal secretions have higher levels of |
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glycogen, a substance that promotes the growth of candida albicans, the organisms that cause yeast infections |
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Oxygen consumption increases by |
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More common during pregnancy |
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Glycosuria and proteinuria |
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Changes in the renal system may take |
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6 to 12 weeks after delivery to return to prepregnancy normal |
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The WHO recommends that a full-term infant receive |
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20mg of DHA per kilogram per day. |
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Women with a BMI of 18.5-24.9 are considered |
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women with a BMI of less that 18.5 are considered |
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women with a BMI of 25-25.9 are considered |
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women with a BMI greater than 30 are considered |
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The general recommendation is that a woman gain up to |
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4.4lbs during the first trimester and 1lb per week during the rest of pregnancy |
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A calorie intake of about |
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300 kcal/day is recommended for growth of the fetus |
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Protein, calcium, iron, and folic acid are |
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The DRI of calcium for pregnant women is |
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The DRI of iron for non-pregnant women is |
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15mg/day and 30mg/day for pregnant women. |
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The DRI for folic acid is |
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400 mcg (.4mg) per day for pregnant women, and may reduce the incidence of neural tube defects such as spina bifida, and anencephaly |
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is the number of years between the onset of menses and the date of conception |
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The younger/smaller teenager may need an additional |
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200kcal/day with an additional 300kcal/day that is recommended |
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Signs and symptoms of lactose intolerance include |
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abdominal distention, flatulence, nausea, vomiting, and loose stools, in such cases a daily calcium supplement can be taken |
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Pregnant diabetic women are susceptible to |
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hypoglycemia during the night because the fetus continues to use glucose while the mother sleeps |
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Fasting blood glucose levels greater than |
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500mg/dL in the last trimester have an increased risk of stillbirth |
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The caloric intake during lactation should be about |
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500 calories more than nonpregnant women |
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The maternal protein intake should be |
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The goal of exercise during pregnancy should be maintenance of |
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fitness, not improvement of fitness or weight loss |
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Maternal body temperature should not exceed |
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If the reduction in uterine blood flow exceeds |
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50% serious adverse effects to the fetus may occur |
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In late pregnancy the increases in |
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catecholamines during exercise can trigger labor |
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Varicosities may occur on the |
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vulva, especially after the 20th week of pregnancy |
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Edema in the face and the hands may be a sign of |
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gestational hypertension and should be reported to the health care provider |
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seeking safe passage from mother to fetus, securing acceptance of her being a mother to her fetus, learning to give of self to receive the care and concern of others, and committing herself to the child as she progresses through pregnancy |
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Labile-higher hormones cause |
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emotions to be more unstable |
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help the father achieve positive outcomes to each phase |
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Women over age 35 years may have a decreased ability to |
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adjust their uterine blood flow to meet the needs of the fetus |
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FDA pregnancy risk categories for drugs |
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A-no risk, B-no adverse effects in animals, C-risks are considered, D-definite fetal risks, and X-absolute fetal abnormalities |
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Live-virus vaccines are contraindicated during pregnancy because of |
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possible adverse effects on the fetus |
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Products containing thimerosal should not be given to pregnant women because of |
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the risk of mercury poisoning |
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HepA and B, inactivated influenza, MCV-4, PPV (if at high risk), Td (after 29 weeks), the H1N1 is also recommended to protect pregnant women |
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