ICSI has made a significant format enhancement in our scientific documents. All scientific documents (excluding Order Sets) now have “interactive” capability that allows a user to click on various links in the document and easily navigate from one area to another. For example, you can click on an algorithm box (those denoted with blue text and those that refer to other algorithm boxes) and link directly to the supporting annotation.

A tip for quickly going back and forth within the document:
Go to View, Toolbars, More Tools, Page Navigation, Previous View.
This should give you a back arrow tool that will allow you to go back and forth between views easily.

Note: The interactive links within ICSI PDF guidelines may not work on some mobile devices. However, the GoodReader App (and possibly some other "reader" applications) will allow anyone to open ICSI interactive PDF Guidelines on their mobile device and utilize most of the interactive capabilities.

Scope and Target Population:
This guideline pertains to the care of all women who are pregnant or are considering pregnancy. All visits are outpatient/clinic based. (See the ICSI Management of Labor guideline for hospital-based care.)

Aims:

1. Increase the percentage of patients pregnant or planning a pregnancy who receive timely, comprehensive screens for risk factors.
   
2. Increase the percentage of pregnant patients or women planning pregnancy who receive timely, prenatal counseling and education as outlined in the guideline.
   
3. Increase the percentage of first-trimester pregnant patients who have documentation of counseling about appropriate aneuploidy screening.
   
4. Increase the percentage of VBAC-eligible pregnant patients who have a collaborative conversation with their clinican about the risks and benefits of VBAC.
   
5. Increase the percentage of pregnant patients who have appropriate interventions for preterm birth (PTB) risk factors.

Clinical Highlights:

• Identify patients with greater potential for high-risk pregnancy and provide appropriate preconception counseling.
  
• Each pregnant patient and each patient planning a pregnancy should receive a comprehensive risk assessment and appropriate risk-related interventions, including risks for preterm labor, relevant infectious diseases, and relevant genetic disorders.
  
• Each pregnant patient should receive visit-specific screening tests, education, immunizations and chemoprophylaxis as described in the schedule of prenatal visits.
  
• Each pregnant patient should be counseled regarding the limitations and benefits of each aneuploidy test and offered the screening and diagnostic tests.
  
• For patients with previous Caesarean section, provide education of risks and benefits associated with vaginal birth after Caesarean (VBAC). Assess and document patient's desire and appropriateness for VBAC.