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Preventive Guidelines - Women

Blue Cross of Idaho is pleased to provide the following guidelines as an important starting point for you and your family. The following recommendations were derived from a number of professional sources. They are guidelines only and should not be used as a substitute for your doctor’s medical judgment.

Ages 19 and over
 
Immunizations

  • Diphtheria and Tetanus - As an adult, you should get a booster once every 10 years to prevent diphtheria and tetanus.
  • Varicella (chickenpox) - People who do not get the vaccine until 13 years of age or older should get 2 doses, 4-8 weeks apart. You may want to verify immunity status by serologic testing. People should not get the chickenpox vaccine if they have ever had a life-threatening allergic reaction to gelatin, the antibiotic neomycin, or (for those needing a second dose) a previous dose of the chickenpox vaccine. Pregnant women should wait to get the chickenpox vaccine until after they have given birth. Women should not get pregnant for 1 month after getting the chickenpox vaccine. Ask your doctor or nurse for more information.
  • Hepatitis B (Hep B) - If not previously immunized, you can begin the immunization process at any time. People should get 3 doses of the hepatitis B vaccine with the second dose given at least 1 month after the first, and the third dose given at least 2 months after the second and at least 4 months after the first. If you miss a dose or get behind schedule, get the next dose as soon as you can. There is no need to start over. All three doses are needed for full and lasting immunity.
  • MMR (Measles, Mumps, Rubella) - Some adults should also get the MMR vaccine. Generally, anyone 18 years of age or older, who was born after 1956, should get at least one dose of the MMR vaccine, unless they can show that they have had either the vaccines or the diseases. Pregnant women should wait to get the MMR vaccine until after they have given birth. Women should not get pregnant for 3 months after getting the MMR vaccine. Ask your doctor or nurse for more information.
  • Influenza - People at risk for getting a serious case of influenza or influenza complications, and people in close contact with them (including all household members) should get the vaccine. An annual flu shot is recommended for anyone who wants to reduce their chance of catching influenza.
  • Pneumococcal Polysaccharide (PPV) - All adults 65 years of age or older should get one dose. Usually one dose of PPV is all that is needed. A second dose is recommended for those people age 65 and older who got their first dose when they were under 65, if 5 or more years have passed since that dose.

For more information, you can contact the Centers for Disease Control and Prevention (CDC) at: 1-800-232-2522 (English) or 1-800-232-0233 (Espanol), or visit the National Immunization Program Web site.

Screening

Age 19 - 39
It is important for you to have an annual preventive health visit. During this visit, your doctor should check your blood pressure and weight. These checks should be done once every 1-3 years. You should also have your height checked at least once during this time period. Also, Pap Smears and pelvic examinations should be performed on an annual basis starting at age 20, or earlier if sexually active. The American Cancer Society recommends that between the ages of 20 and 39, women should have a clinical breast examination by a health professional every 3 years. Women age 20 or older should perform breast self-examinations (BSE) every month. The frequency of exams and/or mammography will differ for each person based on her individual health and risk factors. It is very important to discuss your ongoing health care needs with your doctor.

Age 40 - 49
It is important for you to have an annual preventive health visit. During this visit, your doctor should check your blood pressure and weight. These checks should be done once every 1-3 years. You should also have your height checked at least once during this time period. Pap Smears and pelvic examinations should be performed on an annual basis. Total Serum Cholesterol and HDL-C screen should be checked once every 5 years. The American Cancer Society recommends that between the ages of 40 and 49, women should have a clinical breast examination by a health professional annually. Women age 40 and older should also have a screening mammogram every year. Women age 20 or older should perform breast self-examinations (BSE) every month. The frequency of exams and/or mammography will differ for each person based on her individual health and risk factors. It is very important to discuss your ongoing health care needs with your doctor.

Age 50 and over
It is important for you to have an annual preventive health visit. During this visit, your doctor should check your blood pressure and weight. These checks should be done once every 1-3 years. You should also have your height checked at least once during this time period. Pap Smears and pelvic examinations should be performed on an annual basis. Total Serum Cholesterol and HDL-C screen should be checked once every 5 years. The American Cancer Society has established guidelines for colorectal cancer screening in average-risk adults ages 50 and older. Tests vary in cost, risk and accuracy. You should have a fecal occult home blood test (FOBT) every year. A flexible sigmoidoscopy should be performed every five years. A colonoscopy should be performed every 10 years. Any positive results in either the FOBT or flexible sigmoidoscopy should be followed up with a colonoscopy. Earlier screening may be done at the discretion of your doctor if there is a family history of colon cancer. The American Cancer Society recommends that women age 50+ have a clinical breast examination by a health professional annually. Women age 50 and older should also have a screening mammogram every year. Women age 20 or older should perform breast self-examinations (BSE) every month. The frequency of exams and/or mammography will differ for each person based on her individual health and risk factors. It is very important to discuss your ongoing health care needs with your doctor.
For more information about breast or colorectal cancer detection and symptoms, contact the American Cancer Society at: 1-800-ACS-2345, or, visit the American Cancer Society Web site.

Pregnant Women
Discovering you are pregnant is a very exciting, but potentially stressful, time for most women. Since each pregnancy is different, you cannot assume that just because your first one went smoothly, subsequent ones will also. Whether this is your first or fourth pregnancy, it is especially important that you seek appropriate medical attention to make sure you take the best care of yourself and your baby.

  • First Trimester (conception - 14 weeks) Your first visit to your doctor will usually be scheduled at around 8 weeks of pregnancy. During this visit, your doctor will check your weight and blood pressure. Your doctor will also screen for syphilis (RPR/VDRL) and chlamydia venereal diseases. You should have a screening for anemia (hemoglobin/hematocrit), a rubella serology or vaccination history, blood typing and testing for anti-Rh(D) antibody, and HIV counseling and testing depending on your individual risk factors. Your doctor will collect a urine sample in order to look for a urinary tract infection. Lastly, you should be screened for Hepatitis BsAg. Your second visit is typically scheduled in 4 weeks, but may vary based on your individual health and risk factors.
  • Second Trimester (15 - 28 weeks)  You will likely have several visits during your second trimester, with your visit frequency increasing. During these visits, your doctor will check your weight and blood pressure. Your doctor will also likely use a Dopler instrument to listen to your baby's heartbeat, which allows you to hear it as well. During the second trimester, your doctor may recommend that you have an ultrasound. This procedure can be helpful in detecting multiple gestation and/or congenital abnormalities of the fetus. Between 16-18 weeks, you will have a maternal serum alpha-fetoprotein test, which checks for an increased risk of Down's Syndrome and spina bifida. Depending on the results of this test, your doctor may recommend further testing, such as an amniocentisis, which is recommended for pregnant women at high risk for Down's Syndrome. Your doctor may also suggest a Glucose Tolerence Test, a one hour test that screens for gestational diabetes. This test is usually performed between 24-28 weeks.
  • Third Trimester (29 weeks to birth)  During the third trimester, your visit frequency will continue to increase and in your last few weeks of pregnancy you will typically see your doctor once per week. At each visit, your doctor will check your weight and blood pressure. You will also have another screening for anemia. If your doctor did not screen for syphilis at the initial visit, this will be done at time of delivery.