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2) Thorough clinical examination including: anthropometric measurements including height and weight, vital signs, general and local abdominal examination

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Bacteria and endotoxins from periodontitis can translocate hematogenously to the placenta, directly damaging placental tissue and entering the amniotic fluid to induce chorioamnionitis, thereby increasing the risk of preterm birth (105)

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These effects often matter most when they interfere with fluids, nutrition, work, sleep, or diabetes management

Sterile water is only acceptable for immediate, single-use applications