Anc physiotherapy evaluation

this ppt contains everything about evaluation in antenatal period by a physiotherapist for proper prescription of exercises. also it has details of contraindications & generalised guidelines for exercises in antenatal period.

1. ANC EVALUATION DR. MEGHAN METHA-PHUTANE (PT)

2. Name Age Address Contact no. Date of evaluation Duration of marriage Religion Occupation Occupation of husband Gestational age DEMOGRAPHIC DATA

3. Of present illness (if any) Present pregnancy Obstetric Menstrual Medical Surgical Past complications Family Personal HISTORY

4. GPLAD ( Gravida , Parity, Live, Abortion, Death) Type of previous delivery If C-section – (reasons) Regular hospital visits Medications Vaccinations Hospital admissions Menarche Regularity of MC LMP EDD- LMP + 9m&7d EDD on scan report OBSTETRIC & GYANECOLOGICAL HISTORY

5. Temperature Pulse rate Respiratory rate Blood pressure Height Pre-pregnancy weight Current weight Built Nutrition GENERAL EXAMINATION

6. Pallor Tongue & teeth Tonsils Oedema Breast Abdominal girth Fundal height Lie of baby Diastasis recti Fetal movements Fetal HR GENERAL EXAMINATION

7. Complete blood count Sonography report (USG) Urine reports Cervical cytological studies Serological tests for rubella, hepatitis & HIV Maternal serum alpha feto proteins- high levels in neural tube & other defects Chorionic villus sampling (CVS) – for down’s syndrome Amniocentesis – genetic disorders, STDs Pelvimetry - CPD INVESTIGATIONS

8. Muscle problems Activity level- active/ less active/ bed rest Diastases recti Posture Gait Pain- site/ nature/ VAS Physiological edema- foot/ palm/ abdomen/ face Hemoglobin level MUSCULOSKELETAL EVALUATION

9. Check for Latissimus dorsi Thoraco -lumbar fascia Gluteus maximus Erector spinae Biceps femoris SI JOINT PAIN EVALUATION

10. BEFORE STARTING ANC CLASSES: Take medical clearance from gynecologist Medical & surgical history Check for contraindications Maintain patient’s privacy

11. Avoid jerky, ballistic movements & vigorous activities. Regular exs session – at least 3times a wk are safer than intermittent bursts of activity. Careful warm up should precede exs session & should always be followed by cool down. Strenuous exs should be avoided in hot & humid atmosphere. Maternal HR should not exceed 140bpm & vigorous exs should not be continued for longer than 15mins. GUIDELINES FOR EXERCISES

12. Fluids must be taken before, during & after exertion, to avoid dehydration. Energy intake must be sufficient for the needs of pregnancy & exs. As the woman begin to exs during pregnancy, it is essential that those accustomed to sedentary lifestyle should start with low intensity physical activities like – walking, swimming, stationary bicycle or yoga. Progression should always be gradual. Exs should always be decided on limitations imposed by pregnancy – exclude the competitive elements.

13. ABSOLUTE CVD Acute infection Multiple pregnancies H/O recurrent abortions Bleeding/ruptured membrane Severe HTN Thrombophlebitis Pulm embolism Sedentary lifestyle Blood disorders Thyroid diseases DM Maternal over or under weight Breech presentation Contraindications RELATIVE

14. To develop good posture To decrease constipation & insomnia To alleviate discomfort, postural backache, fatigue To ensure good muscle tone & strengthen PFM To develop good breathing habits, ensure good O2 supply to fetus To prevent circulatory stasis in lower extremities, promote circulation, decrease possibility of venous thrombosis. Purpose of exercise

15. Vaginal bleeding/ spotting Dyspnoea prior to exertion Dizziness Headache Chest pain Muscle weakness Calf pain /swelling Preterm labour Decreased fetal movements Amniotic fluid leakage Warning signs to terminate exercise