Antenatal Care and Antenatal Advise.pptx

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1. Antenatal care

2. Definition: Systematic supervision ( examination and advice) of a woman during pregnancy to ensure a normal pregnancy with delivery of a healthy baby from a healthy mother is called antenatal( prenatal care). It starts before pregnancy and ends at delivery and the post partum period. It comprises of the Careful history taking and examination Advice to the pregnant woman.

3. Aims and objectives To screen the high risk case To prevent or detect and treat at earliest any complication To ensure continued risk assesment and to provide ongoing primary preventive health care To educate the mother about the physiology of pregnancy and labor by demonstrations, charts and diagrams so tht fear is removed and psychology is improved.

4. To discuss with couples about the place, time and mode of delivery, provisionally and care of new born To motivate the couple about the need of family planning and also appropriate advice to couple seeking medical termination of pregnancy.

5. Objective : to ensure a normal pregnancy( single baby in good condition at term, fetal weight of 2.5 kg and no maternal complication) with delivery of a healthy baby from a healthy mother.

6. Procedure at first visit a. History taking Vital statistics : Name Date of first examination Address Age ( elderly primigravida above 35 years) Gravida Parity

7. Duration of marriage Religion Occupation Occupation of hysband Period of gestation: LMP and EDD 2. Complaints 3. History of present illness 4.History of present pregnancy

8. 5. Obstetric history 6.Menstrual history 7.Past medical history 8.Past surgiccal history 9.Family history 10.Present history

9. b. examination General physical examination Build Heights Weight Pallor Jaundice Tongue teeth gums and tonsils Neck Edema of legs

10. Sytemic examnition : heart lungs and spleen Breasts Obstetrical examination Abdominal Vaginal Routine investigation: blood and urine Special investigation: - rubella hepatitisB and HIV -Genetic screening - Ultasound

11. Subsequent visits History Examination Abdominal vaginal

12. ANTENATAL ADVICE

13. Antenatal advice Principles: To counsel the women about the importance of regular check up To maintain or improve the health status of the woman to the optimum till delivery by judicious advice regarding diet, drugs and hygiene. To improve the psychology and to remove the fear of the unknown by counseling the woman.

14. a) DIET: 1. The diet of the pregnant women should be adequate to provide: Good maternal health Optimum fetal growth The strength and vitality required during labor. Succesful lactation. 2. Light, nutritious, easily digestible and rich in proteins, minerals and vitamins 3. Supplementary nutritional therapy: iron, vitamins

15. 3. Daily dietary allowance Components Non pregnant Pregnancy 2 nd half lactation Energy 2200 kcal 2500 kcal 2600 kcal Protein 50 g 60g 65g Iron 18 mg 40mg 30mg Calcium 500 mg 1000mg 15000mg Zinc 12 mg 15mg 19mg Iodine 150 microgram 175 microgram 200 microgram

16. Components Non pregnant Pregnancy 2 nd half lactation Vitamin A 5000IU 6000IU 8000IU Vitamin D 200IU 400IU 400IU Thiamine 1.1mg 1.5mg Same Riboflavin 1.1 mg 1.6mg Same Nicotinic acid 15mg 17mg Same Abscorbic acid 60mg 70mg Same Folic acid 200microgram 400microgram Same Vitamin B12 2microgram 2.2microgram Same

17. b) Antenatal hygiene: the following advices are given Rest and sleep: 8 hours in night 2 hours in day. Bowel: fluids, vegetables and milk Daily Bathing Clothing, shoes and belt Dental care Care of the breast Coitus Travel Smoking and alcohol

18. c) Immunization: tetanus 2 doses. First dose between 16 weeks and 24 weeks. 2 nd dose after 6 weeks interval. d) Drugs: - precaution to be taken while prescribing to woman of reproductive age

19. e) General advice: Antenatal check up on the schedule date. - Advise to visit hospital if painful uterine contraction, leaking per vagina , bleeding.