The document discusses antenatal assessment, which involves the systematic supervision of a pregnant woman. It involves determining risk factors through a comprehensive history and physical exam. Regular checkups are recommended, starting with monthly visits until week 28, then twice monthly until week 36, and weekly during the last 4 weeks. The assessments monitor maternal and fetal health and wellbeing through tests, exams, ultrasounds and more. The goal is to promote a healthy pregnancy and delivery.
4. Determines the wellbeing of the newborn and
chance for survival (mother history)
5. Pre-conception counselling
Assessment of risk factors
Ongoing assessment of fetal well-being
Ongoing assessment of complications
Education
Discussion of birthing care options
6. The first visit should not be deferred beyond the
second missed period.
Once a month until 28 weeks.
Twice a month until 36 weeks.
Every week during the last 4 weeks of pregnancy.
7. > Detailed Health History
> Physical Examination
> Breast and Pelvic Examination
8. Name
Age
Ward/unit
IP no
Address
Religion
Occupation
Education
LMP
EDC
GA
Obstetric score
Blood group
10. Present ob. History:
◦ Diagnosis?
◦ Planned/unplanned
◦ Minor disorders
◦ Immunization
◦ Exposure to drugs/radiation
11.
12.
13. Comprehensive maternal history and physical
examination is important to point out the risk
factors.
Risk factors can be related to mother, during
pregnancy, during labor and delivery, or after
delivery.
Antenatal assessment starts with determination
of risk factors.
Better knowledge about risk factors better
preparation to care for the patient.
14. 31% of pregnancies end in miscarriage
Only rarely would an abortion cause problems in a
subsequent pregnancy
increased risk of miscarriage only in women who
have had multiple induced abortions.
15. Preterm Birth:
What is considered preterm??
The second greatest cause of morbidity and
mortality in neonates.
Previous preterm birth increases the subsequent
preterm birth:
1 prior = 15% of subsequent preterm birth.
2 prior = 32% of subsequent preterm birth.
16. Incompetent Cervix:
Caused by cervical trauma, previous surgery, or
may be congenital.
Usually leads to membrane rupture and
premature delivery.
If severe, a suture around the cervical canal is
performed.
17. Maternal Smoking and Alcohol
Intake:
In the US, about 10% of pregnant mothers smoke,
drink alcohol or use drugs.
Maternal intake of alcohol leads to fetal growth
problems.
Smoking HBCO decreases availability of
oxygen to placenta and fetus.
18. Maternal Hypertension
Complicates 6-8% of pregnancies.
Hypertension during pregnancy (after W24) is
termed: Preeclampsia.
Preeclampsia (High BP, proteinuria, edema)
Can lead to placental abruption, and preterm
delivery.
19. Diabetes:
Increase the risk for CV and CNS
malformations, and metabolic disturbances.
When appears during pregnancy (Gestational
Diabetes Mellitus, GDM).
Treatment: glycemic control.
20. Infections Diseases:
Infections can be transmitted to fetus.
Early screening and detection of the infection is
important.
Complicated by the rupture of the membrane.
21.
Problems in Placenta, UC,
and Fetal Membrane:
premature rupture : causes 50% of preterm
births.
UC : Prolapse, short, single artery (3%)
Placental problems
30. After 14 weeks gestation the SFH in centimeters = Number of
weeks of gestation + 3 cm.
31.
32. First visit: Hb, Blood group, Rubella, Hep B and C
and HIV screening.
10-12 weeks: Chorionic villous sampling
15-18 weeks: USG, serum AFP/triple test ,
amniocentesis
28 weeks: Hb ,TC/DC, ferritin, GTT, and low
vaginal swab to exclude Group B strep.
36 weeks: Hb
33. Weight gain (12-15 kg in total)
BP (a diastolic pressure>90, or increase of >20
from first visit is significant)
Urinalysis (watch for protein, glucose, and UTIs)
Fetal movements
Uterine size in accordance with dates and
ultrasound
Fetal lie, presentation, and engagement,
especially after 36 weeks
34. ULTRASOUND
Uses high frequency sound waves.
Hand-held transducer is placed directly over the
mother’s abdomen, and reflected waves are
recorded on screen image.
Can give valuable information about pregnancy
and fetus
37. AMNIOCENTESIS
Is the procedure of obtaining a sample of amniotic
fluid.
Usually performed after W15 (w15-20).
A needle is inserted through the skin and uterine
wall to the amniotic sac.
Insertion is guided by Ultrasound.
Sample from amniotic fluid is obtained for analysis.
Very safe procedure (complication rate <1%).
38. FETAL HEART RATE (FHR) MONITORING
Heart starts to beat between W16-W20, but beats
can be detected as early as W8.
Normal 120-160 bpm.
Becomes very common test.
39. Diet
exercise
Rest and sleep
Bowel
Bathing
Clothing
Dental care
Coitus
Care of breast
Immunisation