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Prenatal Care

Prenatal care involves regular checkups during pregnancy to monitor the health of the mother and baby. The nurse's role includes registration, assessments, screening for risks, providing education, immunizations, and making referrals. The goals are a healthy pregnancy, detection of issues, and delivery of a healthy baby from a healthy mother.

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536 views40 pages

Prenatal Care

Prenatal care involves regular checkups during pregnancy to monitor the health of the mother and baby. The nurse's role includes registration, assessments, screening for risks, providing education, immunizations, and making referrals. The goals are a healthy pregnancy, detection of issues, and delivery of a healthy baby from a healthy mother.

Uploaded by

REVATHI H K
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We take content rights seriously. If you suspect this is your content, claim it here.
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PRENATAL CARE AND

ROLE OF NURSE IN
PRENATAL CARE

Presented To- Mrs. Jeen Mexina Presented By- Jyothy Kumari


Associate Professor Msc Nursing
Pediatrics 1st Year
WHAT IS PRENATAL CARE
“Periodic and regular supervision
including examination and advice
of a woman during pregnancy is
called Antenatal care”

The supervision should be of


a regular and periodic nature in
accordance with the need of the
individual.
AIMS
The aims are-
• To screen the high risk cases
• To prevent or detect or treat at the any earliest
complication
• To ensure continued medical surveillance and
prophylaxis
• To educate the mother about the physiology of
pregnancy and labor by demonstrations, charts
and diagrams so that fear is removed and
psychology is improved
AIMS (CONT’D)

• To discuss with the couple about the place,


time and mode of the delivery, provisionally
and care of the newborn
• To motivate the couple about the need of
family planning
• To advice the mother about breast-feeding,
post-natal care and immunization
OBJECTIVES
To ensure a normal pregnancy with
delivery of a healthy baby from a
healthy mother
Antenatal Visits
 Ideally 13 visits
 7 in first 7 months
 2 in 8th month
 4 in 9th month

 Minimum 4 visits

 I : As soon as the pregnancy is suspected

(For registration & first check-up)


 II : 26 weeks
 III: 32 weeks
 IV : 36 weeks

(At least one visit at home by health worker)


IMPORTANCE OF PRENATAL CARE

To confirm pregnancy & assess the period of


gestation.
To prevent maternal & neo natal tetanus.
To facilitate health education regarding diet,
rest, avoidance of unnecessary travel &
preparation for delivery.
COMPONENTS OF PRENATAL CARE
Identification of pregnant women’s &
importance of early registration.
Diagnosis of pregnancy.
Clinical assessment.
Advice during AN visit.
Nutrition.
Management of minor ailments.
Risk assessment & appropriate management.
Complications & management.
Complications of late pregnancy.
Management of medical disorders during
pregnancy.
Screening for congenital malformations
during pregnancy.
Management of Anemia during pregnancy.
IDENTIFICATION / REGISTRATION
12 wks..
Early identification helps,
Assessing the health status of the mother.
Obtain baseline information of the mother.
Screen for factors, referral to FRU.
Recall LMP easily.
Do MTP if required.(< 10 wks.)
Counsel on hygiene diet , rest.
Build up rapport with pregnant women.
WITHIN 20 WKS
Screen & treat anemia.
Initiate prophylaxis against anemia.
Screen risk factors & medical conditions.
Develop individualized birth plan.
Immunize with tetanus toxoid.
Investigate – Hb, blood group, urine
examination, VDRL, Blood grouping.
28-32 Wks
Aimed at the following. Detect:
PIH.
Multiple gestation.
Anemia.
Develop individualized birth plan.
Give TT.
Assess IUGR.
Repeat HB estimation.
36 Wks.

PIH.
Detect the following.
Identify foetal & presentation.
Rule out CPD in primi gravida.
ROLE OF NURSE IN PRENATAL
CARE
1. REGISTRATION-
The nurse has to do registration of the prenatal mother.
so that to assess the following condition-

 To assess the health status


 To identify and manage high risk cases
 To estimate EDD more accurately
 To give the first dose of TT (after 12 weeks)
 To help the woman for an early and safe abortion (MTP)
if it is required by her
 To start the regular dose of folic acid during the first trimester
2. PRENATAL SERVICES FOR
 Health history
MOTHERS
 Physical examination
 Laboratory Examination
• Urine/Stool/Blood(Count)/Hb/Serological/Blood group(Rh also)
• Pap test(if facilities)/ Chest X-Ray and Gonorrhea test(if needed)
 High risk approach
 IFA and necessary medications
 TT Immunization
 Health education
 Home visit
 Referral(if needed)
3. MAINTENANCE OF RECORDS

Antenatal Card

Antenatal register
4. ANTENATAL CHECKUP
HISTORY

(I) To diagnose pregnancy


(ii) To identify any complications during
previous pregnancies
(Iii) To identify any medical/obstetric
condition(s) that may complicate this
pregnancy
• Calculation of EDD

• Ask for the first day of the last menstrual cycle


(LMP)
• Ask for the date when the foetal movements
were first felt(quickening)
• Also assess the fundal height to estimate the
gestational age
• Ask for any test done to confirm pregnancy

EDD= LMP + 9 months + 7 days


Age of the woman
• Complications when <16 years/>40 year

Order of the pregnancy


• Primigravida and multipara are at risk

Birth interval
• Ideally should be >3 years
5. Symptoms during the present
pregnancy

• Symptoms indicating discomfort


nausea and vomiting
heartburn
constipation
frequency of urination
• Symptoms indicating that a complication may
be arising
 fever
 vaginal discharge/bleeding
 palpitations
 breathlessness at rest
 generalized swelling of the body; puffiness of the face
 oligouria
 decreased or absent foetal movements
6. Previous pregnancies/Obstetric
history

 Number of earlier pregnancies/abortions/deliveries


 Number of premature birth(s)/stillbirth(s)/neonatal
deaths
 Hypertensive disorders of pregnancy (history of
convulsions)
 Prolonged/obstructed labour
 Malpresentation
CONT…
 APH/PPH
 Modes of deliveries(normal/assisted/caesarean
section)
 Birth weight of the previous baby
 Any surgery on the reproductive tract
 Iso-immunization (Rh-ve) in the previous pregnancy
(Any costly inj. Given to her within 72 hours of her
previous delivery
7. History of any systemic illness
 Hypertension
 Diabetes
 Heart Disease
 Tuberculosis
 Renal Disease
 Convulsions
 Asthma
 Rashes
 Jaundice
CONT..
• Family history of systemic illness
 Above illnesses
 Thalassemia
 Delivery of twins or delivery of an infant with
congenital malformation
• History of drug intake or allergies
• History of intake of habit-forming substances
(tobacco, alcohol)
8. Investigation
The nurse should undergo following investigation-
• CBC
• Blood grouping & Rh typing
• Urine R/E
• RBS
• VDRL
• HBS Ag
• Ultrasound
Ultrasound

early pregnancy (preferably at 10-13 weeks) to:


• Determine gestational age
• Detect multiple pregnancies
• Help with later screening for Down's
syndrome
9. Ultrasound (cont’d)
At 11-14 weeks:
offer nuchal translucency screening for Down's
syndrome, with other tests if available.

At 18-20 weeks:
offer screening with ultrasound for congenital
anomalies.

At 36 weeks:
for foetal maturity, placenta praevia.
10.Antenatal Advice
1.DIET
Diet should be:
1. Nutritious
2. Balanced
3. Light
4. Easily digestible
5. Rich in protein, mineral and vitamin with woman’s
choice
6. Iron & folic acid supplementation.
11.REST & SLEEP
 Night 8 hours ,Day 2 hours (Lt side)
 Avoid heavy work (especially lifting heavy weights)
 Avoid the supine position
(especially in late pregnancy, if it is necessary, a small
pillow under the lower back at the level of the pelvis
should be used)
12. BOWEL
• Regular bowel movement may be facilitated by regulation
of diet, taking plenty fluid, vegetable and milk
13. ABSISTENCE
• Should be avoided in
• 1st trimester
• last 6 weeks
14. TRAVELLING
Should be avoided in
• 1st trimester
• last 6 weeks
Air travelling is contraindicated in
• Placenta praevia
• Preeclampsia
• Severe anemia
15. IMMUNIZATION
Indicated-
• TT
• HAV
• HBV
• Rabies
Contraindicated-
• Live virus vaccine (rubella measles, mumps,
Varicella)
16. PERSONAL HYGIENE
• The nurse should advice the mother regarding
the personal hygiene and its importance.
17. RADIATION
• The nurse should advice the mother to avoid
the X-rays.
17. DRUGS
• Sedative , Anticoagulant, Antithyrodism,
Hormones& Antibiotics Should Be Avoided

18. OCCUPATIONAL HAZARDS


Lead, mercury, X ray s& ethylene oxide.
18.DANGER/WARNING SIGNS
• High fever with/without abd. pain, feels too weak to get out
of bed
• Fast/difficult breathing
• Decreased or absent foetal movements
• Excessive vomiting (woman is unable to take food/fluids)
• Any bleeding P/V during pregnancy
• Heavy (>500 ml) vaginal bleeding during and following delivery
• Severe headache with blurred vision
• Convulsions or loss of consciousness
• Labour lasting longer than 12 hours
• Failure of the placenta to come out within 30 minutes of
delivery
• Preterm labour
• Premature or prelabour rupture of membranes (PROM)
• Continuous severe abdominal pain
19. Health education
The nurse should the mother regarding-
• Breast feeding
• Nutrition
• Family planning
• Postnatal exercises
• Child care
• Dental care
CONT..
• Clothing, shoes and belt
• Care of breast
• Smoking and alcohol
• Birth plan
• Mental preparation
• Diet
• Sleep and rest
• To avoid stressor
• Minor ailments.
SUMMARIZATION

• DEFINITION OF PRENATAL CARE

• IMPORTANCE OF PRENATAL CARE

• OBJECTIVES OF PRENATAL CARE

• ROLE OF NURSE IN PRENATAL CARE

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