PRENATAL CARE
PRENATAL CARE
- Periodic and regular supervision including
examination and advise of a woman during a
pregnancy
PRENATAL CARE GOALS
• To screen the high risk cases
• To prevent or detect or treat at any earliest complication
• To ensure continued medical surveillance and prophylaxis
• To educate the mother about the physiology of pregnancy and labor
demonstrations, charts and diagrams so that fear is removed and psychology
is improved.
• To discuss with the couple about the place and time and mode of delivery.
Provisionally and care of newborn
• To motivate the couple about the need of family planning
• To advice the mother about breastfeeding, postnatal care and immunization
PRENATAL CARE OBJECTIVES
- To ensure a normal pregnancy with delivery of
a healthy baby from a healthy mother
PRENATAL VISITS
• Ideally 13 visits
✓ 7 in first 7months
✓ 2 in the 8th month
✓ 4 in the 9th month
• Minimum 4 visits
✓ I : As soon as pregnancy is suspected (Registration and first check up)
✓ II : 26th week
✓ III : 32nd week
✓ IV : 36th week
• (At least one home visit by health worker)
Importance of PRENATAL CARE
▪ To confirm pregnancy and assess the period of gestation.
▪ To prevent maternal and neonatal tetanus
▪ To facilitate health education regarding diet, rest, avoidance of
unnecessary travel and preparation for delivery.
Components of PRENATAL CARE
▪ Identification of pregnant women and importance of early registration
▪ Diagnosis of pregnancy
▪ Clinical assessment
▪ Nutrition
▪ Management of minor ailments
▪ Risk Assessment and appropriate management
Components of PRENATAL CARE con’t.
▪ Complications and 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 weeks..
▪ Early identification helps
▪ Assessing health status of the mother
▪ Obtain baseline information of the mother
▪ Screen for factors
▪ Recall LMP
▪ Counsel on hygiene, diet, rest, etc.
▪ Build rapport with pregnant women
Within 20 weeks
▪ Screen and treat anemia
▪ Initiate prophylaxis against anemia
▪ Screen risk factors and medical conditions
▪ Develop individualized birth plan
▪ Immunize tetanus toxoid
▪ Investigate hemoglobin levels, blood group, urine examination, VDRL,
etc.
Within 28 - 32 weeks
Monitor for:
▪ PIH
▪ Multiple gestation
▪ Anemia
▪ Develop individualized birth plan
▪ Give TT
▪ Assess IUGR
▪ Repeat of laboratory exams if necessary
Within 36 weeks onwards
Monitor for:
▪ PIH
▪ Identify fetal presentation
▪ Rule ot CPD in primi gravida
ROLE OF NURSE IN PRENATAL CARE
1. REGISTRATION
✓ Health status
✓ Identify and manage high risk cases
✓ Estimate EDD more accurately
✓ Give first dose of TT (after 12 weeks)
✓ To start regular dose of folic acid during the first trimester
ROLE OF NURSE IN PRENATAL CARE
2. PRENATAL SERVICES FOR MOTHERS
✓ Health history
✓ Physical examination
✓ Laboratory examination
✓ High risk approach
✓ Medications
✓ TT Immunization
✓ Health Education
✓ Home visit
✓ Referral
ROLE OF NURSE IN PRENATAL CARE
3. Maintenance of records
✓ Antenatal card
✓ Antenatal register
4. Prenatal Check up
✓ History
✓ EDD
✓ Age of woman
✓ Order of pregnancy
✓ Birth interval
ROLE OF NURSE IN PRENATAL CARE
5. Symptoms during pregnancy
✓ Causing discomfort
✓ Symptoms indicating a complication may be arising
6. Previous Pregnancies / Obstetric History
✓ Pregnancies/abortions/deliveries
✓ Premature births/stillbirths/neonatal deaths
✓ Hypertensive disorders/History of convulsions
✓ Prolonged Obstructive labor
✓ Malpresentation
ROLE OF NURSE IN PRENATAL CARE
7. History of systemic illness
✓ Family history
✓ History of drug intake
✓ Allergies
✓ Substance abuse use
ROLE OF NURSE IN PRENATAL CARE
8. Investigation
✓ CBC
✓ Blood group and Rh Typing
✓ Urinalysis
✓ RBS
✓ VDRL
✓ HBS Ag
✓ Ultrasound
ROLE OF NURSE IN PRENATAL CARE
9. Ultrasound
▪ Early pregnancy (10-13 weeks)
✓ Gestational age, multiple pregnancies
▪ 11-14 weeks
✓ Nuchal translucency screening for Down’s
syndrome, with other tests if available
▪ 18-20 weeks
✓ CAS
▪ 36 weeks
✓ Fetal maturity , placenta praevia
ROLE OF NURSE IN PRENATAL CARE
10. Antenatal Advise
✓ Diet
✓ Rest and Sleep
✓ Bowel
✓ Abstinence
✓ Travelling
✓ Immunization
✓ Personal hygiene
✓ Radiation
✓ Drugs
✓ Occupational hazards
✓ Warning signs
✓ Health education
