ANTE NATAL CARE It is the medical and psychological supervision of the pregnant women so that she will be able

to go through pregnancy, labor and puerperium without complications to herself and to her baby. Health Teaching to the pregnant woman A. Diet during pregnancy 1. Calorie requirements ( in Kcal) About 2,500 Kcal per day Important is the quality of food than the quantity
2. Proteins

More protein needed about 2g/kg body weight per day

Protein deficiency may cause anemia and edema

3. Fats- should be restricted to avoid abnormal gain in weight 4. Carbohydrates- same as the usual amount even before pregnancy 5. Vitamins- all vitamins are needed in increased amount during pregnancy Vitamin A- 5,000 I.U. daily
Vitamin B all are essential

B6 deficiency may cause vomiting of pregnancy Folic acid deficiency leads to megaloblastic anemia in the mother and neural tube defect in the fetus Vitamin c- deficiency leads to scurvy and post partum hemorrhage Vitamin D- mother needs 400 I.U. daily Vitamin K deficiency- leads to post partum hemorrhage & and bleeding in the fetus 6. Minerals Iron deficiency leads to anemia of the mother
1

Daily requirement is 30-60 mg Calcium- pregnant mother needs 1.2 gm daily Iodine- deficiency leads to congenital goiter and goiter in the mother

7. Smoking- should be avoided, it may lead to: Abortion Preterm labor Intrauterine growth retardation Intra uterine fetal death Placenta previa Placental abortion
8. Coffee and Tea-should be minimized during pregnancy, caffeine

content reduces the absorption of iron leading to anemia during pregnancy.

B. Sleep- eight hours at night and 2 hours in the afternoon

C. Exercise- usual activities and work at home is allowed

Walk an hour daily to help engagement of the head

D. TravellingSafe to travel during first half of the pregnancy Travel restricted during the last half of pregnancy especially if there is history of abortion and preterm labor. Long distance travel not advisable

E. Clothing- preferably loose clothing F. Coitus- if there is tendency of abortion or pre term labor, it should be avoided G. Care of the teeth- regular cleansing and if necessary consult the dentist
2

H. Breasts- Crust or dried secretions over nipples are washed by warm water and soap I. Bowels- constipation is avoided by vegetables, milk, exercises and regulation of the bowels.
J.

Bathing- bath tub avoided for fear of ascending infection

Warning signs which demands immediate consultation with the doctor: 1. Vaginal bleeding 2. Severe persistent headache 3. Persistent vomiting 4. Swelling of lower limbs, face, or fingers 5. Sudden escape of fluid from the vagina 6. Blurring of vision 7. Abdominal pain Frequency of Examinations:

Pregnant women are examined every month until the 28th weeks of gestation Then every 2 weeks until the 36th weeks Then weekly until delivery In abnormal cases, more examinations maybe necessary

First Visit: The history is taken, general, abdominal and vaginal examinations are performed
Urine is tested for protein and sugar and cultured to

diagnosed significant bacteruria

Blood is examined for hemoglobin, ABO and RH grouping

Screening test for syphilis is done Hepatitis B Succeeding visit:

3

 The patient is asked about any further complaint The blood pressure and weight are recorded Abdominal examination done and observe for edema Urine tested for protein and sugar At 36th weeks: Internal pelvimetry is done for possible cephalo pelvic disproportion or CPD