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Melly Angriani Lubis 1110311016

Suci Maulidia 1110312016
Duiila Husaina 1110312046
Amalia Emrizal 1110312076
Yulia Eka Hastuti 1110312106
Meilani 1110312136
Puti Risani 1110313009
Adhy Saputra 1110313039
Rana Zara Athaya 1110313069
Ismail Abdullah 1110314006
Nutrition
Drugs
Habit
Psychological
Hormone
Nutrients needed by the fetus during
pregnancy is closely related to setting the
nutritional needs of mothers during
pregnancy so that the needs of calories,
protein, vitamin, mineral, and fluid adequate
for the nutritional needs of the mother, fetus
and placenta.
Habit
Habit of alcohol consumption can lead to a
broad spectrum of birth defects or fetal
alcohol syndrome

Psychological
Pregnant women who are in conditions of
stress can cause vasoconstriction of peripheral
blood vessels that lead to disruption of blood
circulation to the placenta.
Hormones
hCG (human chorionic gonadotropin)
Relaxin
hCS (human chorionic somatotropin)
Estrogen
Progesteron

Method of abdominal exam
Inspection:
Size of the uterus: assess
If the length & breadth are both increased multiple
pregnancies, polyhydramnios
If the length is increased only large baby
Shape of the uterus: length should be larger than broad this indicates
longitudinal lie. But if the uterus is low and broad indicates transverse
fetus lie.
Fetal movement
Contour of the abdomen: full bladder may be visible in late
pregnancy. Umbilicus may become everted
Skin changes: look for stretch marks, linea nigra, scars that indicates
previous surgeries

Palpation: by Leopold maneuver-4 maneuvers
Palpate the fundus (to determine if it contains
breech, head)
By gentle pressure:
if soft consistency/ indefinite outline breech
If hard, smooth, well defined head
Move your fingertips over the fetal mass to determine
mobility and sixe
If cant move independent from the body breech
If moves freely between fingertips head
Lateral palpation: (determine the position of the fetal
back and small parts)

Hands are placed on each side of the umbilicus. The
fetal spine will palpate as firm, flat and linear. The
fetal extremities are palpable by their varying
contour and movements. The purpose of this
maneuver is to determine whether the fetal back is
left or right.

Pelvic palpation: 2 maneuvers

Grasp the lower poles of the uterus between
fingers and thumbs and comment of the size,
flexion and mobility of the head.
To determine the position of the vertex
presentation: try to palpate the prominences
If the sinciput is higher the occiput well flexed
If both prominances are at the same level deflexed
If cant palpate the prominances, and the bulk of the
head is felt at the same side of the back extended
After you examine a pregnant women you should
answer the following questions
1. What is the fundal
height?
It is estimated by
centimeters from upper
border of the fundus to the
pubis symphasis by taping
measure. The height of the
fundus correlates well with
the gestational age
especially during the
weeks of pregnancy.
2. lie of the fetus: only longitudinal lie is normal
3. Attitude: normally it is full flexion and every fetal
joint is flexed.
4. presentation: normally cephalic
5. position: according to the dominator
6. Is the vertex engaged?
Examination during labor
1. Palpate uterine contractions
2. Assessment of the cervix dilatation
1 finger 1-2 cm dilated
2 fingers 3-4 cms dilated
3 fingers 5-6 cms dilated
4 fingers 7-10 cms dilated

3. Effacement of the cervix: thinning of the
cervix (%) or length (cm). The cervix is
normally 3-5 cms. If cervix is about 2 cm from
external to internal os 50% effaced
50% effaced
100% effaced
4. Consistency of the cervix: soft vs. hard.
During labor the cervix becomes soft.
5. Position of the cervix: posterior vs. anterior.
During labor the cervix changes from posterior
to anterior.
6. Membrane is intact or ruptured: assessed by
fluid collection in the vagina

About 55 percent of maternal deaths due
to bleeding associated with malnutrition or poor
nutrition during pregnancy.
Nutrition during pregnancy is a major factor that affects
the health of babies to be born. If
a given quality and nutritional balance, quality of the
next generation will be more secure too.
Therefore, healthcare, both maternal and infant health at
birth, during pregnancyis a priority. Mother's
body condition closely correlated with the condition of the baby's
body. If a pregnant woman is a healthy body condition,
automatically fetus inside the womb will be healthier. The
baby will grow and develop optimally.

Health of pregnant women and babies in the womb is strongly
influenced by the nutrients consumed. If a
complete and balanced nutritional intake, mothers do not have to
worry about their own health and the baby was unborn.
When pregnant women, some nutrition plays a
very important for the development of your baby
Folic Acid
Folic Acid Folic Acid or help reduce the risk of babies born with
disabilities such as spinal deformity, or spina bifida. Folic acid is
found in broccoli, cabbage, beans, and oranges. Meet the intake
of Folic Acid Mother until 12 weeks gestation.
Omega fats (omega fats)
Omega-3 fatty acids important in assisting the development of
your baby's nervous system. A study shows that consumption of
omega-3 fats during pregnancy, will make babies smarter.
Oily fish such as sardines, mackerel and salmon are a source of
omega 3 fatty acids.

Iron and Vitamin C
Iron is needed to carry extra oxygen in red blood cells of
mother. It's important for your baby's brain development.
Iron deficiency anemia is also open opportunities or lack of
blood. Mother becomes easily tired, lethargic, and pale. Iron
intake can be from red meat, fish, eggs, dried fruits, grains,
cereals, bread, and green leafy vegetables. Or she can request
an iron supplement if necessary. Do not forget to take vitamin C
to help absorption of iron by the body.
Vitamin supplements during pregnancy


ANC is the inspection / surveillance antenatal prenatal
care is to optimize physical andmental health
of pregnant women, so as to deal
with labor, childbirth, preparation
forbreastfeeding, and the return
of normal reproductive health




ANC goals
1. Monitor the progress of pregnancy and to ensure the health of
mother and infantgrowth and development.
2. Improve and maintain physical and mental health and
social capital.
3. Know the early abnormalities, complications that may
occur during pregnancy include a history of disease in
general, obstetrics, and surgery.
4. Mother prepares to run normally during childbirth and breast-
feeding exclusively.
5. Preparing for the role of mother and family in order to receive
the birth of a baby can grow and develop optimally.
ANC visits should be conducted at
least four times during pregnancy are:
1 time in first trimester
1 times the second trimester
2 times in the third trimester
The first examination performed soon after a missed
period is known.
ANC visit the saint is:
- Every month until 28 weeks gestation
- Every 2 weeks until 32 weeks gestation
- Each one week since 32 weeks gestation until birth
occurs.
Special examination if there is a specific complaint.
Examination of the concept of Pregnancy
1. Anamnesa
2. inspection
- General Inspection
- Examination of specific obstetric
- Investigations
3. Diagnosis / conclusion
4. The differential diagnosis
5. prognosis