Ante Natal Care

Preconceptional care

A comprehensive preconceptional care program has

the potential to assist women by reducing risks,
promoting healthy lifestyles, and improving readiness
for pregnancy.

Diagnosis of pregnancy
1. Signs and Symptoms
Cessation of menses

Changes in cervical mucus

Change in the breast

Discoloration of the vaginal mucosa

Skin changes

Changes in the uterus

Changes in the cervix

Fetal heart action

Perception of fetal movements

2. hCG
home urine pregnanacy test
confirmatory testing for hCG in urine or
blood

3. Ultrasound
- Transvaginal sonography
- Transabdominal sonography

Initial Prenatal Evaluation

Major goals
To define the health status of the mother
and fetus
To estimate the gestational age of the
fetus
To initiate a plan for continuing obstetrical
care

Initial Prenatal Evaluation

1. Prenatal Record
Normal Pregnancy Duration
History

2. Psychosocial Screening
Cigarette smoking
Alcohol and Illicit Drugs during Pregnancy
Domestic Violence Screening

3. Physical Examination
Pelvic Examination

4. Laboratory Tests
5. High-Risk Pregnancies

Prenatal surveillance
Fetal
Heart rate(s)
Sizecurrent and rate of change
Amount of amnionic fluid
Presenting part and station (late in pregnancy)
Activity

Maternal
Blood pressure : current and extent of change
Weight : current and amount of change
Symptoms
: including headache, altered vision, abdominal pain, nausea and
vomiting, bleeding, vaginal fluid leakage, and dysuria
Height in centimeters of uterine fundus from symphysis
Vaginal examination late in pregnancy often provides valuable
information:
Confirmation of the presenting part
Station of the presenting part
Clinical estimation of pelvic capacity and its general
configuration
Consistency, effacement, and dilatation of the cervix

Assessment of Gestational
Age
Precise knowledge of gestational age is important
(because a number of pregnancy complications may
develop for which optimal treatment will depend on
fetal age. )

Performed clinical examination, coupled with

knowledge of the time of onset of the last menstrual
period.
Fundal Height
Fetal Heart sound
Ultrasound

Ancillary Prenatal Tests

Gestational Diabetes
Chlamydial Infection
Gonococcal Infection
Fetal Fibronectin
Group B Streptococcal (GBS) infection
Special Screening for Genetic Diseases

Nutrition
Maternal weight gain , positive correlation with birthweight

. In general, advise the pregnant woman to eat what she

wants in amounts she desires and salted to taste.
. Make sure that there is ample food to eat in the case of
socioeconomically deprived women.
. Monitor weight gain, with a goal of about 25 to 35 pounds in
women with a normal BMI.
. Periodically explore food intake by dietary recall to discover
the occasional nutritionally absurd diet.
. Give tablets of simple iron salts that provide at least 27 mg
of iron daily. Give folate supplementation before and in the
early weeks of pregnancy.
. Recheck the hematocrit or hemoglobin concentration at 28
to 32 weeks to detect any significant decrease