Antenatal Care: Presented by

ANTENATAL CARE
Presented By
Kainat Khan
＆
M.Fayaz
Objectives:
At the end of this presentation the students will be able to:

Define Antenatal care
Explain the goals of antenatal care
Describe the importance of antenatal care
Elaborate the schedule of antenatal visits
Explain the steps included in antenatal assessment
Describe common discomforts during pregnancy
Describe the nutritional supplements needed during pregnancy
Definition of Antenatal care:
 Comprehensive health supervision of a pregnant woman before

delivery.
OR
 It is planned examination, observation and guidance given to
the pregnant woman from conception till the time of labor.
Goals of Antenatal care:
Antenatal care aims to:

 Reduce maternal and perinatal mortality and morbidity rates.
 Detect and treat existing conditions or complications.
 Prevent complications.
 Improve the physical and mental health of women and children.
 Include health promotion education.

Importance of Antenatal care:
To ensure that the pregnant woman and her fetus are in the best
possible health.
To detect the complications earlier and treat them properly.
Offering education for parenthood.
To prepare the woman for labor.

Schedule for Antenatal Visits:
Once every month till 28th week.
Once every 2 weeks till 36th week.
Once every week , till labor.

Assessment
History Examination Investigation

History:
• Personal history
• Family history
• Medical and surgical history
• Menstual history
• Obstetrical history
• History of present pregnancy
Fetal kick count:
• The pregnant woman reports atleast 10 movements in 12 hours.
• Absence of fetal movements precedes intrauterine fetal death

by 48 hours.
Physical Examination:
Height of over 150 cm indicative of an average sized pelvis.
The approximate weight gain during pregnancy is 12 kg; 2kg in

the first 20 weeks and 10 kg in the remaining 20 weeks( 1.5 kg
per week until term)
Cont....
• Sympysis-fundal height should be measured and recorded at

each antenatal appointment from 24 weeks.
• Fetal presentation should be assessed by abdominal palpation at

36 weeks.
Investigations:
First trimester prenatal screening tests:

CBC
Ultrasound test for fetal nuchal translucency (NT):
Urine analysis for glucose and protien.
Screening tests for TB, Tetanus, Syphilis, Maternal HIV
Cont...
 Two maternal serum (blood) tests.
• Pregnancy-associated plasma protein screening (PAPP-A)
• Human chorionic gonadotropin (hCG)

Cont...
Second Trimester Prenatal Screening Tests:
• Alpha-fetoprotein screening (AFP)

• Amniocentesis
• chorionic villus sampling (CVS)
• Glucose tolerance test
• Urinalysis
Cont...
Third trimester penatal screening tests:

• Rh status
• Ultrasound for SGA and LGA
• Fetal position monitoring
• GBS screening
Health teaching during the first trimester:
• Physiological changes
• weight gain
• Fresh air and sunshine
• Rest and sleep
• Diet
• Daily activities
• Exercises and relaxation
• Hygiene
• Sexual counseling
Common discomforts of pregnancy:
Urinary frequency
Relief measures:
•Decrease fluid intake at night.

•Maintain fluid intake during day.
•Void when feel urge.
Fatigue:
• Relief frequency
• Go to bed earlier
Sleep Difficulties:
Relief measures:
• Rest frequency
• Decrease fluid intake at night
Nasal stuffiness and epistaxis:
• Etiology: Elevated estrogen levels
Relief measures:
• Avoid decongestants
• Use humidifiers, and normal saline drops.
Ptylism(Excessive salivation):
ETIOLOGY: Unknown
Relief Measures:
Perform frequent mouth care.

Chew gum
Decrease fluid intake at night.
Maintain fluid intake during day.
Nausea and vomiting:
• Relief Measures:
• Avoid food or smells that exacerbate condition.
• Eat dry crackers etc early in the morning.
• Eat small, frequent meals.
• Avoid sudden movements.
• Breath fresh air to help relief nausea.
Heart burn:
• Eat small frequent meals.

• Use antacids
• Avoid overeating and spicy foods.
Dependent edema:
• Avoid standing for long time.
• Avoid tight stockings.
• Elevate legs when laying or sitting.
Backache:
Relief measures:
•Wear shoes with low heels.
•Walk with pelvis tilted forward.
•Use medium-firm density mattress.
Faintness:
•Rise slowly from sitting to standing position.
•Evaluate hemoglobin and hematocrit.
•Avoid hot environments.
Nutritional Supplements:
Nutritional Supplements:
• Folic acid:
• Start before conception and throughout the first 12 weeks.
• reduces the risk of having a baby with a neural tube defect (for
example, anencephaly or spina bifida).
• The recommended dose is 400 micrograms per day.
Vitamin D:
• Women at greatest risk are following advice to take this daily

supplement. These include:
 Women who have limited exposure to sunlight, such as women

who are predominantly housebound, or usually remain covered
when outdoors
 Women who eat a diet particularly low in vitamin D.
Vitamin A:
• Vitamin A supplementation (intake above 700 micrograms)

might be teratogenic and should therefore be avoided.
Iron:
• Iron supplementation should not be offered routinely to all

pregnant women. It does not benefit the mother's or the baby's
health and may have unpleasant maternal side effects.
Role of a Nurse in Antenatal care:
• The nurses work closely with parents throughout the gestation

period.
• They might care for children, help parents connect with local
resources, and teach parenting skills.
• The Nurse work to promote and maintain the health of women
and their unborn children.
• Any unpleasant sensation related to pregnancy is relieved
through possible Nursing care.
References:
1. Expert Maternity Group. Woman centred care. Changing Childbirth. Report of the
Expert Maternity Group. Department of Health; London: HMSO; 1993. pp. 5–8.
2. Garcia J, Loftus-Hills A.National Perinatal Epidemiology Unit: Oxford University.
An overview of research on women’s views of antenatal care. Personal
communication. 2001.
3. Cochrane AL. Effectiveness and efficiency, Random reflections on health services.

London: Nuffield Provincial Hospitals Trust; 1972. [PubMed]
4. Department of Health. Screening for infectious diseases in pregnancy: standards to

support the UK antenatal screening programme. 2003.

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ANTENATAL CARE

At the end of this presentation the students will be able to:

 Comprehensive health supervision of a pregnant woman before

Antenatal care aims to:

 Detect and treat existing conditions or complications.

 Improve the physical and mental health of women and children.

 Include health promotion education.

To detect the complications earlier and treat them properly.

Offering education for parenthood.

To prepare the woman for labor.

Once every month till 28th week.

Once every 2 weeks till 36th week.

Once every week , till labor.

History Examination Investigation

• The pregnant woman reports atleast 10 movements in 12 hours.

• Absence of fetal movements precedes intrauterine fetal death

Height of over 150 cm indicative of an average sized pelvis.

The approximate weight gain during pregnancy is 12 kg; 2kg in

• Sympysis-fundal height should be measured and recorded at

• Fetal presentation should be assessed by abdominal palpation at

First trimester prenatal screening tests:

 Two maternal serum (blood) tests.

• Pregnancy-associated plasma protein screening (PAPP-A)

• Human chorionic gonadotropin (hCG)

Second Trimester Prenatal Screening Tests:

• Alpha-fetoprotein screening (AFP)

Third trimester penatal screening tests:

•Decrease fluid intake at night.

• Etiology: Elevated estrogen levels

Perform frequent mouth care.

• Eat small frequent meals.

• Women at greatest risk are following advice to take this daily

 Women who have limited exposure to sunlight, such as women

• Vitamin A supplementation (intake above 700 micrograms)

• Iron supplementation should not be offered routinely to all

• The nurses work closely with parents throughout the gestation

3. Cochrane AL. Effectiveness and efficiency, Random reflections on health services.

4. Department of Health. Screening for infectious diseases in pregnancy: standards to

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