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Prenatal care smeniar

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Prenatal care smeniar

  1. 1. UMM AL-QURA UNIVERSITY<br />College of Medicine<br />Prenatal Care and Identification of Risk<br />Submitted by:<br /><ul><li>Waleed Al-Qurashi
  2. 2. Husam Al-Sohaimi
  3. 3. Ahmed Abeed
  4. 4. Meshary Al-hazmi
  5. 5. Omar Al-Ghamdi
  6. 6. AbdulWaheed Al-Ghamdi</li></ul>To Be Presented to:<br /><ul><li> Associate Professor: Ahmed Malibary
  7. 7. Associate Professor: TimoorKhattab</li></li></ul><li>2<br />Seminar Title:<br />Prenatal Care and Identification of Risk<br />Date & Time :<br />Sunday 25/09/2011 - 11:00 AM to 12:00 PM<br />Place :<br />UMM AL-QURA UNIVERSITY - College of Medicine<br />Submitted by :<br />Waleed Al-QurashiMeshary Al-hazmi<br />Husam Al-Sohaimi Ahmed Abeed<br /> Omar Al-GhamdiAbdulWaheed Al-Ghamdi<br />Index :<br />Case History<br /> Presentation<br /> Researches & Evidences<br />
  8. 8. :: Antenatal Care ::<br />1 - Case History<br />3<br />
  9. 9. 4<br />Salma is a 20 years old pregnant gravida2 para1 at 40 weeks gestational age came to ER in Friday 25-10-1432 complaning of abdominal pain. <br />Case History<br />
  10. 10. 5<br />Present obestatric history:<br />LMP: 14-1-1432 sure preceded by regular periods with no contraception used. The pregnancy test was confirmed at the 6th week , she did not have any antenatal care visit . she did not do any ultrasound imaging .first kick movement felt at 20th week after that she felt fetal movement regularly. She reported no complication during her pregnancy until last night she started to have abdominal pain which is on and off , progressive , sever , last for 2-3 minutes .<br />Case History<br />
  11. 11. 6<br />6<br />Physical exam:<br />- Vital sign: BP105/64 RR:26 PULS:103 TEMP:36C.<br />- In general she was in labor, conscious, well oriented.<br /><ul><li>The abdomen was soft, not tender, normal liquor, the fundal height was 37cm, the uterus was REGULAR NOT TENDER, with one longitudinal fetus, breech , engaged , the back in right side with normal fetal heart.
  12. 12. Past obestatric history:</li></ul>Gravida 2 para1<br />Case History<br />
  13. 13. 7<br />7<br />Gynecological history:<br />Menarch at age of 14 years old with regular menses and that last 4 days with out pain.<br />Medical and surgical history :<br /> No DM, HTN, cardiac disease or any chronic disease . no surgical history.<br />Case History<br />
  14. 14. 8<br />8<br />Allergy and medication:<br /> She is not taking any corticosteroids or broad spectrum antibiotics or any medication. she has no allergy to any medication.<br />Social history:<br /> A nonsmoker Saudi housewive married once for two year living in azizai.<br />She delivered a normal healthy boy by through SVD.<br />The baby's weight is height is head circumference<br />Case History<br />
  15. 15. :: Prenatal Care ::<br />2- Presentation<br />9<br />
  16. 16. Prenatal Care Embraces:<br />10<br /><ul><li> Maternal health care
  17. 17. Evolution of fetal health and development
  18. 18. Disease screening
  19. 19. Analysis the risk for development of complication
  20. 20. Provision of advice and education</li></li></ul><li>Prenatal Care Components:<br />11<br /><ul><li> 2.1 - Antenatal record
  21. 21. 2.2 - First trimester
  22. 22. 2.3 - Second trimester
  23. 23. 2.4 - Third trimester
  24. 24. 2.5 - Imaging
  25. 25. 2.6 - Fetal assessments
  26. 26. 2.7 - Complications and emergencies</li></li></ul><li>2.1 - Antenatal record:<br />12<br /><ul><li> Medical history and physical examination
  27. 27. Gestational age (GA)
  28. 28. Symphysis-fundal height (SFH; in cm)
  29. 29. Leopold maneuver
  30. 30. Blood pressure</li></li></ul><li>2.2 - First trimester:<br />13<br /><ul><li> Complete blood count (CBC)
  31. 31. Blood type
  32. 32. Rapid plasma reagent (RPR)
  33. 33. Rubella antibody screen
  34. 34. Hepatitis B surface antigen
  35. 35. Gonorrhea and Chlamydia culture
  36. 36. PPD
  37. 37. Pap smear
  38. 38. Urinalysis and culture
  39. 39. HIV screen
  40. 40. Group B Streptococcus screen</li></li></ul><li>2.3 - Second trimester:<br />14<br /><ul><li> Maternal serum alpha-fetoprotein screen (MSAFP/quad)
  41. 41. Amniocentesis:</li></ul>triple test, nuchal screening, nasal bone, alpha-fetoprotein Chorionic villus sampling<br />
  42. 42. 2.4 - Third trimester:<br />15<br /><ul><li>Hematocrit
  43. 43. Glucose loading test (GLT)
  44. 44. Glucose tolerance test (GTT)</li></li></ul><li>2.5 - Imaging:<br />16<br /><ul><li> Ultrasound 12th week (dating scan) and the 20th week (detailed scan):</li></ul> Gestational age<br /> Multiple gestation<br /> Ectopic pregnancy <br /> Evaluated of placentae and amniotic sacs<br /><ul><li> X-rays and (CT) (MRI) </li></li></ul><li>2.6 - Fetal assessments:<br />17<br /><ul><li> Fetal karyotype
  45. 45. Biophysical profiles (BPP)
  46. 46. Percutaneous umbilical blood sampling (PUBS)
  47. 47. Nonstress test (NST)
  48. 48. Oxytocin challenge test</li></li></ul><li>2.7 - Complications and emergencies:<br />18<br /><ul><li> Ectopic pregnancy
  49. 49. Pre-eclampsia
  50. 50. Placental abruption
  51. 51. Fetal distress
  52. 52. Shoulder dystocia
  53. 53. Uterine rupture
  54. 54. Prolapsed cord
  55. 55. Obstetrical hemorrhage such as placenta previa, uterine rupture of tears, uterine atony, retained placenta or placental fragments, or bleeding disorders
  56. 56. Puerperal sepsis </li></li></ul><li>:: Prenatal Care ::<br />3- Researches & Evidences<br />19<br />
  57. 57. :: Prenatal Care ::<br />3- Researches & Evidences<br />20<br />Does lowering of antenatal care visit’s well increase the risk of pregnancy?!<br />
  58. 58. 3.1 –<br />3.2 -<br />Who systemic review of randomized controlled trials of routine antenatal care<br />Antenatal care in Saudi Arabia - Lifestyle<br />
  59. 59. Background<br />Methods<br />The main hypothesis was: <br /><ul><li> New Model Vs Standard Model</li></ul>There is a lack of evidence of the content, frequency, and timing of visits in standard antenatal-care programmes.<br />The selected outcomes were:<br /><ul><li> Preeclampsia
  60. 60. Urinary-tract infection
  61. 61. Postpartum anaemia
  62. 62. Maternal mortality
  63. 63. Low birthweight
  64. 64. Women’s satisfaction & cost effectiveness.
  65. 65. Standard Model (14 visits):</li></ul>8-28 weeks every 4 weeks<br />28-36 weeks every 2 weeks<br />36 weeks every 1 weeks<br /><ul><li>New Model:</li></ul>Less than 14 visits (4-8 visit)<br />
  66. 66. Findings<br />Interpretation<br /><ul><li> New-mode visits could be introduced into clinical practice
  67. 67. 7 eligible randomised controlled trials
  68. 68. 57 418 women participated :
  69. 69. 30 799 (new-model)
  70. 70. 26 619 (standard-model)
  71. 71. NO risk to mother or baby
  72. 72. Some degree of dissatisfaction by the mother could be expected
  73. 73. No clinically differential effect in reduced number of visit
  74. 74. Lower costs can be achieved
  75. 75. Mortality were similar
  76. 76. Dissatisfaction with care was observed
  77. 77. The cost of the new model was equal to or less than that of the standard model.</li></li></ul><li>Antenatal care in Saudi Arabia has been improved due to:<br /><ul><li> Good planning and strategy
  78. 78. Provide community education & health Facilities
  79. 79. Participate in international research & trial</li></li></ul><li>Ministry of Health <br />متوسط وفيات الأطفال دون الخامسة لكل ألف مولود حي في المملكة ودول منظمة التنمية والتعاون الأقتصادي والأوروبي (1990 – 2009)<br />مؤشر الوفيات<br />
  80. 80. Ministry of Health <br />Best Time To Get Pregnant <br />Pregnancy Due Date Calculate <br />
  81. 81. Saudi Society of Family and Community Medicine<br />
  82. 82. Mobily Telecom Company<br />
  83. 83. “<br />Thank<br />”<br />You<br />The END<br />

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