Antenatal care involves regular checkups during pregnancy to monitor the health of the mother and baby. Checkups typically occur every 4 weeks until week 28, every 2 weeks until week 36, and weekly until delivery. The goals of antenatal care are to promote maternal health, recognize and treat any medical issues, detect fetal abnormalities early, and educate expectant mothers. Common screens include ultrasound scans to check fetal development and analyze blood tests for potential issues. Physical and lifestyle assessments also occur to identify risks and provide treatment and advice.

1. ANTENATAL CARE

2. INTRODUCTION
 Systemic supervision of a woman during pregnancy is
called antenatal care
 This antenatal care comprises of – detailed history taking
and examination and advice given to the pregnant
woman
 Criteria of normal pregnancy: Delivery of a single baby
in good condition at term(b/w 38-42), with fetal weight
2.5kg or more with no complication.

3. AIMS
 To promote and maintain optimal physical and
emotional maternal health throughout pregnancy
 To recognize & treat correctly medical/ obstetrics
complications occurring during pregnancy
 To detect fetal abnormalities as early as possible
 To discuss with the couple about labor, puerperium
and subsequent care of the baby

4.  Generally check up is done at interval of 4weeks up
to 28wks, at interval of 2wks up to 36wks and
thereafter weekly till delivery
 First in 2nd
trimester around 16wks, second b/w 24-
28wks, the third visit at 32wks and the fourth visit at
36wks (WHO)

5. EARLY PREGNANCY CLASSES
 The typical class introduces anatomy, physiology,
nutrition, body mechanics, muscle strengthening and an
understanding of emotional issues.
 The class consist of discussions, audiovisual
presentations, handouts and practical sessions.
 Using this information women will able to make
appropriate choices regarding ex’s, relaxation, nutrition,
body mechanics and plan of delivery
 Women are encouraged to bring partner, sibling, parent
or a friend

6.  Logistically the early pregnancy class is geared to the woman 1-5
month pregnant and her partner.
 3weekly 2hr classes, 8-10 couples limited
 Class 1: introduction, relaxation instruction, immediate concern
of couples --break-- emotional aspects of pregnancy and fetal
and maternal changes
 Class 2: options of delivery, nutrition, pelvic floor training --
break-- body mechanics, pelvic tilt/ position of comfort and
relaxation
 Class 3: continue relaxation father’s role --break-- stretching and
toning , discussion, questions and course valuation

7. ANTENATAL CARE OPTIONS
 Water births:
 Benefits: immersion in warm water include relaxation,
pain relief and less perineal trauma
 Adverse effect: infection, water inhalation by the baby &
decrease mobility
o Home birth:
o Midwifery led units

8. ROUTINE ANTENATAL CARE
 After confirmation of the pregnancy, women are usually
referred to a booking clinic, either at local hospital/
private or home
 This ideally occurs 12 & 14 week gestation, but
realistically ranges from 9-16wks
 Booking visit: BMI more than 30 indicates obesity &
lead to increase risk factors. Less indicates eating
disorder – undernourished.
 1st
visit: provide advice and education regarding general
life style like diet, exercise, alcohol & smoking.

9.  Subsequent visit: anomaly scan at 20th
wk.
 BP, urine, presence of oedema, fundal height and lie of
the fetus, fetal movements and fetal heart rate.

10. ANTENATAL SCREENING
 Maternal serum screening:
 High level of alpha fetoprotein (AFP) indicates neural tube
defect such as spina bifida or encephaly.
 Ultrasound scanning:
 11 & 14 wks - Nuchal translucency, an area of
subcutaneous fluid at the nape of the fetal neck. Increase
thickness may indicates Down’s syndrome or any
chromosomal and structural abnormalities.
 In UK most pregnant women will have at least one
anomaly scan at around 20 weeks gestation.

11.  Chorionic villus sampling:
 It is done by transabdominally.
 Benefit of this tech is that it can be done early in
pregnancy b/w 11 and 13 weeks.
 Amniocentesis:
 Small amt of amniotic fluid is withdrawn transabdominally
with the assistance of ultrasound monitoring.
 Drawbacks of this is- performed after 15wks of gestation

12. ASSESSMENT OF PHYSICAL HEALTH
 Posture assessment: drooped shoulders, saging
breast, hyperlordosis, hyper-extension of knee.
 Assess for conditions like pedal edema, weakness
of any muscle, decreased bed mobility, carpal
tunnel syndrome, tarsal tunnel syndrome.
 Back care and lifting strategies must be taught.
 Standing, sitting, sleeping positions, must be
taught.

13. TREATMENT OF NEUROMUSCULAR
AND MUSCULOSKELETAL PROBLEMS
 Pubic pain: d/t diastasis rectii, esp following many
pregnancy, treated by FEMBRACE.
 Lumbar pain:
 Hip pain:
 Rib cage pressure:
 Pelvic pressure:
 Cramp:
 Stitch:
 Bladder control:

14. PT RX
 Relaxation techniques:
 Breathing awareness:
 Touch and manage:
 Rocking movements:
 Swimming:
 Walking:
 Bicycling:
 Group aqua exercise:
 Teaching positions for labour: first stage (waiting for
cervical dilatation), second stage (expulsive effort of
giving birth), and third stage (expulsion of placenta
cord and membrane).

15. Thank you