Antenatal care involves comprehensive health supervision and guidance for pregnant women from conception through delivery. It aims to reduce maternal and infant mortality and morbidity. Key aspects of antenatal care include detecting and treating complications, educating mothers, and preparing for labor, lactation, and infant care. Pregnant women should have regular checkups including medical history, exams, and tests to monitor health. Care also involves addressing common discomforts of pregnancy through lifestyle and dietary adjustments.

1. Usman zafar
Batch ‘J’
final year
mBBs

2. Antenatal Care

4. 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.

5. Goals
To reduce maternal and perinatal
mortality and morbidity rates
To improve the physical and mental
health of women and children

6. Importance of Antenatal Care
 To ensure that the pregnant woman and her
fetus are in the best possible health.
 To detect early and treat properly
complications
 Offering education for parenthood
 To prepare the woman for labor, lactation and
care of her infant

7. Schedule for Antenatal Visits:
The first visit or initial visit should be made
as early is pregnancy as possible.
Return Visits:
Once every month till 7th month.
Once every 2 weeks till the 9th month
Once every week during the 9th month,
till labor.

9. Assessment
History Examination Investigation

10. History
Personal history
Family history
Medical and surgical history
Menstrual history
Obstetrical history
History of present pregnancy

11. Physical Examinations
Height of over 150 cm indication 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).

12. Obesity (more than 20 kg above the
weight-height formula) leads to an
increased risk of gestational diabetes,
pregnancy-induced hypertension and
thrombo-embolic disorders

13. Local Examination
The uterus may be higher than expected
due to large fetus, multiple pregnancy,
polyhydrammnios or mistaken date of last
menstrual period.
The uterus may be lower than expected due
to small fetus, intrauterine growth
retardation, oligohydramnios or mistaken
date of last menstrual period.

14. Fetal heart sound is heard by sonicaid
as early as 10thweek of pregnancy.
Fetal heart sound is heard by Pinard' s
fetal stethoscope after the 20thweek of
pregnancy.
The normal fetal heart rate is 120-160
beats/min

15. Investigations:
Urine should be tested for sugar,
ketones and protein.
Hemoglobin will be repeated:
At 36 weeks of gestation.
Every 4 weeks if Hb is < 9 g/dl.

16. Fetal kick count
The pregnant woman reports at
least 10 movements in 12 hours.
Absence of fetal movements
precedes intrauterine fetal death
by 48 hours.

17. Prevention of neonatal tetanus
Clean delivery practices
3cleans : clean hands, clean delivery
surface, clean cord care
Tetanus toxoid protects both mother & child
Unimmunized pregnant women : 2 doses
tetanus toxoid
•1st
dose as early as possible during
pregnancy
•2nd
dose – at least a month later / 3 wks
before delivery

18. Health Teaching during the First
Trimester
 Physiological changes
during pregnancy
 Weight gain
 Fresh air and sunshine
 Rest and sleep
 Diet
 Daily activities
 Exercises and relaxation
 Hygiene
 Teeth
 Bladder and bowel
 Sexual counseling
 Smoking :
 Medications
 Infection
 Irradiation
 Occupational and
environmental hazards
 Travel
 Follow up
 Minor discomforts
 Signs of Potential
Complications

19.  Exercise should be simple, mild exercise avoid
lifting heavy weights
 A tooth can be extracted during pregnancy,
but local analgesia is recommended
 Catheter and enema should be avoided.
 Smoking may lead to ptyalism, nervousness
and hyper emesis and make pregnant woman
at increased risk of chest infections and
thrombo-embolic disorders

20.  Pregnant woman should avoid contact with
infectious diseases especially rubella or
(German measles) because it has deleterious
effects on the fetus
 Pregnant woman should avoid exposure to x-
ray or irradiation because of possible
teratogenic effects on the fetus such as birth
defects or childhood leukemia

21. Common Discomforts of Pregnancy,
Etiology, and Relief Measures:
Urinary frequency
RELIEF MEASURES:
 Decrease fluid intake at night.
 Maintain fluid intake during day.
 Void when feel the urge.

22. Fatigue
RELIEF MEASURES:
 Rest frequency.
 Go to bed earlier.

23. Sleep difficulties
RELIEF MEASURES:
Rest frequency
 Decrease fluid intake at night

24. Breast enlargement and
sensitivity
RELIEF MEASURES:
 Wear a good supporting bra.
 Assess for other conditions.

25. Nasal stuffiness and epistaxis
ETIOLGY: Elevated estrogen levels
 RELIEF MEASURES :
Avoid decongestants.
Use humidifiers, and normal saline drops.

26. Ptyalism (excessive
salivation(
ETIOLGY: Unknown
RELIEF MEASURES:
Perform frequent mouth care.
Chew gum.
Decrease fluid intake at night.
Maintain fluid intake during day.

27. Nausea and vomiting
 RELIEF MEASURES:
 Avoid food or smells that exacerbate condition.
 Eat dry crackers or toast before rising in
morning.
 Eat small, frequent meals.
 Avoid sudden movements. Get out of bed slowly
 Breath fresh air to help relieve nausea.

28. Shortness of breath
RELIEF MEASURES:
 Use extra pillows at night to keep more upright.
 Limit activity during day

29. Heartburn
RELIEF MEASURES:
 Eat small, more frequent meals.
 Use antacids.
 Avoid overeating and spicy foods.

30. Dependent edema
 Avoid standing for long periods.
 Elevate legs when laying or sitting.
 Avoid tight stockings.

31. Varicosities
 Rest in sims' position.
 Elevate legs regularly.
 Avoid crossing legs.
 Avoid tight stockings.
 Avoid long periods of standing

32. Hemorrhoids
RELIEF MEASURES:
Maintain regular bowel habits.
Use prescribed stool softeners.
Apply topical or anesthetic
ointments to area.

33. Constipation
RELIEF MEASURES:
Maintain regular bowel habits.
Increase fiber in diet.
Increase fluids.
Find iron preparation that is
least constipating

34. Leucorrhea
RELIEF MEASURES:
Take a daily bath or shower.
Wear cotton underwear.

35. Backache
RELIEF MEASURES:
Wear shoes with low heels.
Walk with pelvis tilted forward.
Use firmer mattress.
Perform pelvic rocking or tilting

36. Leg cramps
RELIEF MEASURES:
 Extend affected leg and dorsiflex the foot.
 Elevate lower legs frequently.
 Apply heat to muscles.
 Evaluate diet.

37. Faintness
RELIEF MEASURES:
•Rise slowly from sitting to standing.
•Evaluate hemoglobin and
hematocrit.
•Avoid hot environments

38. Its begging of the end…….