This document provides guidance on prenatal care, including pre-conception counseling to address lifestyle factors, investigations and monitoring during pregnancy, exercises to do/avoid during pregnancy, diet and common symptoms, and travel safety. The goals of antenatal care are to monitor the progress of pregnancy, provide guidance for delivery preparation, enable early detection of abnormalities, and allow for corrective measures if needed. Prenatal care starts with confirmation of pregnancy and includes history taking, examinations, ultrasounds, and basic bloodwork and screening tests.

1. Director
Centre of IVF and Human Reproduction

2. First trimester
Workup & algorithms
Dr. Abha Majumdar

3. Behavioral
choices
Dietary
choices
Physical
fitness
Health
issues &
medication
Ideal pre natal care should start before conception
Pre-conception counseling allows

4. Any interventions
offered should have
known benefits
Current models of
antenatal care
originated in early
20th century
They should be
acceptable to the
pregnant women
Pregnancy is a normal
physiological process
NICE /RCOG guidelines 2010

5. Monitoring
of progress
of pregnancy
Guidance &
preparation of
for delivery
Early
detection of
deviation
from normal
Institution of
corrective
measures
AIMS OF
ANTENATAL
CARE

6. Investigations
USG at 11 to 13
weeks: dating &
NT NB
01
02
03
04
History taking
General &
systemic
examination
Antenatal care starts with
confirmation of pregnancy

8. Advanced
Hemoglobin PCV
Urine routine
Blood sugar
Blood group Rh
Thyroid profile
HbsAg
HIV 1 &11
VDRL
Thalassemia screen
Anti HCV
Dual marker of 1st
trimester
Basic Premium
Investigations

9. Driving & travel
Common
symptoms
Pregnancy is a normal
physiological process
medication
Diet
Work and
exercise
Positive thinking

11. Brisk walking
Aerobics
Abdominal exercises
Dancing
Swimming
Yoga
Contact sports
Sports with risk of
falling
Jumping bouncing
Supine exercise
Racquet Sports
Exercises to
avoid
Exercises to
do
Benefits of
exercises
Improves mood,
aches and pains,
blood circulation,
heightened energy &
lowers gestational
diabetes.

12. Frequent meals

13. Glucose drinks, aerated drinks, fruit
juices, fried food, chat, spicy pickles &
masala curries best avoided.
Bland food like toasted bread, boiled
eggs, paneer, cheese and ice-creams
better tolerated.
Mid-day nap essential
otherwise lack of sleep
translates into feeling of
tiredness all day.
Rest: Common due to P4 effect on GI
tract. Only bulk forming laxatives
recommended.
Cremaffin not good as may reduce
absorption of essential vitamins.
Constipation
Nausea and vomiting:

14. Papaya
Rich in vitamin c,
antioxidants & other
wholesome nutrients
Excellent in heartburn
& constipation.
RIPE PAPAYA RAW PAPAYA
Unsafe for pregnant women
Contains latex may
start contractions in
late pregnancy
Has pepsin &
papain; may reduce
growth of fetus.
Safe in first trimester
Consume in
moderation

16. Folic acid
Progesterone
supplementation
Medication in first trimester in natural
spontaneous conceptions

17. In a car:
Seat belt a must
Be comfortable, carry a little
pillow, snacks and water
For nausea ginger lozenges or
crushed ginger
Slow pace, break journey for a
nap in a quiet place
Loose-fitting clothes &
comfortable flat shoes
Avoid altitudes above 3,658
metres;
Travellers’ diarrhoea can
cause miscarriages in 1st
trimester
Stay away from activities
that are too adventurous,
In a plane:
aisle seat
carry snacks