This document provides information on antenatal care including defining the antenatal period, describing the benefits of antenatal care, and emphasizing the role of physiotherapy during pregnancy. It outlines common problems during pregnancy and recommended exercise approaches. It also describes general health advice and nutritional recommendations for a healthy pregnancy. The physiotherapist's role includes assessing physical health, identifying problems, advising on exercises and positions, and teaching relaxation techniques to reduce stress.
Women’s Health & Physical Rehabilitation..pptxSalmaAzeem3
This document discusses the history and role of physiotherapists in women's health, with a focus on obstetrics and gynecology. It provides an overview of how physiotherapists became involved in these areas in the late 19th/early 20th centuries. It then covers various techniques and areas of expertise used by obstetric physiotherapists, including exercises for pregnancy, postpartum recovery, pelvic floor issues, and other women's health concerns. Guidelines for safe exercise during pregnancy are also discussed.
The document discusses women's health and exercise during pregnancy. It provides guidelines for exercise during each trimester, including frequency, intensity, time and type of exercise recommended. It also discusses potential complications during pregnancy, labor, and the postnatal period. Exercise is recommended to reduce health risks during pregnancy, but should avoid high impact activities and the supine position after the first trimester. Guidelines are given for safe exercise during and after pregnancy.
The document discusses postnatal care and exercises. During the postnatal period, a woman's body begins to recover from pregnancy but full recovery can take 4-5 months as ligaments and muscles stretch and weaken during pregnancy. Physiotherapy aims to aid recovery through mobility, deep breathing, pelvic floor exercises, and specific exercises to strengthen the abdominal muscles and pelvic floor if needed. Exercises are progressed based on individual assessments and priorities like perineal pain.
Low Back Pain management among Pregnant ladyPKS Lectures
The document discusses the management of low back pain during pregnancy. It notes that around 45-75% of pregnant women experience low back pain, which is caused by hormonal, circulatory, and mechanical changes. Non-pharmacological treatment options include exercises, yoga, Pilates, aquatic therapy, acupuncture, massage, and spinal manipulation. Studies show that programs including education and physical therapy can reduce pain and disability in pregnant women with low back pain.
Physiotherapy plays an important role in women's health from puberty through postpartum. It treats conditions like back pain, pregnancy issues, pelvic floor dysfunction, and more. Physiotherapists help with pain management, exercises, and techniques to enhance vaginal childbirth. During pregnancy, they focus on exercises, pain relief, and positions to facilitate labor and delivery. Postpartum care includes exercises to address issues like diastasis recti and incontinence. Physiotherapy thus encompasses women's health from conception through all life stages.
Hysterectomy is a very common conditions occuring in womens due to many reasons .pre-operative & post operative physiotherapy will help to deal with the condition and improve the health status of women.
PPT that made a short and crisp description on physiotherapy role in women's health at a glimpse.
Physical therapist plays a over all role in all stages of a women.Physiotherapist or a pelvicfloor physicall therapist plays a all arounder in childbirth educator, as a labour doula, as lactation expert , as a postpartum doula, as a pelvicrehab practitioner etc.. So all you need to understand is a WOMEN'S HEALTH/ PELVICFLOOR PT is a person who benifits women at all the stages.
Women’s Health & Physical Rehabilitation..pptxSalmaAzeem3
This document discusses the history and role of physiotherapists in women's health, with a focus on obstetrics and gynecology. It provides an overview of how physiotherapists became involved in these areas in the late 19th/early 20th centuries. It then covers various techniques and areas of expertise used by obstetric physiotherapists, including exercises for pregnancy, postpartum recovery, pelvic floor issues, and other women's health concerns. Guidelines for safe exercise during pregnancy are also discussed.
The document discusses women's health and exercise during pregnancy. It provides guidelines for exercise during each trimester, including frequency, intensity, time and type of exercise recommended. It also discusses potential complications during pregnancy, labor, and the postnatal period. Exercise is recommended to reduce health risks during pregnancy, but should avoid high impact activities and the supine position after the first trimester. Guidelines are given for safe exercise during and after pregnancy.
The document discusses postnatal care and exercises. During the postnatal period, a woman's body begins to recover from pregnancy but full recovery can take 4-5 months as ligaments and muscles stretch and weaken during pregnancy. Physiotherapy aims to aid recovery through mobility, deep breathing, pelvic floor exercises, and specific exercises to strengthen the abdominal muscles and pelvic floor if needed. Exercises are progressed based on individual assessments and priorities like perineal pain.
Low Back Pain management among Pregnant ladyPKS Lectures
The document discusses the management of low back pain during pregnancy. It notes that around 45-75% of pregnant women experience low back pain, which is caused by hormonal, circulatory, and mechanical changes. Non-pharmacological treatment options include exercises, yoga, Pilates, aquatic therapy, acupuncture, massage, and spinal manipulation. Studies show that programs including education and physical therapy can reduce pain and disability in pregnant women with low back pain.
Physiotherapy plays an important role in women's health from puberty through postpartum. It treats conditions like back pain, pregnancy issues, pelvic floor dysfunction, and more. Physiotherapists help with pain management, exercises, and techniques to enhance vaginal childbirth. During pregnancy, they focus on exercises, pain relief, and positions to facilitate labor and delivery. Postpartum care includes exercises to address issues like diastasis recti and incontinence. Physiotherapy thus encompasses women's health from conception through all life stages.
Hysterectomy is a very common conditions occuring in womens due to many reasons .pre-operative & post operative physiotherapy will help to deal with the condition and improve the health status of women.
PPT that made a short and crisp description on physiotherapy role in women's health at a glimpse.
Physical therapist plays a over all role in all stages of a women.Physiotherapist or a pelvicfloor physicall therapist plays a all arounder in childbirth educator, as a labour doula, as lactation expert , as a postpartum doula, as a pelvicrehab practitioner etc.. So all you need to understand is a WOMEN'S HEALTH/ PELVICFLOOR PT is a person who benifits women at all the stages.
Yoga for the journey of pregnancy- yoga teacher training course project work ...Karuna Yoga Vidya Peetham
Introduction
Pregnancy is a period of three semesters each about three months long. The three trimesters help measure the fetus’s milestones in the womb. It also helps to differentiate the magnitude of care and therapy required by the mother each month.
The first trimester starts from the conception to the thirteenth week, or the first 3 months. The mother begins to experience physical and hormonal changes within the first few weeks. The first trimester is crucial for the developing fetus and the mother, as the chances of miscarriage are high in this period.
The second trimester begins from the thirteenth week of pregnancy till the twenty-seventh week. Pregnant mothers feel a lot more active during this period. The abdomen grows significantly in the trimester. By the end of the trimester, the mothers feel the baby’s movements.
This document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including screening for abnormalities and educating on nutrition, and the roles of various healthcare professionals on the antenatal care team. Physiotherapy focuses on preventing and treating musculoskeletal issues, promoting healthy lifestyle, providing postural advice, preparing for labor, and teaching relaxation techniques. Exercises are described as beneficial if done in moderation, and contraindications are provided. Postnatal physiotherapy aids with problems like pelvic floor dysfunction.
This document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including screening for abnormalities and educating on nutrition, and the roles of various healthcare professionals on the antenatal care team. It describes physiotherapy's role in preventing and treating musculoskeletal issues during pregnancy, promoting healthy lifestyle, providing postural advice, preparing for labor, and teaching relaxation techniques. Guidelines are provided for safe exercise during pregnancy and contraindications. Postnatal physiotherapy aids with problems like pelvic floor dysfunction.
This document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including screening for abnormalities and educating on nutrition, and the roles of various healthcare professionals on the antenatal care team. It describes physiotherapy's role in preventing and treating musculoskeletal issues during pregnancy, promoting healthy lifestyle, providing postural advice, preparing for labor, and teaching relaxation techniques. Guidelines are provided for safe exercise during pregnancy and contraindications. Postnatal physiotherapy aids with problems like pelvic floor dysfunction.
This document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including screening for abnormalities and educating on nutrition, and the roles of various healthcare professionals on the antenatal care team. Physiotherapy focuses on preventing and treating musculoskeletal issues, promoting healthy lifestyle, providing postural advice, preparing for labor, and teaching relaxation techniques. Exercises are described as beneficial unless contraindicated by certain high risk conditions. Postnatal physiotherapy addresses problems like pelvic floor dysfunction.
Types of delivery And Physiotherapy management after c-section.pptxRajveer71
This document provides information on different types of childbirth, including:
1. Vaginal delivery - the natural birth process where the baby passes through the birth canal. It has benefits like shorter recovery but risks like respiratory issues for babies.
2. C-section - a surgical procedure where the baby is delivered through incisions in the abdomen and uterus. It may be scheduled or due to complications. Transverse or vertical incisions can be used.
3. Post c-section exercises include belly breathing, pelvic floor exercises, low-impact exercises like wall sits and leg slides, and scar massage to improve range of motion. Always consult a doctor before beginning an exercise routine after c-section.
The document outlines an antenatal physiotherapy program with the aims of teaching safe body mechanics during and after pregnancy, developing posture control, preventing impairments, promoting cardiovascular fitness, and preparing for labor and infant care. It describes common physical changes in pregnancy like weight gain, abdominal stretching, and postural changes. The program consists of exercises targeting the pelvic floor, back, ankles, legs, and breathing to address issues like back pain, pelvic girdle pain, and relaxation. Guidelines stress safety and avoiding high-risk movements.
The document outlines the components of a prenatal visit, which include a pre-consultation, consultation, and post-consultation phase. The pre-consultation involves an initial interview and medical history. The consultation involves a physical exam, lab tests, ultrasound, and fetal growth assessment. The post-consultation includes health teachings on nutrition, exercise, sexual activity, sleep, travel, bathing, clothing, and immunizations. Routine prenatal visits and tests like ultrasound and nonstress tests are also described to monitor the health and development of the fetus.
The document discusses postnatal care and management. It defines puerperium as the period following childbirth when the body's tissues, especially the pelvic organs, return to their non-pregnant state over approximately 6 weeks. It outlines the principal goals of postnatal management as restoring the mother's health, preventing infection, promoting breastfeeding, and providing contraceptive information. It also describes various postnatal exercises that can help recovery.
1) The document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care, and the physiotherapy role in addressing musculoskeletal issues and promoting healthy lifestyle.
2) During postnatal care, physiotherapy aims to help the mother's physical recovery through exercises and treatment of issues while educating on ergonomics of caring for a baby.
3) Specific conditions that may require special considerations during pregnancy and appropriate exercises in each trimester are also covered.
1) The document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care, and the physiotherapy role in addressing musculoskeletal issues and promoting healthy lifestyle.
2) During postnatal care, physiotherapy aims to help the mother's physical recovery through exercises and treatment of issues while educating on ergonomics of caring for a baby.
3) Physiotherapy techniques like relaxation, breathing exercises, and advice on posture are provided to mothers during both antenatal and postnatal periods.
This document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including screening for abnormalities and preparing mothers for labor. It also discusses postnatal physiotherapy focusing on treating musculoskeletal issues like perineal pain and preventing problems like varicose veins. Exercises are outlined for each trimester and postpartum recovery.
1) The document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including a multidisciplinary team, and the physiotherapist's role in addressing musculoskeletal issues and promoting healthy lifestyle.
2) During postnatal care, the physiotherapist focuses on exercises and education to aid the mother's physical recovery, treat any issues, and provide guidance on proper posture and ergonomics for childcare activities.
3) Advice is also given for special needs, including exercise guidelines tailored to each trimester of pregnancy and considerations for conditions like gestational diabetes.
This document provides information on the role of physiotherapy for antenatal and postnatal women. It discusses the importance of antenatal classes and earlybird classes in educating women about back care, pelvic floor exercises, and safe exercises during pregnancy. The postnatal period focuses on physiotherapy assessment, exercises to aid recovery like pelvic floor muscle training, and early postnatal classes to guide safe return to activity. Exercises are progressed from static to dynamic based on muscle re-education principles. Physiotherapists play a key role in supporting women's physical and emotional health during pregnancy and postpartum recovery.
This document provides information on the role of physiotherapy for antenatal and postnatal women. It discusses the importance of antenatal classes and earlybird classes in educating women about back care, pelvic floor exercises, and safe exercises during pregnancy. The postnatal period focuses on physiotherapy assessment, exercises to aid recovery like pelvic floor muscle training, and early postnatal classes to guide safe return to activity. Exercises are progressed from static to dynamic based on muscle re-education principles. Overall the document outlines the key role of physiotherapy from pregnancy through the postnatal period to support women's health, recovery, and return to normal activities.
1. Physiotherapy plays an important role in both antenatal and postnatal care by addressing musculoskeletal issues, promoting healthy lifestyles, providing education on posture, exercise and preparing for labor.
2. During antenatal care, physiotherapists help prevent and treat back pain and pelvic girdle pain, teach exercises to strengthen the pelvic floor, and provide relaxation techniques and advice for maintaining mobility.
3. Postnatal physiotherapy can help with common issues like pelvic floor dysfunction and back pain, as well as educate new mothers on recovering from birth.
1. Physiotherapy plays an important role in both antenatal and postnatal care by addressing musculoskeletal issues, promoting healthy lifestyles, providing education on posture, exercise and preparing for labor.
2. During antenatal care, physiotherapists help prevent and treat back pain and pelvic girdle pain, teach exercises to strengthen the pelvic floor, and provide relaxation techniques and advice for maintaining mobility.
3. Postnatal physiotherapy can help with common issues like pelvic floor dysfunction and back pain, as well as educate mothers on recovering from birth and resuming normal activities.
1. Physiotherapy plays an important role in both antenatal and postnatal care by addressing musculoskeletal issues, promoting healthy lifestyles, providing education on posture, exercise and preparing for labor.
2. During antenatal care, physiotherapists help prevent and treat back pain and pelvic girdle pain, teach exercises to strengthen the pelvic floor, and provide relaxation techniques and advice for maintaining mobility.
3. Postnatal care involves addressing common issues like diastasis recti, pelvic floor dysfunction, and back pain, as well as ensuring a smooth recovery through continued education and guidance on exercises.
The document discusses the causes and effects of bullying. It explains that bullies often lack empathy, need power and control, and have low self-esteem. Victims of bullying can experience mental health issues like depression, physical health problems, and poor academic performance. Breaking the cycle requires compassion, diversity, and open communication. Spotting bullying involves looking for physical, emotional, and social symptoms in potential victims. The document calls for speaking out against bullying to address this growing problem.
Burn rehabilitation aims to reduce complications and promote healing through proper positioning, splinting, and mobilization. A burn injury is classified based on depth, cause, appearance, capillary return, and healing time. A multidisciplinary team evaluates burn severity, edema, range of motion, strength, and function to guide individualized treatment. Physical therapy focuses on wound care, edema control, preventing contractures with splinting and stretching exercises, and restoring full function.
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Yoga for the journey of pregnancy- yoga teacher training course project work ...Karuna Yoga Vidya Peetham
Introduction
Pregnancy is a period of three semesters each about three months long. The three trimesters help measure the fetus’s milestones in the womb. It also helps to differentiate the magnitude of care and therapy required by the mother each month.
The first trimester starts from the conception to the thirteenth week, or the first 3 months. The mother begins to experience physical and hormonal changes within the first few weeks. The first trimester is crucial for the developing fetus and the mother, as the chances of miscarriage are high in this period.
The second trimester begins from the thirteenth week of pregnancy till the twenty-seventh week. Pregnant mothers feel a lot more active during this period. The abdomen grows significantly in the trimester. By the end of the trimester, the mothers feel the baby’s movements.
This document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including screening for abnormalities and educating on nutrition, and the roles of various healthcare professionals on the antenatal care team. Physiotherapy focuses on preventing and treating musculoskeletal issues, promoting healthy lifestyle, providing postural advice, preparing for labor, and teaching relaxation techniques. Exercises are described as beneficial if done in moderation, and contraindications are provided. Postnatal physiotherapy aids with problems like pelvic floor dysfunction.
This document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including screening for abnormalities and educating on nutrition, and the roles of various healthcare professionals on the antenatal care team. It describes physiotherapy's role in preventing and treating musculoskeletal issues during pregnancy, promoting healthy lifestyle, providing postural advice, preparing for labor, and teaching relaxation techniques. Guidelines are provided for safe exercise during pregnancy and contraindications. Postnatal physiotherapy aids with problems like pelvic floor dysfunction.
This document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including screening for abnormalities and educating on nutrition, and the roles of various healthcare professionals on the antenatal care team. It describes physiotherapy's role in preventing and treating musculoskeletal issues during pregnancy, promoting healthy lifestyle, providing postural advice, preparing for labor, and teaching relaxation techniques. Guidelines are provided for safe exercise during pregnancy and contraindications. Postnatal physiotherapy aids with problems like pelvic floor dysfunction.
This document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including screening for abnormalities and educating on nutrition, and the roles of various healthcare professionals on the antenatal care team. Physiotherapy focuses on preventing and treating musculoskeletal issues, promoting healthy lifestyle, providing postural advice, preparing for labor, and teaching relaxation techniques. Exercises are described as beneficial unless contraindicated by certain high risk conditions. Postnatal physiotherapy addresses problems like pelvic floor dysfunction.
Types of delivery And Physiotherapy management after c-section.pptxRajveer71
This document provides information on different types of childbirth, including:
1. Vaginal delivery - the natural birth process where the baby passes through the birth canal. It has benefits like shorter recovery but risks like respiratory issues for babies.
2. C-section - a surgical procedure where the baby is delivered through incisions in the abdomen and uterus. It may be scheduled or due to complications. Transverse or vertical incisions can be used.
3. Post c-section exercises include belly breathing, pelvic floor exercises, low-impact exercises like wall sits and leg slides, and scar massage to improve range of motion. Always consult a doctor before beginning an exercise routine after c-section.
The document outlines an antenatal physiotherapy program with the aims of teaching safe body mechanics during and after pregnancy, developing posture control, preventing impairments, promoting cardiovascular fitness, and preparing for labor and infant care. It describes common physical changes in pregnancy like weight gain, abdominal stretching, and postural changes. The program consists of exercises targeting the pelvic floor, back, ankles, legs, and breathing to address issues like back pain, pelvic girdle pain, and relaxation. Guidelines stress safety and avoiding high-risk movements.
The document outlines the components of a prenatal visit, which include a pre-consultation, consultation, and post-consultation phase. The pre-consultation involves an initial interview and medical history. The consultation involves a physical exam, lab tests, ultrasound, and fetal growth assessment. The post-consultation includes health teachings on nutrition, exercise, sexual activity, sleep, travel, bathing, clothing, and immunizations. Routine prenatal visits and tests like ultrasound and nonstress tests are also described to monitor the health and development of the fetus.
The document discusses postnatal care and management. It defines puerperium as the period following childbirth when the body's tissues, especially the pelvic organs, return to their non-pregnant state over approximately 6 weeks. It outlines the principal goals of postnatal management as restoring the mother's health, preventing infection, promoting breastfeeding, and providing contraceptive information. It also describes various postnatal exercises that can help recovery.
1) The document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care, and the physiotherapy role in addressing musculoskeletal issues and promoting healthy lifestyle.
2) During postnatal care, physiotherapy aims to help the mother's physical recovery through exercises and treatment of issues while educating on ergonomics of caring for a baby.
3) Specific conditions that may require special considerations during pregnancy and appropriate exercises in each trimester are also covered.
1) The document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care, and the physiotherapy role in addressing musculoskeletal issues and promoting healthy lifestyle.
2) During postnatal care, physiotherapy aims to help the mother's physical recovery through exercises and treatment of issues while educating on ergonomics of caring for a baby.
3) Physiotherapy techniques like relaxation, breathing exercises, and advice on posture are provided to mothers during both antenatal and postnatal periods.
This document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including screening for abnormalities and preparing mothers for labor. It also discusses postnatal physiotherapy focusing on treating musculoskeletal issues like perineal pain and preventing problems like varicose veins. Exercises are outlined for each trimester and postpartum recovery.
1) The document discusses the role of physiotherapy in antenatal and postnatal care. It covers maternal physiology changes during pregnancy, objectives of antenatal care including a multidisciplinary team, and the physiotherapist's role in addressing musculoskeletal issues and promoting healthy lifestyle.
2) During postnatal care, the physiotherapist focuses on exercises and education to aid the mother's physical recovery, treat any issues, and provide guidance on proper posture and ergonomics for childcare activities.
3) Advice is also given for special needs, including exercise guidelines tailored to each trimester of pregnancy and considerations for conditions like gestational diabetes.
This document provides information on the role of physiotherapy for antenatal and postnatal women. It discusses the importance of antenatal classes and earlybird classes in educating women about back care, pelvic floor exercises, and safe exercises during pregnancy. The postnatal period focuses on physiotherapy assessment, exercises to aid recovery like pelvic floor muscle training, and early postnatal classes to guide safe return to activity. Exercises are progressed from static to dynamic based on muscle re-education principles. Physiotherapists play a key role in supporting women's physical and emotional health during pregnancy and postpartum recovery.
This document provides information on the role of physiotherapy for antenatal and postnatal women. It discusses the importance of antenatal classes and earlybird classes in educating women about back care, pelvic floor exercises, and safe exercises during pregnancy. The postnatal period focuses on physiotherapy assessment, exercises to aid recovery like pelvic floor muscle training, and early postnatal classes to guide safe return to activity. Exercises are progressed from static to dynamic based on muscle re-education principles. Overall the document outlines the key role of physiotherapy from pregnancy through the postnatal period to support women's health, recovery, and return to normal activities.
1. Physiotherapy plays an important role in both antenatal and postnatal care by addressing musculoskeletal issues, promoting healthy lifestyles, providing education on posture, exercise and preparing for labor.
2. During antenatal care, physiotherapists help prevent and treat back pain and pelvic girdle pain, teach exercises to strengthen the pelvic floor, and provide relaxation techniques and advice for maintaining mobility.
3. Postnatal physiotherapy can help with common issues like pelvic floor dysfunction and back pain, as well as educate new mothers on recovering from birth.
1. Physiotherapy plays an important role in both antenatal and postnatal care by addressing musculoskeletal issues, promoting healthy lifestyles, providing education on posture, exercise and preparing for labor.
2. During antenatal care, physiotherapists help prevent and treat back pain and pelvic girdle pain, teach exercises to strengthen the pelvic floor, and provide relaxation techniques and advice for maintaining mobility.
3. Postnatal physiotherapy can help with common issues like pelvic floor dysfunction and back pain, as well as educate mothers on recovering from birth and resuming normal activities.
1. Physiotherapy plays an important role in both antenatal and postnatal care by addressing musculoskeletal issues, promoting healthy lifestyles, providing education on posture, exercise and preparing for labor.
2. During antenatal care, physiotherapists help prevent and treat back pain and pelvic girdle pain, teach exercises to strengthen the pelvic floor, and provide relaxation techniques and advice for maintaining mobility.
3. Postnatal care involves addressing common issues like diastasis recti, pelvic floor dysfunction, and back pain, as well as ensuring a smooth recovery through continued education and guidance on exercises.
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Lect. (3) Antenatal Care fall 2023 ٧.pdf
1. Antenatal Care (ANC)
presented By:
Dr. Radwa M. Yehia
lecturer of PT ACU
Department of PT for Pediatrics & women’s health
2. Objectives
Define antenatal period.
• Describe benefits & aims of ANC.
• Emphasize role of physiotherapy during pregnancy
• List interventions for common problems during pregnancy.
• List recommended exercise approaches meeting the physical
condition of each pregnant women.
• Describe general health advices and nutritional
recommendations for best pregnancy outcome.
3. Antenatal Period
• Definition:
It is the period during pregnancy.
Aims of adequate antenatal care:
1. To detect and treat any physical or psychological defect.
2. Prepare the parents for the birth and care of the baby.
3. Give confidence to the woman in her own abilities
through an understanding of how her body functions
and the various changes occurring during pregnancy and
birth.
4. Who provide antenatal care?
• Antenatal care team:
1. Obstetrician,
2. Pediatrician,
3. Physiotherapist specialized in woman’s health &
4. Dietitian
5. Date of starting physical therapy program
• Depends on the medical advisor and should be
before the woman increases her weight.
• After end of 1st trimester.
6. Psychological preparation for pregnant women
• Most primigravidae women experience an increase in anxiety
during pregnancy and have fears about childbirth due to:
• Baby will die in uterus.
• Baby will not be born normally.
• Baby will not be healthy.
• Childbirth will be traumatic and pain relief will not be
provided.
• Drugs taken during pregnancy may cause birth defects .
7. Psychological preparation for pregnant women
• The greater the anxiety, the greater the chance that labour
will be more difficult.
• So the pregnant women should talk about their anxieties.
The team members must describe to them, the changes
which are occurring in their bodies and explain the
purpose of investigation they make.
8. Physical preparation for pregnant women
• Physical plane should include certain anatomical
structure of :
• The bony pelvis, its size and shape.
• Its position in the body in relation to posture.
• The attachment of pelvic inlet and outlet.
• The attachment of the muscle of the pelvic floor.
• The development of muscles, ligaments, joints.
• The role of pelvic floor muscles and abdominal muscles
during labour.
• A selected number of illustration will greatly helpful.
9. Ante natal classes applied in small groups
Advantages:
1. Time saving.
2. Allow meeting between pregnant
woman with another at the same
state so, give psychological support.
3. Helps to emphasize the view that
pregnancy is physiological process.
10. Role of physiotherapist during pregnancy
1. Assess physical health & identify any musculoskeletal or neuro-muscular
problems that could be aggravated by pregnancy. The physiotherapist should
identify and try to prevent any problem. e.g. pregnant woman should
perform:
a) leg exercises to prevent varicose veins.
b) Abdominal contractions are taught to be practiced in sitting, lying and
standing positions.
c) Pelvic tilting and postural correction exercise from various positions.
d) Pelvic floor contractions are taught in stride sitting with elbows resting on
the knees.
11. Role of physiotherapist during pregnancy
2. Advices on back care, standing, sitting & lying: back strain
is minimized when the spine is held in its normal curves. So it is
important to teach the woman how to adapt positions which
minimize stress. So, Postural correction exercises are practiced
from different positions:
• Standing.
• Sitting.
• Lying position.
• Crock lying position.
12. Role of physiotherapist during pregnancy
3. Lifting advices: It involves lifting from
a height and carrying as well as lifting
from the ground level.
• The principles to follow when lifting
are:
a) Foot should be apart to increase the base of support.
b) Any object to be lifted must be held close to the body.
c) When lifting from the ground, it is important to ensure that the weight is
light enough to be lifted comfortably.
d) When lifting from a height, it is important to hold the object close to the
body and to make sure that the height is easy reached
13. Role of physiotherapist during pregnancy
4. Treat any problem with appropriate physio-therapy skills.
• Pubic pain: related to diastasis of the rectus abdominis muscles
due to repeated pregnancies. This pain is treated by pelvic support
as a firm elastic corset which modified to fit under the main bulb
of the baby.
• Lumbar pain: may be eased by soft tissue kneading and
mobilization.
• Cramps: occurs most commonly in the calf muscles. It can be
relieved by slow, sustained stretch on the muscles, and by foot
exercises.
14.
15. Role of physiotherapist during pregnancy
5. Teach methods for controlling tension and pain:
• Neuromuscular tension: The physiotherapist must teach the
pregnant woman how to recognize tension and how to deal with
it though:
a) Relaxation techniques: that taught as a mean by reducing
stress in all life situation. During labour, relaxation principles
can reduce the severity of pain.
b) Breathing awareness: can help with relaxation during painful
contraction of labour.
16. Role of physiotherapist during pregnancy
6. Teaching positions that may be used at First stage labour
a) Walking and leaning forward on a support during
contractions.
b) Sitting comfortably, using a back chair or a rocking chair.
c) As labour progress, fatigue sets in and rest is essential in a side
lying position.
d) Relaxation techniques can be used to preserve energy
between contractions.
18. Exercises during pregnancy
• Regular moderate aerobic exercise, at least three times a
week is recommended for all pregnant women with no
contraindications
• Best time to initiate program in the second trimester
when nausea & vomiting of first trimester have passed &
before the physical limitations of third trimester
19. Structured aerobic exercise program based on FITT
principle (frequency, intensity, time, type of activity)
• Frequency: 3 increasing to 4 times/week
• Intensity: previous sedentary mild increasing to moderate intensity
• Time (duration): 15 minutes increasing to 30 minutes with 5-10
minutes of warm up & cool down
• Type of activity: aerobic exercise should involve large muscles
groups as walking , swimming, bicycle, each woman must find the
modality to which she can adhere for long term, the best modalities
of exercise are swimming & walking (safe has no negative effect on
mother & foetus).
20. Model of P.T program for normal
pregnant women
• Not before 4th month to avoid abortion.
• If the is history of abortion, no ante partum
exercise.
21. From 4th to 6th month
• Instruction about anatomy & physiology of female pelvic
structures.
• Training for:
1) Deep breathing ex.
2) Relaxation training: in any comfortable position chosen
by mother, room must be calm, quite, warm, no air
draft, no direct light, light music assist physical and
mental relaxation.
3) Postural correction: to avoid postural problems.
22. From the end of 6th month till the end of 8th
month
All previous in addition to:
1. Pelvic rocking ex.
2. Leg & foot ex.
3. Pelvic floor ex.
4. Abdominal ex.
5. Core stability ex.
6. Arm strengthen ex.
23. During the last month ( woman & her partner)
All previous in addition to:
1. Instruction about onset of labour.
2. Stages of labour.
3. Walking in fresh air.
4. Teaching panting breathing.
5. Relaxation training (diversion drill)
6. Explanation about effect of TENS on pain.
7. Avoid supine hypotension syndrome.
25. Obstetric examination
• Lie:
The relation between the long axis of the fetus & that of
the uterus (feto-pelvic relationship). Longitudinal,
transverse or oblique.
26. Obstetric examination
• Presentation:
The part of the fetus that is closest to the birth canal.
1. Cephalic (95%) =by occiput (vertex, sinciput, brow or
face).
2. Breech (4%).
3. Shoulder (1%).
28. Obstetric examination
Position
The relation of the back of the fetus
(occiput) to the Rt. or Lt. side of
the mother directed anteriorly or
posteriorly.
Common positions in cephalic
presentation:
Lt. occiput anterior (60%).
Rt. occiput anterior (20%).
Rt. occiput posterior (15%).
Lt. occiput posterior (5%).
30. Obstetric examination
Fetal Station
It is the relationship of the presenting
part to the ischial spines (assessed
vaginally). It is measured in
centimeters above (-) or below (+) the
ischial spines.
Floating The presenting part is moving
toward the pelvic inlet (not engaged)
31. Obstetric examination
Engagement
• The passage of a widest
transverse diameter of the
presenting part through the
pelvic inlet (at level of ischial
spines).
• In the majority the engagement
occurs between 38-42 weeks or
even during the first stage of
labour.
32. Obstetric examination
Crowning
The passage of a widest transverse diameter of the
presenting part through the pelvic outlet (at level of
coccyx).
• Occur at end of 2nd stage
of labour.
33. Advices
1. Exercises: The pregnant woman must avoid vigorous
exercises as swimming, tennis and cycling especially in the
first part of pregnancy, the best exercise is walking in open
fresh air, at least one hour daily.
2. Travelling: should be avoided, particularly during the
last month especially on hard roads and for a long
distances. If there is a history of habitual abortion or
premature labours, travelling should be completely
prevented.
34. Advices
3. Sleep and Rest: Sleep for at leas8 hours every night
Rest in a quiet room for 2 or 3 hours every afternoon.
Avoid prone position to avoid intrauterine fetal death.
4. Breasts: massage the nipple with a mixture of glycerin
and alcohol to reduce the incidence of cracking
5. Daily washes, Baths: The bath should be tepid and
given by a shower, vaginal douching should be avoided
because it leads to ascending infection.
35. The best sleep position during pregnancy
• It is “SOS” (sleep on side) because it
1. provides the best circulation for you and your baby.
2. It also places the least pressure on your veins and
internal organs.
3. Sleeping on your left side will increase the amount of
blood and nutrients that reach the placenta.
36. Advices
6. bowel-habit: Avoid constipation because it leads to
straining down, so, piles and genital prolapse may occur.
This could be avoided by eating fresh vegetables, milk,
performing pelvic floor exercise and taking mild
laxatives
7. Clothes: Should be loose, comfortable, avoid tight breast
support. The shoes should be easily fitting, with low heels.
37. Advices
8. Teeth: Regular cleaning at least in the morning and
night.
9. Warning signs: As vaginal bleeding, abdominal pain,
severe persistent headache, swelling in lower limbs
which demand immediate physician calling.
38. Advices
10. Nutrition during pregnancy
• Caloric requirements of pregnant woman: 2300-2500 Kcal/day
• Protein requirement is increased (120gm of red meat, fish, liver)
• 400ml milk or its derivatives
• Iron: 30-60mg/day
• Folic acid: 400 µg/day important for cell division and replication so reduce risk of
neural tube defects
• Fresh fruits and vegetables (dark green)
• Vitamin A and B are essential for growth of fetus and formation of fetal skeleton.
• Vitamin C and K reduce the incidence of abortion and either ante or post
partum hemorrhage.
• Salt restrictions (in cases with marked edema and tendency to hypertension)
• Avoid excess carbohydrates and fats
• Sufficient fluids
39. Sources of vitamins and minerals
calcium Milk and its derivatives, dark green vegetables
iron Lean red meat, poultry, fish
iodine Dairy products, sea food, eggs, cereals, iodized
table salt
Vitamin A dark green vegetables
Vitamin C Citrus fruits
Vitamin D Sun light, milk, sea food
B6 Whole grain cereals
B12 Meat ,poultry, fish, milk
41. Common complains during pregnancy
A- Pubic pain: related to diastasis of rectus abdominis
muscles due to repeated pregnancies.
• TTT: firm elastic corset and abdominal exercises.
42. Common complains during pregnancy
B- Low back pain (LBP) pain and sacroiliac joint
pain(SIJP): TTT OF LBP & SIJP:
1- Gentle soft tissue massage
2- Abdominal exercises, core stability ex. & posture
correction ex.
3- Ice packs under painful region from crock lying position
or ice cube massage for 25 minutes
43. Common complains during pregnancy
B- Low back pain (LBP) pain and sacroiliac joint
pain(SIJP): TTT OF LBP & SIJP:
4-TENS
• Frequency: 80-120 Hz
• Width:150 microsecs
• Minimal intensity
• 1hour, 3-4 times daily
44. TENS (Electrode placement):
• From modified side lying position sticky electrodes
placed:
• LBP: paravertebral
• SIJP: over each SIJ on both sides
• TENS can be used for Sciatic radiculopathy.
• (Channel 1): L5 nerve root & Gluteus maximus,
• (Channel 2): Popliteal space & Post to lateral
malleolus
• Electrodes are placed close to the vertebral column, so
that, there is no risk of current spread to the abdomen.
45. Common complains during pregnancy
TTT OF LBP & SIJP:
5-Interferential (IF)
• Frequency: 80-100HZ, 20minutes, co-planner
application, 4 electrodes on both sides of the painful area
46. Common complains during pregnancy
C- Carpal Tunnel Syndrome (CTS):
It is associated with:
-Oedema
-Parasthesia and pain, which is commonly experienced at
night
-Difficulty holding objects and performing fine movements
47. Management of CTs
• Avoid sleeping on the affected side & elevate the hand
• Wrist and hand exercises to increase circulation &
reduce edema
• Night splint with hand in neutral position
• Ice packs: on the wrist, while support arm over pillow for
15 minutes (Mechanism of pain relieve)
48. Management of CTs
• Contrast bath:
2 baths of cold 15º C & hot 40-45º C water
Each cycle: Begin & end with hot one, place hand 2 min
in hot water immediately afterwards place for 1min in
cold water, repeat cycle 3 times with total time should not
take more than 15 min
49. Management of CTs
• TENS:
Frequency: 80-120HZ
Pulse width: 150micrsecs
1hour, daily
Electrode placement: one above & other below wrist
joint on palmar surface of hand
• Ultrasound (US):
Low intensity : 0.5-2W/Cm2 for 15 min
50. Common complains during pregnancy
D- Morning sickness (Nausea & vomiting):
Caused by the raised level of Human chorionic
gonadotropin (HCG) at this stage, decreased intestine
mobility & lower esophageal sphincter pressure by
elevated levels of estrogen, progesterone & relaxin
hormones.
51. Common complains during pregnancy
D- Morning sickness (Nausea & vomiting):
It is often more severe in multiple gestation (if severe
nausea & vomiting leading to dehydration & nutrition
disorders called hyperemesis gravidarum rare affect 0.5-
2%).
52. TTT of morning sickness:
Deep breathing & relaxation exercises
Regular walking facilitate movement of the intestine
Vitamin B6 supplement
Nutritional instructions: eating small frequent meals,
avoiding spicy & high fat food, drink herbals like ginger
can help digestion
53. TTT of morning sickness: TENS
Frequency: 80-120 Hz, pulse width: 150 µs, minimal
intensity 30 min each morning can control all through
the day
Electrode placement: one electrode: at the right
acromioclavicular tip
Other electrode: at the right dorsal web space between
thumb and forefinger