This document discusses the scientific basis for antenatal care. It outlines that antenatal care aims to promote, protect and maintain the health of the mother through regular checkups. During checkups, high-risk pregnancies are detected and treated. The document also discusses trends in antenatal care like a focus on community-based and integrated health services. Key components of antenatal care include history collection, examinations, screening tests, immunizations and nutritional supplementation.

1. SCIENTIFIC BASISFOR ANTENATAL
CARE
Dr. (Prof). Sudha A. Raddi
Dean & Principal
KLEU INS
Belagavi
And
Mrs. Asha Bhat
Sr. Tutor, Dept. of OBG
Nursing, KLEU INS,
Belagavi

3. INTRODUCTION
 Antenatal care is a routine part of pregnancy for
most of the women who give birth in India each
year.
 Effective models of antenatal care have a focus
on the individual woman’s needs and preferences,
collaboration and continuity of care at community
and hospital-based settings.

4. CONT......
 Taking a woman-centred approach and holistic approach
also ensures that a woman’s needs and expectations are
considered and respected.
 Women should be given evidence-based information that
enables them to make decisions about care.
 All women have the right to be treated with respect and
dignity, have their privacy respected, and be assured that
all their health information is confidential.

5. SOME FACTS.......
 Among young women age 15-19, 16 percent have already
begun childbearing.
 Less than half of women received antenatal care during the
first trimester of pregnancy, as is recommended.
 Three out of every five births in India take place at home.
 Every seven minutes an Indian woman dies from
complications related to pregnancy and childbirth.

6. ANTENATAL CARE…… WHY ?
Three types of health problems exist in pregnancy.
 First, the complications of pregnancy itself,
 Second, diseases that happen to affect a pregnant
woman and which may or may not be aggravated by
pregnancy,
 Third, the negative effects of unhealthy lifestyles

7. MEANING…..
 It is a care of a woman during pregnancy
including visit to antenatal clinic, examination,
investigations, immunization, supplements (Iron,
Folic acid, Calcium, Nutritional) and
interventions as required.

8. 4. To educate
women on
warning
signals ,
child care,
family
planning
1. To promote
, protect and
maintain
health of the
mother
2. To detect ‘ at
risk ’ cases and
provide
necessary care
9. To provide
care to any
child
accompanyi
ng the
mother
8. To plan for “
Birth” and
emergencies /
7. To provide
early diagnosis
and treatment
6. To allay
anxiety
associated
with
pregnancy
and childbirth
5. To prepare
the woman
for labour
and lactation
3. To provide
advise on
self care
during
pregnancy
Objectives

9. CURRENT
TRENDSIN ANTENATAL
CARE
Structure of health care
delivery
Involving consumers
and promoting self care
Emphasis on high
technology care
Community based care
Increase in high risk
pregnancy
Integrative health care
Health of a woman
Trends in fertility and birth
rate

10. SCIENTIFIC BASIS FOR ANTENATAL CARE

11. WHY......?
 Traditional method of ANC
 Life-threatening conditions
 High-risk pregnancy
 Excessive fertility
 Poor socioeconomic status
 High mortality and morbidity
 An Evidence based path
 Accessible first-level referral
service
 Community-based maternity
services
 Family planning
 Revising the status of women
 Lower mortality and morbidity

12. PRECONCEPTION CARE
 Preconception care refers to
physical and mental preparation
of both parents for pregnancy
and childbearing in order to
improve the pregnancy
outcome

13. ANTENATAL VISIT
 Visits Regular Ideally
- once a month during first seven
months,
- twice a month for 8th month
- every week thereafter till delivery
Minimum - 4 Besides 1st visit, visits
at 20,
32 and 36 weeks are recommended

14. LABORATORY EXAMINATION
 Hb, ABO Rh, blood sugar, urine analysis, HIV,
VDRL, HbsAg

15. HISTORY COLLECTION
 Present obstetrical history
 Past obstetrical, medical and
surgical history
 Family history
 Menstrual history
 Contraceptive history
 Socio economic back ground

16. SCREENING FOR HIGH RISK
Ultrasonography
Non Stress
Test
Contraction Stress
Test
Cardiotocography
Non Invasive Methods

17. INVASIVE METHODS

19. CHORIONIC VILLUS SAMPLING

20. CORDOCENTESIS
All information obtained from
amniocentesis and chorionic
villus sampling can be obtained .
In addition:
 Fetal anaemia, bleeding disorder
hemoglobinopathies
 Fetal infections, toxoplasmosis
 Fetal blood gas and acid base in
IUGR
 Fetal therapy – Blood transfusion

21. AMNIOCENTESIS

22. NUTRITIONAL SUPPLEMENTATION
Iron and folic acid 1 cap
60 mg elemental iron
500 mg of folic acid

23. NUTRITIONAL SUPPLEMENTATION
Calcium 500-1000 Mg with Vitamin
D

24. VACCINATION
Two doses of Inj.
TT 4-6 weeks
apart after 16
weeks of
pregnancy

25. DIET

27. HABITS

28. PSYCHOLOGICAL ASPECTS

29. WHAT IS NOT EVIDENCE BASED!!
 Kick Counts - There is no evidence that a formal
program of fetal kick counts reduces the
incidence of intrauterine fetal deaths. (A)
 The evaluation of clinical pelvimetry during the
prenatal period is of little value in predicting the
occurrence of cephalopelvic disproportion (CPD)
during delivery.

30. NOT EVIDENCE BASED…..
 A systematic review concluded a 1+ dipstick
reading had no clinical value, since a negative
dipstick did not necessarily exclude significant
proteinuria, while many women with positive
tests did not have it
 Universal screening for bacterial vaginosis.
However, women with a history of preterm labor
may be advised that such a screening is necessary

31. And if you the right…
you get a GREAT outcome!!!