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ERA’S COLLEGE OF
NURSNG
PRESENTATION
ON
ANTENATAL CARE
NIDHI MAURYA
M.Sc NURSING
ANTENATALCARE
INTRODUCTI0N
 Antenatal care refers to the education, supervision,
treatment and care given to an expectant mother
from the time the conception is confirmed until the
beginning of labor. It includes monitoring the
progress of pregnancy, providing appropriate
support to the women and her family and providing
information, which will assist them to make
sensible choices.
DEFINITION
 Systemic supervision (examination and advice) of
women during pregnancy is called antenatal care
(ANC).
 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.”
GOAL
o To screen the high risk cases.
o To prevent or to detect and treat at the earliest any
complications.
o To ensure continued risk assessment and to provide
ongoing primary preventive health care.
o To educate the mother about the physiology of pregnancy
and labor by demonstration, charts and diagrams so that
fear is removed and psychology is improved.
CONTINUE...
o To discuss the couple about the place, time and
mode of delivery, provisionally and care of the
newborn.
o Decision regarding timing and mode of delivery.
o To motivate the couple about the need of family
planning and also appropriate advice to couple
seeking medical termination of pregnancy.
o To remove anxiety associated with delivery.
o To improve the physical and mental health of
women and children.
OBJECTIVE
 To ensure a normal pregnancy with delivery of a
healthy baby from a healthy mother.
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.
Antenatal Visits:
The WHO recommends that pregnant women should
all receive four antenatal visits to spot and treat
problems and give immunizations.
Although antenatal care is important to improve the
health of both mother and baby, many women do
not receive four visits.
CONT..
• First visit: confirmation of pregnancy
• Second visit: 20-28 weeks
• Third visit: 34-36 weeks
• Fourth visit: before expected date of delivery or when
the pregnant woman feels she needs to consult health
worker.
Every woman should have a record file and every event
should be written in it. If pregnancy is passing
uneventfully these visits are enough but if
complications arise we need more visits.
Antenatal Visits
FirstTrimesterVisit
 Confirm intrauterine pregnancy and assess the
gestational age.
 We have to deal with complications that present
with vaginal bleeding and abdominal pain.
 Women can be investigated using history,
examination, biochemical testing & trans-vaginal
U/S to exclude non-viable pregnancy, ectopic
pregnancy or hydatiform mole.
Second Trimester Visit
 Assessment of maternal health & fetal growth &
wellbeing.
 The results of tests performed at 1st trimester visit
are reviewed with the mother
 The results of the U/S scan for fetal abnormality are
also reviewed.
 Any incidental maternal symptoms are dealt with,
this period is also important in insuring the
education of the woman regarding the rest of
pregnancy & her delivery.
Third Trimester Visit
 The primary objective of this visit is to anticipate any
problems regarding the prospective delivery. Uterine
fundal height, fetal lie, presentation & position are
mandatory.
 Vaginal examination will help us to check for any
abnormality in the pelvis, cervical status, fetal
presenting part, station & position.
 Mode of delivery & planned contraception after
delivery should is discussed at this time.
HISTORY
HISTORY
HISTORY TAKING /HEALTH HISTORY:
 Identification data
of the patient
 Name
 Age
 Sex
 Bed no.
 Ward
 Address
 Nationality
 Diagnosis
 Religion
 Education
 Occupation
 Dr. incharge
 D.o.a
 Source of information
Cont..
 Chief complaints
 Present history of illness
 Past medical history
 Childhood illness
 Immunization
 Medical history
 Surgical history
 Personal history
 Drug addiction
 Dietary habits
 Sleeping patterns
 Nutritional patterns
 Hygiene
 Allergies
 hobbies
 Menstrual history
 Age of menarche
 Cycle
 Duration
 LMP
 Dysmenorrhoea
 Marital history
 Age of marriage
 Type of marriage
 No. of children
 Any sexual disorder
 Relationship with husband
Cont..
 Past Obstetrical history
 Mode of delivery
 Still birth
 Abortion
 Year of last delivery
 no. of live birth
 Health of
parents/sibling/spouse/child
ren
 Parents
 Siblings
 Spouse
 Children
 Family members
 Family medical history
 Family surgical history
 Family tree
 Psychosocial history
 Primary language
 Secondary language
 House(rent/own)
 Position of patient in family
 Socio economic status of the
patient.
Cont..
 Environmental
history
 Cleanness of house
 Type of residence
 Village/city/town
 Water supply
 Sanitation
 Drainage system
 Mode of transportation
 Vital signs
o Temperature
o Respiration
o Pulse
o Blood pressure
Cont..
 Investigations-
(Lab. Investigations )
 Hb estimation Blood
grouping, Rh typing ,
 Urine R/M/E,
 VDRL, RBS, HBs Ag test ,
 USG for Pregnancy ,
 Profile check Stool/ urine
for the presence of
albumin.
 Pap test (if facilities)
 Chest X-Ray and
Gonorrhoea test(if
needed).
 Medication-
 Other supportive therapies.
Physical Examination
Physical Examination
 General appearance
 Head and neck
 Face
 Eye
 Nose
 Ear
 Mouth: lips, mucosa, tongue, teeth, neck
 Breast inspection
Shape
Nipple shape
Dryness
Cracked nipple
Scar formation
Enlargement
Cont..
 Chest
Symmetry
Respiratory rate
Apical pulse
Percussion(fluid accumulation)
Auscultation
Wheezing sounds
Heart rate
Abdomen-
Shape
Abdomial girth
Linea nigra
Measurement of fundal height
Fetal heart sounds
Fetal movements
Fetal parts multiple pregnancies
Fetal lie and presentation
Inspection of abdominal scar
 Genital area
Hygiene
Tenderness
Chadwick sign
Cont..
Cont..
Extremities
 Range of motion
 Pain
 Leg cramps
 Edema
Health Teaching During Pregnancy
 Health promotion during pregnancy begins with
reviewing :
 Hygiene
 Sleep
 Breast care
 Dental care
 Dressing
 Travel
 Sexual activity
 Exercises
Hygiene:
 Daily bath is recommended, as it stimulation
refreshing and relaxing.
 Daily all over wash is necessary because it is
stimulating, refreshing, and relaxing.
CONTINUE…..
 Hot bath should be avoided because they may
cause fatigue & fainting.
 Regular washing for genital area, axila, and breast
due to increased discharge and sweating.
 Vaginal douches should avoid except in case of
excessive secretion or infection.
SUMMARY
 Definition and introduction of the topic
 about antenatal care &
 the goals of antenatal care,
 antenatal visit &
 the collection of history from the patient &
 their heath teaching &
 the hygiene about antenatal woman.
BIBLIOGRAPHY
 Dutta DC “textbook of obstetric”, edition 8th
Jaypee publication, page 52-64
 Myles “textbook for midwives”, 16th edition
Elsevier publication, page no.55-77.
 Jacob Annamma a comprehensive “textbook
of midwifery and gynecological nursing” 3rd
edition, Jaypee publication page no,37-51.

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Antenatal care deepti ppt

  • 3. INTRODUCTI0N  Antenatal care refers to the education, supervision, treatment and care given to an expectant mother from the time the conception is confirmed until the beginning of labor. It includes monitoring the progress of pregnancy, providing appropriate support to the women and her family and providing information, which will assist them to make sensible choices.
  • 4. DEFINITION  Systemic supervision (examination and advice) of women during pregnancy is called antenatal care (ANC).  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. GOAL o To screen the high risk cases. o To prevent or to detect and treat at the earliest any complications. o To ensure continued risk assessment and to provide ongoing primary preventive health care. o To educate the mother about the physiology of pregnancy and labor by demonstration, charts and diagrams so that fear is removed and psychology is improved.
  • 6. CONTINUE... o To discuss the couple about the place, time and mode of delivery, provisionally and care of the newborn. o Decision regarding timing and mode of delivery. o To motivate the couple about the need of family planning and also appropriate advice to couple seeking medical termination of pregnancy. o To remove anxiety associated with delivery. o To improve the physical and mental health of women and children.
  • 7. OBJECTIVE  To ensure a normal pregnancy with delivery of a healthy baby from a healthy mother.
  • 8. 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.
  • 9. Antenatal Visits: The WHO recommends that pregnant women should all receive four antenatal visits to spot and treat problems and give immunizations. Although antenatal care is important to improve the health of both mother and baby, many women do not receive four visits.
  • 10. CONT.. • First visit: confirmation of pregnancy • Second visit: 20-28 weeks • Third visit: 34-36 weeks • Fourth visit: before expected date of delivery or when the pregnant woman feels she needs to consult health worker. Every woman should have a record file and every event should be written in it. If pregnancy is passing uneventfully these visits are enough but if complications arise we need more visits.
  • 12. FirstTrimesterVisit  Confirm intrauterine pregnancy and assess the gestational age.  We have to deal with complications that present with vaginal bleeding and abdominal pain.  Women can be investigated using history, examination, biochemical testing & trans-vaginal U/S to exclude non-viable pregnancy, ectopic pregnancy or hydatiform mole.
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  • 14. Second Trimester Visit  Assessment of maternal health & fetal growth & wellbeing.  The results of tests performed at 1st trimester visit are reviewed with the mother  The results of the U/S scan for fetal abnormality are also reviewed.  Any incidental maternal symptoms are dealt with, this period is also important in insuring the education of the woman regarding the rest of pregnancy & her delivery.
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  • 17. Third Trimester Visit  The primary objective of this visit is to anticipate any problems regarding the prospective delivery. Uterine fundal height, fetal lie, presentation & position are mandatory.  Vaginal examination will help us to check for any abnormality in the pelvis, cervical status, fetal presenting part, station & position.  Mode of delivery & planned contraception after delivery should is discussed at this time.
  • 19. HISTORY HISTORY TAKING /HEALTH HISTORY:  Identification data of the patient  Name  Age  Sex  Bed no.  Ward  Address  Nationality  Diagnosis  Religion  Education  Occupation  Dr. incharge  D.o.a  Source of information
  • 20. Cont..  Chief complaints  Present history of illness  Past medical history  Childhood illness  Immunization  Medical history  Surgical history  Personal history  Drug addiction  Dietary habits  Sleeping patterns  Nutritional patterns  Hygiene  Allergies  hobbies  Menstrual history  Age of menarche  Cycle  Duration  LMP  Dysmenorrhoea  Marital history  Age of marriage  Type of marriage  No. of children  Any sexual disorder  Relationship with husband
  • 21. Cont..  Past Obstetrical history  Mode of delivery  Still birth  Abortion  Year of last delivery  no. of live birth  Health of parents/sibling/spouse/child ren  Parents  Siblings  Spouse  Children  Family members  Family medical history  Family surgical history  Family tree  Psychosocial history  Primary language  Secondary language  House(rent/own)  Position of patient in family  Socio economic status of the patient.
  • 22. Cont..  Environmental history  Cleanness of house  Type of residence  Village/city/town  Water supply  Sanitation  Drainage system  Mode of transportation  Vital signs o Temperature o Respiration o Pulse o Blood pressure
  • 23. Cont..  Investigations- (Lab. Investigations )  Hb estimation Blood grouping, Rh typing ,  Urine R/M/E,  VDRL, RBS, HBs Ag test ,  USG for Pregnancy ,  Profile check Stool/ urine for the presence of albumin.  Pap test (if facilities)  Chest X-Ray and Gonorrhoea test(if needed).  Medication-  Other supportive therapies.
  • 25. Physical Examination  General appearance  Head and neck  Face  Eye  Nose  Ear  Mouth: lips, mucosa, tongue, teeth, neck  Breast inspection Shape Nipple shape Dryness Cracked nipple Scar formation Enlargement
  • 26. Cont..  Chest Symmetry Respiratory rate Apical pulse Percussion(fluid accumulation) Auscultation Wheezing sounds Heart rate Abdomen- Shape Abdomial girth Linea nigra Measurement of fundal height Fetal heart sounds Fetal movements Fetal parts multiple pregnancies Fetal lie and presentation Inspection of abdominal scar  Genital area Hygiene Tenderness Chadwick sign
  • 28. Cont.. Extremities  Range of motion  Pain  Leg cramps  Edema
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  • 30. Health Teaching During Pregnancy  Health promotion during pregnancy begins with reviewing :  Hygiene  Sleep  Breast care  Dental care  Dressing  Travel  Sexual activity  Exercises
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  • 32. Hygiene:  Daily bath is recommended, as it stimulation refreshing and relaxing.  Daily all over wash is necessary because it is stimulating, refreshing, and relaxing.
  • 33. CONTINUE…..  Hot bath should be avoided because they may cause fatigue & fainting.  Regular washing for genital area, axila, and breast due to increased discharge and sweating.  Vaginal douches should avoid except in case of excessive secretion or infection.
  • 34. SUMMARY  Definition and introduction of the topic  about antenatal care &  the goals of antenatal care,  antenatal visit &  the collection of history from the patient &  their heath teaching &  the hygiene about antenatal woman.
  • 35. BIBLIOGRAPHY  Dutta DC “textbook of obstetric”, edition 8th Jaypee publication, page 52-64  Myles “textbook for midwives”, 16th edition Elsevier publication, page no.55-77.  Jacob Annamma a comprehensive “textbook of midwifery and gynecological nursing” 3rd edition, Jaypee publication page no,37-51.