5. AIMS
1 . To screen high risk pregnancy
2 . Prevant & treat complication
3 . To continue medical survellence
4 . To educate mother about physiology
of pregnancy & labour by
demonstration charts & diagrams
5 . To discuss with couple about
place,time & mode of delivery
6 . Need of family planning
7. CRITERIA OF NORMAL
PREGNANCY
1. Retrospective term
2. Delivery of a single baby between
38-42 weeks by date, weight 2.5
kg with no maternal complication
9. OBJECTIVES
1.Asses health status of mother &
foetus & screen out at risk
pregnancy
2.Base line information above
subsequent changes are
assessed to determine
gestational age
10. HISTIRY TAKING
VITAL STATISTICS
Name
Age
Gravida/Para
Religion
Occupation
Occupation of husband
Period of gestation
Complaints
If no complaints then inquire about
sleep,appetite,bowel habit,urinary problems
12. OBSTETRICAL HISTORY
Number of living child
-boy
-girl
Health status of Baby
Immunisation
Last issue
MENSTRUAL HISTORY
1. LMP
2. Regular cycle
E.D.D
Naegele’s formula
13. PAST MEDICAL HISTORY
PAST SURGICAL HISTORY
FAMILY HISTORY
High BP
Diabetes
Thyroid disorder
Blood Dyscrasia
PERSONAL HISTORY
Smoking
Alcohol
Contraception
21. OBJECTIVE
Foetal well being
Lie , presantation , position &
number of foetus
Growth restriction , pre
eclampsia anaemia ,
polyhydroamnios
Special antenatal clinic for
cardiac diseases & diabetes
Chorion villous sampling or
amniocentesis when indicated
23. ABDOMAN EXAMINATION
Fundal height
Second trimester external ballotment
Third trimester
abdominal palpation
-presantation
-position
-Volume of liquor
Abdominal girth increases by 1 inch per
week beyond 30 weeks
26. DIET
Adequate
1 . Maternal health
2 . Need for growing foetus
3 . Strength of vitality required
during labour
4 . Successful lactation
Normal 1800 to 2000 + 300
calory
27. PREGNANCY DIET
SHOUD BE
Rich in –Carbohydrates
-Proteine
-Vitamins
-Mineral
It shoud be –Light
-Nutritious
-Easily digestible
32. BATH
CLOTHES/SHOES/BELT
DENTAL CARE
-Extraction
-Filling carries tooth
CARE OF BREAST
Retracted nipple – correction done by
manipulation or by using shields
34. GENERAL ADVICE
Come to hospital if
1.Painful uterine contraction
2.Sudden gush of watery fluid per
vaginum
3.Any vaginal bleeding
35. MATERNAL EXERCISE , DANCE ,
YOGA THERAPY
COCHRANE REVIEW
Pregnant woman engaged in vigorous
exercise of atleast 2-3 times a week
1 . Pregnancy of same length
2 . Improves physical fitness
3 . No late pregnancy complication
36. BENEFITS OF EXERCISE
Strengthens the muscle
Improve posture
Give enegy & improve mood
Decreased discomfort of
pregnancy
Increased sleep,stamina,strength
37. BENEFITS TO INFANT
LESS BODY FAT
LESS CRANKY & LESS
INFANTILE COLIC
GREATER
NEURODEVELOPMENTAL
SCORE AT 5 YEAR
39. RISK OF SEDENTARY LIFE
Decreased muscular tone
Decreased cardio vascular fitness
Excessive maternal weight gain
Development of varicose vein
PIH
DVT
Dyspnoea
Low back pain
Poor psychological adjustment
41. 1.ANTENATAL CARE AT
PRIMARY HEALTH CENTRE
TETANUS TOXOID immunisation
Iodide & folate supplementation
Breast feeding counselling
Identification of major risk of
obstructed labour
42. 2.CHRMOSOMAL
ABNORMALITY
1 . FIRST TRIMESTER
-beta HCG
-PAPP(pregnancy associated plasma
proteine)
2 . SECOND TRIMESTER
triple marker
It includes-AFP
-HCG
-unconjugated oestrogen
43. QUADRUPLE TEST
Fourth biochemical marker
INHIBIN-A it is increased in down’s
syndrome
FACTORS AFFECTING MARKERSFACTORS AFFECTING MARKERS
-maternal weight
-no of foetus
-smoking
-ethinicity
-gravidity & parity
-assisted reproduction
-diabetes
44. OSCAR CLINIC
ONE STOP CLINIC FOR ASSESMENT
OF RISK FOR FOETAL ANOMALY
Beta HCG + PAPP & USG for nuchal
translucency + crown rump length +
anomaly scan carried out between 11 to
14th
weeks