3.2c Variations in Prenatal Care

Question 1

Variations in Prenatal Care

Answer 1

Due to

• Culture
• Maternal Age
• Number of fetuses
• Health/OB history

Question 2

Cultural Prescriptions/Proscriptions

Answer 2

Prescriptions - Tell women what to do
Proscriptions - Establish taboos (forbidden)

Cultural Prescriptions/Proscriptions regulate emotional response, clothing, activity, sexual activity, and dietary practice

Question 3

Adolescent Care

Answer 3

• Less likely to get adequate prenatal care
• More likely to smoke
• Less likely to gain adequate weight during pregnancy
• Risk of LBW is high

Question 4

Risks for adolescent pregnancy

Answer 4

• Maternal anemia
• Preterm birth
• Preeclampsia
• HELLP Syndrome (high blood pressure)
• Postpartum hemorrhage
• Chorioamnionitis (Bacteria infection of chorion and amnion)

Question 5

Women over 35 care

Answer 5

Multiparous - Intentionally or unintentionally got pregnant in perimenopausal period
Primigravidae - Deliberately delayed childbearing until late 30s early 40s or had fertility issues in the past

• Greater chance of hypertension and diabetes

Question 6

Women over 35 risks

Answer 6

Fetal loss - Miscarriage, Still Birth
Medical Complications - Diabetes, Hypertension
OB Complications - Placenta Previa, Placental Abruption, C-section, Pregnancy related mortality
Fetal Complications - Chromosomal Abnormalities, LBW, Preterm, Multiple Gestation

Question 7

Multifetal Pregnancy

Answer 7

• Increases in chance with use of assisted reproductive technology (ART) and women over 35
• Places mother at increased risk
• Prenatal care should be scheduled more frequently and diagnostic tests more often
• Hyperemesis Gravidarum - Significantly increased hormones
• Increase blood volume causing cardiovascular strain
• Anemia due to higher iron demands
• Diastasis of rectus abdominus muscles

Question 8

Risks of Multifetal Pregnancy

Answer 8

Miscarriage, Neonatal Death
Gestational Diabetes
Hypertension
Preeclampsia
Placenta previa
Postpartum Hemorrhage 
Preterm Birth
IUGR 
LBW
Congenital Abnormalities
Cerebral Palsy (affects balance and posture) 
Risk of fetal death 
- Shunting of blood between placentas
(One twin will be larger and other will be smaller and malnourished) 
(Larger twin may develop congestive heart failure within 24 hours of birth)