Antenatal Care Flashcards
What are the visiting week for antenatal
The first visit or initial visit should be made as early is pregnancy as possible.
Return Visits:
Once every month till 28 w.
Once every 2 weeks till the 36 w
Once every week, till labor.
Frequency of antenatal care
Nulliparous with an uncomplicated pregnancy, a schedule of 10 appointments.
Parous with an uncomplicated pregnancy, a schedule of 7 appointments.
How many fetal kick count?
¡The pregnant woman reports at least 10 movements in 12 hours.
Absence of fetal movements precedes intrauterine fetal death by 48 hours
Total weight and height during pregnancy?
Height of over 150 cm indication of an average-sized pelvis
The approximate weight gain during pregnancy is 12 kg.; 2kg in the first 20 weeks and 10 kg in the remaining 20 weeks (1.5 kg per week until term
What is symphysis and when should be measured?
Symphysis–fundal height should be measured and recorded at each antenatal appointment from 24 weeks.
When do you check fetal presentation
Fetal presentation should be assessed by abdominal palpation at 36 weeks.
When do you hear fetal heart sound? How can it be heard?
Fetal heart sound is heard by sonicaid as early as 10thweek of pregnancy.
Fetal heart sound is heard by Pinard’ s fetal stethoscope after the 20thweek of pregnancy.
Why urine be tested?
¡Urine should be tested for ketones and protein.
Urinary frequency relief measures?
Urinary frequency
RELIEF MEASURES:
÷Decrease fluid intake at night.
÷Maintain fluid intake during day.
÷Void when feel the urge.
Nasal stuffiness and estrogen - cause and management
ETIOLGY: Elevated estrogen levels
¡RELIEF MEASURES :
÷Avoid decongestants.
Use humidifiers, and normal saline drops
Ptyalism? Excessive saliva?
ETIOLGY: Unknown
RELIEF MEASURES:
÷Perform frequent mouth care.
÷Chew gum.
÷Decrease fluid intake at night.
÷Maintain fluid intake during day.
Management of nausea and vomiting
- most cases of nausea and vomiting in pregnancy will resolve spontaneously within 16 to 20 weeks.
- that nausea and vomiting are not usually associated with a poor pregnancy outcome.
- non-pharmacological:
- ginger
- P6 (wrist) acupressure
- pharmacological: antihistamines.
÷dry crackers or toast before rising in morning.
÷ Eat small, frequent meals.
÷Avoid sudden movements. Get out of bed slowly
÷Breath fresh air to help relieve nausea.
÷Avoid food or smells that exacerbate condition.
Vericosities management
÷Rest in sims’ position.
÷Elevate legs regularly.
÷Avoid crossing legs.
÷Avoid long periods of standing
Hemorhoide. management
RELIEF MEASURES:
÷Maintain regular bowel habits.
÷Use prescribed stool softeners.
÷Apply topical or anesthetic ointments to area.
Constipation management
÷Maintain regular bowel habits.
÷Increase fiber in diet.
÷Increase fluids.
÷Find iron preparation that is least constipating
Backache measures
÷Wear shoes with low heels.
÷Walk with pelvis tilted forward.
÷Use firmer mattress.
÷Perform pelvic rocking or tilting
LEG CRAMP MANAGEMENT
¡RELIEF MEASURES:
÷Extend affected leg and dorsiflex the foot.
÷Elevate lower legs frequently.
÷Apply heat to muscles.
Faintness managment
RELIEF MEASURES:
- Rise slowly from sitting to standing.
- Evaluate hemoglobin and hematocrit.
- Avoid hot environments
When should pregnant women have ultrasound?
Pregnant women should be offered an early ultrasound scan between 10 weeks 0 days and 13 weeks 6 days to determine gestational age and to detect multiple pregnancies.
Why combined test is used?
The ‘combined test’ (nuchal translucency, beta-human chorionic gonadotrophin, pregnancy-associated plasma protein-A) should be offered to screen for Down’s syndrome between 11 weeks 0 days and 13 weeks 6 days
Risk factors for gestational diabetes
body mass index above 30 kg/m2
previous macrosomic baby weighing 4.5 kg or above
previous gestational diabetes (refer to ‘Diabetes in pregnancy
family history of diabetes (first-degree relative with diabetes)
family origin with a high prevalence of diabetes:
¡South Asian (specifically women whose country of family origin is India, Pakistan or Bangladesh)
¡black Caribbean
¡Middle Eastern (specifically women whose country of family origin is Saudi Arabia, United Arab Emirates, Iraq, Jordan, Syria, Oman, Qatar, Kuwait, Lebanon or Egypt).
When is screening for sickle cell performed?
Screening for sickle cell diseases and thalassaemias should be offered to all women as early as possible in pregnancy (ideally by 10 weeks
When is anemia screening is performed
Screening shouldtake place early in pregnancy (at the booking appointment).
at 28 weeks when other blood screening tests are being performed.
At 36 weeks
11 g/100 ml at first contact and 10.5 g/100 ml at 28 weeks) should be investigated and iron supplementation considered
When is anti-D given ?
Women should be offered testing for blood group and rhesus D status in early pregnancy.
To give anti-D at 28 weeks and post delivery if the baby (+)
Hepatitis B, Rubella or hepatitis C which should be performed routinely?
HEP B- not done routinely
Rubella and Hep B is done done routinely
Folic acid recommendation?
Start before conception and throughout the first 12 weeks.
reduces the risk of having a baby with a neural tube defect (for example, anencephaly or spina bifida).
The recommended dose is 400 micrograms per day.
Vitamin D recommendation
women at greatest risk are following advice to take this daily supplement. These include:
women of South Asian, African, Caribbean or Middle Eastern family origin
women who have limited exposure to sunlight, such as women who are predominantly housebound, or usually remain covered when outdoors
women who eat a diet particularly low in vitamin D, such as women who consume no oily fish, eggs, meat, vitamin D-fortified margarine or breakfast cereal
women with a pre-pregnancy body mass index above 30 kg
What dose of vitamin A is teratogonic?
Vitamin A supplementation (intake above 700 micrograms) might be teratogenic and should therefore be avoided
Iron is routine or not? Dont confused with folic acid?
Iron supplementation should not be offered routinely to all pregnant women. It does not benefit the mother’s or the baby’s health and may have unpleasant maternal side effects.
