ANTENATAL CARE…

Presented by - Chitra.Gajanan.Date

3rd year basic b.s.c nursing

Terna nursing college

Defination

Systematic supervision(examination and advice) Systematic supervision(examination and advice) of a woman during pregnancy is called antenatal of a woman during pregnancy is called antenatal or prenatal care. or prenatal care.

Aims.…

1. to screen the high risk cases.1. to screen the high risk cases.

2. to prevent or detect and treat at earliest any complication .2. to prevent or detect and treat at earliest any complication .

3. to ensure continued medical surveillance and prophylaxis .3. to ensure continued medical surveillance and prophylaxis .

4. to educate mother about physiology of pregnancy and labour by 4. to educate mother about physiology of pregnancy and labour by demonstration of charts to reduce the fear and improve the psychology.demonstration of charts to reduce the fear and improve the psychology.

5.To discuss with couple about the place, time and mode of delivery, 5.To discuss with couple about the place, time and mode of delivery, provisionally care of newborn .provisionally care of newborn .

6.To motivate the couple about family planning and appropriate advice for 6.To motivate the couple about family planning and appropriate advice for medical termination of pregnancymedical termination of pregnancy

Objective

The Objective is to ensure a normal pregnancy The Objective is to ensure a normal pregnancy with delivery of healthy baby from a healthy with delivery of healthy baby from a healthy mother.mother.

ANTENATAL ADVICES

To impress the patient about the regular To impress the patient about the regular checkup.checkup.

To maintain or improve the health status of To maintain or improve the health status of women, diet, drug and hygiene.women, diet, drug and hygiene.

To improve and tone up the psychology and rule To improve and tone up the psychology and rule the fear. the fear.

Continued..

Diet – The diet during should be adequate to provide Diet – The diet during should be adequate to provide maintenance of maternal health, growth of fetus , maintenance of maternal health, growth of fetus , strength and vitality required during strength and vitality required during labour,successful lactation increase calorie labour,successful lactation increase calorie requirement due to growth of maternal tissue , requirement due to growth of maternal tissue , placenta.placenta.

The increased calorie requirement is the extent of The increased calorie requirement is the extent of 300 during second half of pregnancy the optimum 300 during second half of pregnancy the optimum weight gain must be of 11 kgsweight gain must be of 11 kgs

DIET…

The pregnancy diet ideally should be light nutritious The pregnancy diet ideally should be light nutritious easily digestible and rich in protien minerals and easily digestible and rich in protien minerals and vitaminsvitamins

The food must include milk ,gren leafy vegetables, The food must include milk ,gren leafy vegetables, fruits, salt for taste, first class protiens all amino acid fruits, salt for taste, first class protiens all amino acid fats , meat , and vitamin A ,D .fats , meat , and vitamin A ,D .

Dietetic advice should be given keeping Dietetic advice should be given keeping socioeconomic condition and food habbits and socioeconomic condition and food habbits and normal BMI of women. normal BMI of women.

Supplementary nutrition theraphy…

Dietetic iron is not enough to meet the daily Dietetic iron is not enough to meet the daily requirement specially In second half of pregnancy.requirement specially In second half of pregnancy.

The supplementary iron theraphy is needed for all The supplementary iron theraphy is needed for all pregnancy mothers from 16 week onwards one tablet pregnancy mothers from 16 week onwards one tablet of ferrous sulphate contains 60mg of elemental iron of ferrous sulphate contains 60mg of elemental iron and 2-3 tablets for lower hemoglobin level.and 2-3 tablets for lower hemoglobin level.

Essential vitamins are given daily from 20 week Essential vitamins are given daily from 20 week onwards .onwards .

Antenatal hygiene

Rest and sleep –the patient may continue her Rest and sleep –the patient may continue her exercise and activities but strenous activities must exercise and activities but strenous activities must be avoided specially in first trimester and last 4 be avoided specially in first trimester and last 4 weeks , the individual should sleep for 10 hours weeks , the individual should sleep for 10 hours specially in last 6 week. In late pregnancy lateral specially in last 6 week. In late pregnancy lateral position is more comfortable.position is more comfortable.

Bowel- there is a tendency of constipation during Bowel- there is a tendency of constipation during pregnancy ,bowel movements may be facilated by pregnancy ,bowel movements may be facilated by having fiber rich diet plenty water milk mild laxatives having fiber rich diet plenty water milk mild laxatives like Isafgul 2 tbs with warm milk can be given.like Isafgul 2 tbs with warm milk can be given.

Antenatal hygiene continue…

Bathing- the patient must bath daily but be careful of Bathing- the patient must bath daily but be careful of slipping in bathroom due to imbalance.slipping in bathroom due to imbalance.

Clothing shoe and belt- the patient should wear loose Clothing shoe and belt- the patient should wear loose but comfortable garments. High heels should be but comfortable garments. High heels should be avoided in advance stage of pregnancy.avoided in advance stage of pregnancy.

Dental care-the dentist should be consulted Dental care-the dentist should be consulted earliest ,to facilitate extraction or filling of tooth earliest ,to facilitate extraction or filling of tooth caries 2caries 2ndnd trimester is best for such procedures. trimester is best for such procedures.

Other advices

Care of breast – if the nipples are retracted Care of breast – if the nipples are retracted ,correction should be done and anatomically ,correction should be done and anatomically normal nothing is required beyond ordinary normal nothing is required beyond ordinary cleanliness.cleanliness.

Coitus- coitus should be avoided during first Coitus- coitus should be avoided during first trimester preferable during time of missed trimester preferable during time of missed period and also during last 6 weeks coitus must period and also during last 6 weeks coitus must be avoided in risk of preterm labour. Otherwise be avoided in risk of preterm labour. Otherwise its not harmful.its not harmful.

Other advices

Travel-travelling by vehicles with jerks are better to Travel-travelling by vehicles with jerks are better to be avoided in first trimester and last trimester. Long be avoided in first trimester and last trimester. Long journeys must be limited to second trimester. Rail journeys must be limited to second trimester. Rail route is preferable than bus route.travel in route is preferable than bus route.travel in pressurised aircraft offer less risk. AIR TRAVEL is pressurised aircraft offer less risk. AIR TRAVEL is contraindicated in PLACENTA PRAEVIA, PRE-contraindicated in PLACENTA PRAEVIA, PRE-ECLAMPSIA,SICKLE CELL Anemia ECLAMPSIA,SICKLE CELL Anemia

Smoking and alcohol – its better to avoid smoking Smoking and alcohol – its better to avoid smoking and drinking alcohol as it may result to abortion and drinking alcohol as it may result to abortion ,maldevelopment,growth restriction. ,maldevelopment,growth restriction.

Immunisation Live virus vaccines like Live virus vaccines like rubella,measles,mumps,varicella,yellow feverare rubella,measles,mumps,varicella,yellow feverare contraindicated, Rabies,hepatitis A and B vaccines contraindicated, Rabies,hepatitis A and B vaccines can be given in nonpregnant state.can be given in nonpregnant state.

Tetanus toxoids is given intramuscularly at 6 weeks Tetanus toxoids is given intramuscularly at 6 weeks of intervals 2 times between 16-24 week, booster of intervals 2 times between 16-24 week, booster dose of 0.5ml is given for woman who is immunised dose of 0.5ml is given for woman who is immunised in past in last trimester.in past in last trimester.

Drugs..

Drugs- all most all the drugs cross placenta to Drugs- all most all the drugs cross placenta to reach fetus possibility of pregnancy should be reach fetus possibility of pregnancy should be kept in mind while prescribing drug to any kept in mind while prescribing drug to any woman of reproductive age.woman of reproductive age.

Exercise

Pelvic floor exercise / kegel exercise Pelvic floor exercise / kegel exercise

Tailor sitting-Tailor sitting-

Wall side squat-Wall side squat-

Cont.

Knee extension-Knee extension-

Wall press-Wall press-

Cont.

General advices.

Attend antenatal care check up as per schedule Attend antenatal care check up as per schedule of visit. Report the physician about intense of visit. Report the physician about intense headache , disturbed sleep with restlessness , headache , disturbed sleep with restlessness , urinary trouble, epigastria pain, vomiting.urinary trouble, epigastria pain, vomiting.

She should be hospitalized if painful uterine She should be hospitalized if painful uterine contraction at interval of 10 mins for an hour contraction at interval of 10 mins for an hour

Sudden gush of watery fluid, bleeding Sudden gush of watery fluid, bleeding paravaginal. paravaginal.

Minor aliments of pregnancy

Nausea and vomiting .Nausea and vomiting .

BackacheBackache

ConstipationConstipation

Leg crampsLeg cramps

Acidity and HeartburnAcidity and Heartburn

Varicose veinsVaricose veins

Ankle edemaAnkle edema

Vaginal discharge Vaginal discharge

Nausea and vomiting

Backache

Constipation.

Leg cramps

Acidity and Heartburn

Varicose veins…

Ankle edema

Vaginal discharge ..

RESEARCH

Dr. Tom Brewer found through more than 30 years of research that Dr. Tom Brewer found through more than 30 years of research that each day, pregnant women need a well-balanced, high-quality diet each day, pregnant women need a well-balanced, high-quality diet that includes 80 to 100 grams of protein, adequate salt (to taste), that includes 80 to 100 grams of protein, adequate salt (to taste), and water (to thirst), as well as calories from all of the food groups. and water (to thirst), as well as calories from all of the food groups. The World Health Organization recommends that a pregnant woman The World Health Organization recommends that a pregnant woman eat a minimum of 75 grams of protein per day, but protein is just a eat a minimum of 75 grams of protein per day, but protein is just a marker for a nutritious diet. It must be obtained from a wide variety marker for a nutritious diet. It must be obtained from a wide variety of whole food sources in order to get all of the important nutrients a of whole food sources in order to get all of the important nutrients a woman needs during pregnancy. While the government’s food woman needs during pregnancy. While the government’s food pyramid is a good example of a well-balanced diet, pregnant women pyramid is a good example of a well-balanced diet, pregnant women need more protein and calories in general. While this may seem like need more protein and calories in general. While this may seem like a lot of food, it will supply the 2000 to 3000 calories needed per day a lot of food, it will supply the 2000 to 3000 calories needed per day to make a healthy baby.to make a healthy baby.

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