Transcript Antenatal care

References
-Book of Readings. Nursing Practice 2015 .
-Ladewig, P., London, M., Olds, S.(2012) Maternal
Newborn Nursing Care. Forth Edition. Addison
Wesley.
-Papalia, D.E., & Feldman, R.D. (2013) Human
Development.12th Edition, McGraw Hill. New York.
Antenatal care
The systematic supervision
of women during pregnancy.
Aims:
1.Promote and maintain
maternal and fetal
health and welfare.
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2. Detect early and treat problems that
occur.
3. Prepare the woman and her family for the
labour, delivery and care of the baby.

Achieved by:
1. Education of mother and family
regarding pregnancy, labour and care
of the baby.
2. Social and psychological support- to
own optimal wellness
3. Regular attendance for ongoing
antenatal assessment and
appropriate actions to problems that
arise.
Lead Maternity Caregiver (LMC)
-Takes responsibility for the care of the
woman during her pregnancy, labour,
delivery and postnatal period.
(independent midwife, GP, obstetrician,
group
Midwives, team based at hospital)
The LMC role includes:
-
antenatal care during the pregnancy
Support during labour and the birth of the
baby (midwife)
postnatal care from the baby’s birth until
4-6 weeks after the birth.
- refers to Well Child provider.
Antenatal History
A thorough antenatal history is taken in an
attempt to identify all existing factors
which may compromise a healthy mother
and baby.
These include:
-medical
-surgical,
-family,
-gynaecological,
-past obstetric, present obstetric
Frequency of visits.
-4 weekly until 28 weeks gestation
-2 weekly until 36 weeks gestation
weekly until the birth of the baby.
Routine assessments include:
1. Maternal status / wellbeing
-general health (physical and emotional)
-blood pressure
-weight
-urinalysis (? protein-glucose- ketones)
Why are these tests important?
2. Fetal status / wellbeing
- abdominal examination (size, shape
indicates gestation of the pregnancy)

-kick chart / fetal movement chart
-fetal heart rate.
Abdominal examination.
 The height of the abdomen indicates
fetal growth

Assessing the position of the fetus
General assessments include
-the date of quickening

-braxton-Hicks contractions
-diagnostic tests ( haemoglobin, STDs
Rh status)
Fetal movement chart / Kick Chart




non-invasive assessment of fetal well
being carried out by the mother.
Mother notes on the chart the time when
she has felt 10 kicks each day (she starts
counting at the same time each day eg
0700 hours).
-a pattern will emerge over a few days.
If the pattern changes to very few or no
kicks late in the day contact her LMC


Supine Hypotension
When a pregnant woman lies on her back ,
the weight of the growing uterus presses
the vena cava against the verebrae,
obstructing blood flow from the lower
extremities.
Supine hypotension
-causes decreased blood return from the
heart and consequently decreased
cardiac output and hypotension
-woman feels light headed and nauseous,
may produce less blood flow to the
placenta.

ROLL her onto her side
AVOID letting pregnant woman lie flat on
their backs
A pregnant woman should contact her
doctor with any of the following:
-vaginal bleeding
-premature labour
-rupture of the membranes
-decreased fetal movements
-severe headaches, visual blurring or
“spotting of vision”, swelling
explain why?

Prenatal Testing
For various reasons some pregnant women
maybe offered prenatal testing.

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Reasons include:
-maternal age
-indicators from previous pregnancy
-previous child with a congenital abnormality
-family history of known conditions
-mother’s medical history
-unknown dates
-assess fetal wellbeing
Maternal serum screening test
-estimates risk of having a child with a
chromosomal abnormality

-performed between 15 and 17 weeks
gestation.
Ultrasound
-using an ultrasound fetal wellbeing can be
observed:
-through assessing growth, size and
length of bones and skull a close estimate
of the gestation can be made.

-fetal organs
-fetal movements
-the position of the placenta

Fetal Nuchal Translucency Test (NT)
-screening to detect chromosomal
abnormality.
A scan at 11-14 weeks measures the size
of the collection of fluid under the skin
behind the fetal neck.
Provides a risk estimate or
probability of an abnormality.
Normally is less than 2.5 mm

Chorionic villus sampling (CVS)
between (11-12 weeks ) tissue is
taken from the developing placenta
-amniocentesis: 15 -16 weeks

An ultrasound guides, a needle into the uterus
through the abdomen
-both tests take fluid or tissue directly.
Chromosomal analysis is available from
the tissue.
Results are available 2-3 weeks later.
Both procedures carry the risk of
miscarriage (up to 1%)
Childbirth education classes
-available from: -maternity hospital
-private childbirth
educators
-independent midwives
-Parent Centre, Homebirth
Association
-Marae based classes

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Benefits from attending antenatal classes
include:
-learn about the labour and birth process
-learn and prepare coping strategies for
labour
-meet other families
-
Antenatal care : key points
1.Promote and maintain maternal and fetal
health and welfare.
2. Detect early and treat problems that
occur.
3. Prepare the woman and her family for the
labour, delivery and care of the baby.