Anc antenatal care

Anc antenatal care

Anc antenatal care

Systematic supervision (examination and care ) of a women during pregnacy is called antenatal care
anc comprie of

careful history taking and examination (general and obstretical)
advice given to pregnant women

procedure at first visit



history taking

gravida -denotes pregnant state both present and past irrespective of period of gestation
parity -denotes previous pregnancy beyond the period of viability

EDD

naegeles formula -by adding 9 calender months and 7 days to first day of the last normal (28 days) period

general examination

built, nutrition, hight, weighit, pallor, laundice, tongue, gums, teeth, oedema of legs
bp -disappeasence of sounds rather than muffling of sound is best representation of distolic pressure during pregnancy
heart lungs liver spleen
breasts

obstetrical examination

abdominal
vaginal -done when pt attends clinic for first time before 12 weeks
ultrasound exam.

routine exam.

1 exam. Of blood
for -Hb , ABO ,Rh grouping and VDRL
screening for blood glucose in selected pt
2 urine
for- proteins sugar and pus cells
clean catch specimen of midstream urine is collected
3 cervical cytology study by papanicolau stain has become a routine in many clinics
special investigation
ultrasound exam. -first trimester scan either transabdominal or transvaginal helps to detect -1 early pregnancy 2 accurate dating 3number of fetuses 4 gross fetal anomalies 5 any uterine pathology

b) Serological tests for rubella and hepatitis
c) maternal serum alpha feto proteine

repeatation of investigations

1 Hb estimation is repeated at 28 and 36 week
2 urine is tested for protein and sugar at every anc visit

schedule

generally check up is done at interval of 4 weeks upto 28 weeks
at interval of 2 weeks upto 36 weeks and thereafter weekly till expected date of delivery

w h o recommendation
the visits may curtailed to at least 4  visits
fist  in 2 trimester around 16 weeks
second between 24-28 weeks
third at 32 weeks
fourth at 36 weeks    

subsequent visits

history - 1 appearence of new complaints  2 date of quickning
general exam. 1 weight 2 pallor 3 oedema of legs 4 blood pressure
abdominal exam

antenatal device

1 diet
supplementsy nutritional therapy -supplementsy iron therapy is needed for all pregnant women from 16 weeks onwards
above 10gm% hb 1 tab of ferrous sulphate containing 60 mg of elemental iron is enough

anc hygine
following advices are given
rest and sleep . Bowl . Bathing . Clothing .dental care .care of breasts . Coitus travel . Smoking and alchohol . Drugs

immunisation

tetanus
immunisation against tetanus not only protects the mother but also fetus
0.5 ml tetanus toxide i m  at 6 weeks interval for 2 such first 16-24 Weeks

women who immunised in past a booster dose of 0.5 ml is given in the last trimester