OBG Detailed Notes for Students
ANTENATAL CARE (ANC)
Definition
Antenatal care refers to the care and supervision given to a pregnant woman from conception until the onset of labor to ensure safe pregnancy and delivery.
Objectives of Antenatal Care
- To ensure healthy mother and healthy baby
- To detect high-risk pregnancies early
- To prevent maternal and fetal complications
- To provide nutritional guidance
- To educate mother about pregnancy, labor, and newborn care
- To prepare mother physically and psychologically
- To reduce maternal and neonatal mortality
Aims of Antenatal Care
- Early registration of pregnancy
- Regular antenatal check-ups
- Identification of complications
- Health education
- Immunization
- Nutritional support
- Components of Antenatal Care
- 1. History Taking
Personal History- Name
- Age
- Address
- Occupation
- Education
Menstrual History
- Last Menstrual Period (LMP)
- Expected Date of Delivery (EDD)
- Duration of cycle
Obstetric History
- Number of pregnancies
- Previous abortions
- Previous deliveries
- Complications in past pregnancies
Medical History
- Diabetes
- Hypertension
- Tuberculosis
- Heart disease
Family History
- Genetic disorders
- Twins
- Hypertension
2. Physical Examination
General Examination- Height
- Weight
- Blood pressure
- Pulse
- Temperature
- Respiratory rate
- Pallor
- Edema
Systemic Examination
- Cardiovascular system
- Respiratory system
- Abdomen
- Breast examination
3. Obstetric Examination
Abdominal Examination
Includes:
Inspection- Shape of abdomen
- Skin changes
- Linea nigra
- Striae gravidarum
Palpation
Includes Leopolds maneuvers:- Fundal grip
- Lateral grip
- Pawliks grip
- Pelvic grip
Used to assess:
- Fetal lie
- Fetal presentation
- Fetal position
Auscultation
- Fetal Heart Rate (FHR)
Normal: 110160 beats/minute
4. Investigations in Antenatal Care
Blood Tests- Hemoglobin (Hb)
- Blood group and Rh typing
- VDRL test
- HIV test
- Blood sugar
- Hepatitis B test
Urine Examination
- Albumin
- Sugar
- Infection
Ultrasound Scan
Used to detect:- Fetal growth
- Congenital anomalies
- Placenta location
- Amniotic fluid level
Immunization During Pregnancy
- Tetanus Toxoid (TT) or Td vaccine
Schedule:
- TT1: Early pregnancy
- TT2: 4 weeks after TT1
- Booster if previously immunized
Nutrition During Pregnancy
Diet Requirements- Extra 300 calories/day
- Protein-rich diet
- Iron-rich foods
- Calcium-rich foods
- Folic acid supplements
Important Nutrients
Iron
Prevents anemia
Sources:- Green leafy vegetables
- Dates
- Liver
Calcium
For bone development
Sources:- Milk
- Cheese
- Curd
Folic Acid
Prevents neural tube defects
Sources:- Spinach
- Citrus fruits
Danger Signs During Pregnancy
- Vaginal bleeding
- Severe headache
- Blurred vision
- Swelling of face and hands
- Severe abdominal pain
- Decreased fetal movements
- High fever
- Convulsions
These require immediate medical attention.
Minor Disorders of Pregnancy
- Nausea and vomiting
- Heartburn
- Constipation
- Backache
- Leg cramps
- Frequency of urination
High-Risk Pregnancy
Definition
Pregnancy in which mother or fetus has increased risk of complications.Risk Factors
- Age below 18 or above 35
- Previous cesarean section
- Hypertension
- Diabetes
- Multiple pregnancy
- Anemia
- Malpresentation
Health Education to Antenatal Mother
- Importance of regular check-ups
- Balanced diet
- Personal hygiene
- Adequate rest
- Avoid smoking and alcohol
- Breast care
- Preparation for labor
Nursing Management in Antenatal Care
- Monitor vital signs
- Record maternal weight
- Assess fetal growth
- Administer supplements
- Provide health education
- Detect complications early
- Maintain antenatal records
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