Prenatal Care .

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Prenatal Care.
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Prenatal Care - Introduction

• Prenatal care focuses on prevention
• Majority of pregnant females will deliver
• without major complications
• Goal of prenatal care is to select females at
• risk for development of major complications
• and early prevention/intervention in order to
• affect improved outcome

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Prenatal Care

• Decide who will provide care
• Obstetrician-Dr. who specializes in the care of
  the female and her child
• Certified nurse-midwife- advanced practical nurse
  who specializes in prenatal care and deliveries
• Where will birth take place?
• Hospital- most common
• Birthing Center- facility in which low-risk women
  can deliver their babies in a more home like
  setting
• Home

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Gestational Age

• Outcome in pregnancy is gestational age dependant
• Calculation of gestational age is made using a
  variety
• of methods
• Patient history
• Initial pelvic exam/biochemical test of
  pregnancy
• Fetal heart auscultation (10-11 or 18-19 weeks)
• Serial fundal height measurement (at umbilicus -
  20 weeks)
• Ultrasound estimation of gestational age
• Dating (U.S.) best based upon MENSTRUAL
• DATING (Last normal menstrual period to
  estimate date of confinement 40 7-day weeks

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Ultrasound

• Real time images produced on computer screen
  using sound waves
• Used to monitor fetus in uterus
• Determines how well the fetus is developing
  including organ development
• ULTRASOUND VIDEO

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Laboratory Tests

• Blood typically drawn each Dr. Visit
• Hemoglobin/hematocrit
• Urinalysis
• Glucose testing (gestational Diabetes)
• Blood Type
• Test for STDs
• Numerous other tests

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Additional Testing

• High risk pregnancies at risk for fetal loss
  receive antenatal testingat least once per week
• Non Stress testing
• Contraction stress testing
• Other tests as ordered by Dr.
• AMNIOCENTESIS VIDEO

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Visit Interval - Pregnancy(Uncomplicated
Patient)

• Conception until 26-28 weeks gestational age -
  Every 4 weeks (Pelvic exam on first visit)
• 28-36 weeks gestational age - Every 2 weeks
• 36-40 weeks gestation - Every week (Pelvic exam
  at least by term)
• High risk pregnancy may alter visit intervals
• Preterm labor risk may alter pelvic exam interval

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Possible Concerns

• Bleeding
• Decrease in fetal movement
• Swelling
• Headache
• Visual Disturbance
• Contractions
• Leakage of Fluid

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Weight Gain

• It is normal for female to gain between 20-40 lbs
  during pregnancy
• Too much increased risk of gestational diabetes
• Gestational Diabetes
• Too little risks for fetus

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Health of Fetus

• Females must be very careful about what they take
  into their body
• Everything she takes baby does too!

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Tobacco

• Smoking is estimated to count for up to
• 30 of low birth weight babies
• 14 of premature birth
• 10 of all infant deaths
• Studies also suggest that smoking during
  pregnancy can affect growth, mental development,
  and behavior
• Females exposed to secondhand smoke can also have
  increased risks

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Alcohol

• ANY alcohol consumed during pregnancy quickly
  passes through the umbilical cord to the fetus.
  Alcohol breaks down much more slowly in a fetus
  then in an adult, therefore fetus may have much
  higher BAC then mother and it will stay higher
  for longer.

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Alcohol and Pregnancy

• Fetal Alcohol Syndrome- group of alcohol related
  birth defects that can cause both physical and
  mental problems
• Mental retardation
• Learning disabilities
• Serious behavior problems
• Slowed Growth
• Physical deformities
• Heart defects
• FAS is entirely preventable by avoiding alcohol
  completely during pregnancy as well as for those
  considering pregnancy

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Medicines and other drugs during Pregnancy

• Using drugs while pregnant can have serious
  consequences even OTC medications
• Babies can be born addicted to the drug mother
  used while pregnant
• ALL MEDICINES should be discussed with Dr. before
  taken

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Environmental Hazards- some environmental
substances can be harmful to fetus when exposed
to mother

• Lead- linked to miscarriages, mental
  disabilities, and behavior problems
• Smog- linked to birth defects, low birth weight,
  premature births, stillbirth, and infant death
• Radiation- x-rays can affect fetal growth and
  cause mental retardation
• Cat litter- may contain parasite which can cause
  Toxoplasmosis which can result in miscarriage,
  premature labor, and health problems in a newborn.

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• As a pregnant mother you are your unborn childs
  lifeline. You are solely responsible for the
  health of your baby for the next 9 months he or
  she is in you