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  • PRENATAL CARE by Chamir - MD: BPS For High Risk

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    Neumir Ramos
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    This document provides information on prenatal care, including diagnosing pregnancy and recommended prenatal visits. It discusses signs and symptoms of pregnancy organized by trimester. These include amenorrhea, nausea, breast changes in the first trimester and quickening in the second. The height of the fundus is used to estimate gestational age. Physical exams include measuring vital signs, fundal height, listening for fetal heart tones, and Leopold maneuvers to determine fetal position and presentation. Prenatal visits are typically every 4 weeks until 28 weeks, every 2 weeks until 36 weeks, and weekly thereafter. Routine tests and vaccines are recommended based on gestational age. Weight gain and nutrition guidelines are also provided.

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    Prenatal needs

    Original Title

    Prenatal Care

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    This document provides information on prenatal care, including diagnosing pregnancy and recommended prenatal visits. It discusses signs and symptoms of pregnancy organized by trimester. These include amenorrhea, nausea, breast changes in the first trimester and quickening in the second. The height of the fundus is used to estimate gestational age. Physical exams include measuring vital signs, fundal height, listening for fetal heart tones, and Leopold maneuvers to determine fetal position and presentation. Prenatal visits are typically every 4 weeks until 28 weeks, every 2 weeks until 36 weeks, and weekly thereafter. Routine tests and vaccines are recommended based on gestational age. Weight gain and nutrition guidelines are also provided.

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    14 views1 page

    PRENATAL CARE by Chamir - MD: BPS For High Risk

    Uploaded by

    Neumir Ramos
    This document provides information on prenatal care, including diagnosing pregnancy and recommended prenatal visits. It discusses signs and symptoms of pregnancy organized by trimester. These include amenorrhea, nausea, breast changes in the first trimester and quickening in the second. The height of the fundus is used to estimate gestational age. Physical exams include measuring vital signs, fundal height, listening for fetal heart tones, and Leopold maneuvers to determine fetal position and presentation. Prenatal visits are typically every 4 weeks until 28 weeks, every 2 weeks until 36 weeks, and weekly thereafter. Routine tests and vaccines are recommended based on gestational age. Weight gain and nutrition guidelines are also provided.

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    © All Rights Reserved
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    of 1

    PRENATAL CARE by chamir_MD

    DIAGNOSIS OF PREGNANCY
    TIMING OF PREGNANCY
    PRESUMPTIVE SIGNS
    SYMPTOMS
    1) NAEGELES RULE- AOG by
    Amenorrhea
    Chloasma
    Nausea
    Menstrual age
    Breast enlargement
    Linea Nigra
    Vomiting
    + 7 days; -3 mos; +1 year
    Chadwicks (Vagina)
    Striae
    Urinary
    2) Quickening- (rough estimate)
    Gravidarum
    symptoms
    Multipara- 16-18wks
    Goodells (Cervix)
    Heagars
    (frequency)
    Primi- 18-20 wks
    (soft isthmus)
    Basal Body Temp by 0.3 to 0.5 C
    3) Height of Fundus
    PROBABLE SIGNS
    -Above symphysis pubis 12 wks
    Abdominal enlargement
    Physical outline of the fetus
    -b/n Symph pubis & umbilicus- 16
    Size, shape of uterus
    (+) serum beta hcg/
    wks
    Positive preg test
    - umbilicus 20 wks
    Braxton-hicks contractions
    20-34wks AOG correlate well w/
    POSTIVE SIGNS
    FH
    Fetal Heart rate separate from the mother
    OB Score G P (FPAL)
    4) By Trimester
    10 DANGER SIGNS OF
    1st tri- upto 14 wks
    PREGNANCY
    PHYSICAL EXAMINATION
    2nd tri 15- 28 wks
    1) Vaginal bleeding
    1) VS, Weight, BMI
    2) Watery vaginal
    PRENATAL VISITS
    2) Fundic ht
    discharge
    TRADITIONAL
    WHO
    3) Fetal heart tones
    3) Persistent vomiting
    q
    4wks
    upto
    28
    1x
    in 1st
    a. Doppler- 10wks
    4) Abdominal pain
    tri
    b. Stethoscope 16-20 wks
    5) Continuous headache
    q
    2
    wks
    upto
    Then at
    4) LEOPOLDS MANEUVER
    6) Blurring of vision
    36
    26,
    Breech- irregular nodular mass
    7) Fever & chills
    q
    week
    upto
    32, 38
    Head- Ballotable mass
    8) BP
    del
    wks
    LM1 Fundal grip
    9) No/ fetal movement
    Median
    of
    :
    8
    5 visits
    LM2- Umbilical grip (det fetal position
    10)
    Edema
    RECOMMENDED
    WEIGHT
    GAIN
    for FHT localization)
    2
    BMI
    (kg/m
    )
    TOTAL
    (lb)
    Wt gain in
    LM3- Pawlicks grip
    2nd& 3rd tri
    LM4- Pelvic grip (det fetal attitude by
    (lb/week)
    using cephalic prominence)
    <18.5
    (under
    28
    40
    1
    (1 - 1.3)
    5) Pelvic exam
    wt)
    18.5 24.9
    25 - 35
    1 (0.8 - 1)
    AOG
    Diag test/Vaccine/ Meds
    (Normal)
    0-14 wks
    Routine lab (CBC, ABO Rh, ua,
    25 29.9
    15 - 25
    0.6 (0.5 0.7)
    VDRL/RPR, HbsAg, Rubella,
    (Over
    wt)
    Paps smear, HIV)
    >30
    11 - 20
    0.5 (0.4 0.6)
    UTZ if indicated (bleeding, abd
    (obese)
    pain)
    RDA (daily)
    Start Folic acid, MV, Calcium
    Calories
    100- 300 kcal
    16-18 wks
    MSAFP- screening for NTD
    Protein
    5-6 grams
    : Multiple gest, Gastroschisis,
    Ferrous
    27
    mg
    of
    Iron supplement
    Congenital Nephrosis, Fetal
    7 mg
    Death, Cystic Hygroma
    Iodine
    220
    ug
    : Trisomy 21
    Calcium
    1000

    1300mg
    Start: FeSo4, cont all meds
    Zinc
    12 mg
    20-22 wks
    Congenital anomaly scan
    Folic
    acid
    400
    ug
    24-28 wks
    75g OGTT
    Vit
    B12
    2.6
    ug
    28 weeks
    BPS for high risk:
    Vit B6
    2 mg
    Vit
    C
    85
    mg
    27-36 wks
    TdAP
    Vit
    A
    750
    ug
    28-32 wks
    Rpt CBC, VDRL/RPR,
    Vit
    D
    15
    ug
    Rh (D) negative and
    Vit E
    15- 19 mg
    unsensitized for Antibody
    Vit
    K
    75- 90 ug
    screening (28-29wks)

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