INTR0DUCTI0N

0F
ANTENATAL
CARE
NURUL NADÌAH JAAFAR
INTR0DUCTI0N
W 1he care of a pregnanL woman durlng Lhe Llme
ln Lhe maLernlLy cycle LhaL beglns wlLh
concepLlon and ends wlLh Lhe onseL of labor
AIMS
W 1o provlde evldenceŴ based lnformaLlon and supporL Lo woman and Lhelr
parLnerŦ
W 1o advlse on mlnor problems Ǝ sympLoms of pregnancyŦ
W 1o assess maLernal Ǝ feLal rlsk facLors aL Lhe onseL of pregnancyŦ
W 1o faclllLaLe of prenaLal screenlng Ǝ subsequenL managemenL of any
abnormallLles deLecLed
W 1o monlLor feLal and maLernal wellŴ belng LhroughouL pregnancy Ǝ screen
commonly occurrlng compllcaLlon
W 1o deLermlne Llmlng Ǝ mode of dellvery when compllcaLlon arlse or lf
pregnancy conLlnues afLer LuuŦ
CLASSlllCA1lCn
Shared
care
CommunlLy
based care
PosplLal
based care
Sbared eare
W 9rovlded by a hosplLal maLernlLy Leamţ C9 and
communlLy mldwlves
W Women are booked ln under a named consulLanL and
seen ln Lhe hosplLal for Lhe booklng vlslL by a member
of Lhe consulLanLs Leam
W MosL low rlsk women are noL revlewed agaln by Lhe
hosplLal Leam unLll afLer Lhey have pasLed Lhelr Luu
W All oLher rouLlne check ups are carrled ouL by
communlLy Leam
W Women who are hlgh rlsk or experlence problems can
be referred back for hosplLal care
CommunIry
based eare
W ooklng appolnLmenL carrled ouL by
communlLy mldwlfe
W 8ouLlne scans and lnvesLlgaLlons are also done
by communlLy mldwlfe and lnLerpreLed by
communlLy Leam
W Cenerally offered Lo low rlsk women
W 9rovldes greaLer degree of conLlnulLy of care
ospIraI
based eare
W An exLenslon of shared care
W More focused for women who are hlgh rlskŦ
W lnvolves a sLrucLured program of vlslLs Lo
hosplLals anLenaLal cllnlc whlch may well be
hlghly speclallzed (eŦgŦ an anLenaLal cllnlc for
women wlLh dlabeLes)
W Whlchever mode of care ls chosen Lhe women
ls lssued wlLh a seL of paLlenLŴheld records ln
whlch all healLhcare professlonals wrlLe lnŦ
ln18CuuC1lCn Cl An1LnA1AL
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Pow Lo dlagnose?
W 4 meLhod ť
lŦ PlsLory Laklng
llŦ Looklng for slgn and sympLoms
lllŦ 9hyslcal examlnaLlon
lvŦ 1esL
W 1he classlc presenLaLlon of pregnancy ls a woman wlLh regular
menses who presenLs wlLh AMLnC88PLAţ nauseaţ vomlLlngţ
generallzed malalseţ and breasL LendernessŦ
W A compleLe medlcal hlsLory should be obLalnedţ lncludlngŤ
1Ŧ 9revlous Medlcal hlsLory
2Ŧ 9asL obsLeLrlc hlsLory
3Ŧ 9revlous gynecologlcal hlsLory
4Ŧ Soclal hx
3Ŧ MensLrual hx
6Ŧ lamlly hx
1Ŧ 9revlous Medlcal hlsLory
W Meds may be LeraLogenlc or alLer feLal physlology
W 9regnancy may cause a deLerloraLlon (or lmprovemenL) ln a coexlsLlng medlcal
condlLlon
W CLher healLh problems may lncrease pregnancy rlsk
2Ŧ 9asL obsLeLrlc hlsLory
W 9revlous pregnancy compllcaLlons
W ueLalls of prevlous labours and dellverles
3Ŧ 9revlous gynaecologlcal hlsLory
W lnferLlllLy or recurrenL mlscarrlage
W Cynaecologlcal surgery
4Ŧ Soclal hx
W smoklngţ alcoholţ llllclL drugs
3Ŧ lamlly hx
W ulabeLes lncreases rlsk of gesLaLlonal dlabeLes
W 9reŴeclampsla
W 1hromboembollc dlsease lncreases rlsk of uv1 or 9L
W AuLolmmune dlsease?
6Ŧ MensLrual hx
W menarcheţ duraLlon ť days per cycleţ flowţ hx of lrregular mensesţ
W use of conLracepLlve meLhodsţ
W uA1L Cl CnSL1 Cl LAS1 9L8lCu (LM9)

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