PRENATAL CARE

Things you need:

1. Tape Measure
2. Calculator
3. Stethoscope
4. Cellphone: OB app suite

Procedure:
1. Obtain History: OB Score

2. Ask LMP: Pattern, Amount and Duration (to diff. spotting vs menstruation)
MIDAS: Menarche, Interval, Duration, Amount, Symptoms (dysmenorrhea)

3. Naegele’s Rule: LMP + 7 days — 3 mo + 1 yr

4. Ask previous USD, Contraceptive methods, Laboratory, Pap smear

5. Ask the ff symptoms: fever, vaginal discharge, cough, colds, urinary pain

6. Ask if social history: smoking, alcohol

7. Compute for AOG (Age of Gestation) and Estimated Date of Confinement (EDC)
AOG:
Example 1:
LMP: Jan 19, 2018; Date Today: June 6, 2018

31 — 19 = 12 (January)
28 (Feburary)
31 (March)
30 (April)
31 (May)
6 (June)
AOG: 138 days OR 19 weeks 5/7 days

Example 2:
LMP: Sep 18, 2017 Date Today: June 6, 2018

30 — 12 18 (September)
31 (October)
30 (November)
31 (December)
31 (January)
28 (February)
31 (March)
30 (April)
31 (May)
6 (June)
261 days OR 37 2/7 weeks

8. Palpate abdomen for contractions and describe: intensity, duration, interval

9. Obtain Fundic Height
Bartholomew’s Rule: estimation of AOG based on the FH
Above pubic symphysis - 3 months
1/2 from PS to umbilcus -
Level of umbilicus - 20 weeks (5 months)
1/2 from umbilicus to xiphoid process - 7 months

McDonald’s Rule: Age of gestation = Fundic Height (18-32 weeks)

10. Perform Leopold’s Maneuver

AKA Descriptors
L1 Fundal grip Breech/Cephalic palpated
L2 Umbilical grip Fetal back/extremities on the L/R maternal side
L3 Pawlik’s grip Head ballotable(or not), (un)/engaged
L4 Pelvic grip Fetal neck flexed or extended (fetal attitude) OR
Vertex/Face presentation

11. Obtain Fetal Heart Tones, place stethoscope bell at the maternal abdomen where the fetal
back is located

12. Calculate the estimemtated Fetal weight based on Fundic Height

OPTION 1: JOHNSON RULE (11-12-155)

FH (in cm) — 12 x 155 = Fetal Wt in grams (if unengaged)

FH (in cm) — 11 x 155 = Fetal Wt in grams (if engaged)

OPTION 2:
FH — 13 x 0.34 = Fetal Wt in lbs / 2.2 = Fetal wt in grams

13. Ask for quickening