1/2 Introduced the topic According to WHO

min
PRENATAL OR
ANTENATAL period is
the process in which a
At the end of class human embryo or fetus
students will able to gestates during
: pregnancy(i.e fetal
development or
embryology) and from
fertilization until birth.

ANTENATAL EXAMINATION
1 min
Define antenatal Antenatal examination is a planned examination or observation for the Student teacher defines Define antenatal
examination. woman from conception till birth. antenatal examination. examination.

2 min OBJECTIVES OF ANTENATAL EXAMINATION

Enlist the objectives - To promote , protect and maintain the health of pregnant woman Student teacher enlist What are the
of antenatal - To detect high risk cases and give them special attention the objectives of objectives of
examination. - To forsee complications and prevent them antenatal examination. antenatal
- To remove anxiety associated with pregnancy associated with examination ?
pregnancy
- To reduce maternal and infant mortality and morbidity
- To teach elements of child care , nutrition, hygiene, and
sanitation
- To sensitize her regarding family planning
- To attend the under 5 clinic accompanying the mother
ANTENATAL EXAMINATION
 Elaborate the steps GENERAL EXAMINATION Student teacher What are the steps
of antental elaborate the steps of of antenatal
3 min examination  Body build antenatal examination. examination?
 Height/ weight
 Vital signs
 Head to toe examination
- Scalp
- Face
- Neck
- Breast examination
- Upper extremities
- Bowel and bladder
- Back
Lower extremities
ABDOMINAL EXAMINATION
INSPECTION
Preparation of Woman for Abdominal Examination:

 Ask the woman to empty the bladder before examination.

 Assist her for dorsal or supine position on the examination
couch with legs flexed.
 Provide emotional support.

INSPECTION
(a) Uterus

 Shape and size of abdominal contour.

 Foetal movements.
  Skin changes:
Linea nigra, linea alba and presence ofany scar.
(b) Check Abdominal Girth
(c) Check fundal height
(d) Foetus in Utero

 Foetal Lie
 Presentation
 Attitude
 Denominator
 Position
 Presenting Part
PALPATION
 FUNDAL GRIP
 LATERAL GRIP Student teacher
 PELVIC GRIP elaborate the abdominal
Elaborate the  PAWLIK GRIP palpations.
abdominal
5 min palpations for FUNDAL GRIP
antenatal -The palpation is done facing the patient’s face Explain the steps
examination of abdomainal
-The whole of the fundal area is palapated using both hands laid flat on
palpations
it to find out which pole of the fetus is lying in the fundus.
 Broad, soft, and irregular mass suggestive of breech
 Smooth, hard, and globular mass suggestive of head
LATERAL GRIP
-The hands are to be placed flat on either side of the umbilicus to
palpate one after other
-The sides and front of the uterus is palpated to find out the position of
the back , limbs and the anterior shoulder
 The back is suggested by smooth curved and resistant feel
 The limb side is comparatively empty and there are small
knob like irregular parts
PELVIC GRIP
-Four fingers of both the hands are placed on either side of the midline
in the lower pole of the uterus and parallel to the inguinal region
-The fingers are pressed downwards and backwards in a manner of
approximation of finger tips to palpate the part occupying the lower
pole of the uterus (presentation)
If it is head , the characteristics to note are:
 Precise presenting area
 Attitude
 Engagement
PAWLIK GRIP
-The examination is done facing toward the patient’s face
-The overstretched thumb and four fingers of the right hand are placed
over the lower pole of the uterus keeping the ulnar border of the palm
on the upper border of symphysis pubis
-When the fingers and the thumb are approximated, the presenting
part is grasped distinctly (if not engaged) and also the mobility
 from side to side is tested
-In transverse lie the pawlik grip is empty
AUSCULTATION

½ min AUSCULTATION Student teacher explains

that how fetal heart
Explain how fetal Foetal heart sounds can be hard with the Stethoscope from 18-20 weeks
sound can be heard
heart sound can be onwards. It states whether the foetus is alive or not. Normally, the
according to
heard according to foetal heart rate ranges from 120-140 beats/minute. presentation of fetus.
the presentation of
fetus.
How can the fetal
heart sound can
be heard
according to
presentation?

VAGINAL EXAMINATION
 Vaginal examination is generally done by the doctor when needed,
especially towards the end of pregnancy to ensure normalcy and
adequacy of pelvis to deliver the baby.
LABORATORY INVESTIGATIONS
It is necessary to take laboratory investigation for abdominal
examination. The following are the laboratory investigations.

 Haemoglobin
 Urinalysis (albumin. sugar and pus cells). (iii) Blood grouping
and rhesus typing. (iv) VDRL and HIV testing
 Pap smear
 Blood sugar

CALCULATING EXPECTED DATE OF DELIVERY

This is done according to Nagele’s formula, it. expected date of
delivery a Last menstrual period +9 months and 7 days, e.g., if last
menstrual period (LMP) date is 14/11/06 then the expected date
ofdelivery will be 21/08/07.
Indicators of the Foetal Well-Being:

 Uterine size compatible with gestational age of the foetus.

1 min  Normal and regular foetal movements (10 in 12 hours.)
 Foetal heart rate in range of 120-160/mt.
Student nurse discuss
ADVICE T0 PREGNANT WOMAN IN ANTENATAL PERIOD
the advices given to
Discuss the advices
 Nutrition antenatal mother
given to the
antenatal mother  Follow-up
  Rest
 Exercise and Work
 Comfort Measures
 Warning Signs of Pregnancy
 Minor Disorders of Pregnancy
 Sex SUMMARY What are the
 Preparation advices given to a
Antenatal examination is
antenatal mother?
a thorough and systemic
examination done in
order to diagnose
diseases or complicating
obstetric conditions
without symptoms, and
to provide information
about lifestyle,
pregnancy and delivery.

BIBLIOGRAPHY
- Dutta D.C ,Textbook of obstetrics,New Central Book
Agency,7th edition, 75-82
- Sira Sanju ,Textbook of Midwifery and Obstetrics,3rd edition,
171-179
- Bunnett V. Ruth ,Myles Textbook of Midwifery, 13th edition,
209-230