HEALTH PROMOTION

DURING PREGNANCY
 Learning Objectives
1.Identify the components of prenatal visits.
2.Calculate the age of gestation based on the
different methods.
3.Develop a plan or program on health
promotion.
 Objectives of Antenatal Care
• Early, accurate estimation of gestational age.
• Identification of the patient at risk for complications.
• Ongoing evaluation of the health status of both
mother and fetus.
• Anticipation of problems and intervention, if
possible, to prevent or minimize morbidity.
• Patient education and communication.
 What is the adequate no of visit ?

nulliparous • a schedule of ten

with an appointments
uncomplicated should be adequate
pregnancy

multiparous • a schedule of seven

with an appointments
uncomplicated should be adequate
pregnancy
 In the United States

every four to every two to

five weeks three weeks weekly until
from 1st visit from 28 to 36 delivery
until 28 weeks weeks
What to in the antenatal clinic ?
 Complete
History

Estimated
Plan to
Date Of
next visits Delivery

1st Appointment

Patient Physical
Education Examination

Laboratory
Tests
 History

Physical
Plan to next Examination
visits (BP, Fundal
height)
Other Visits

Patient Laboratory
Education Tests
History Taking
 Initial prenatal social and demographic
assessment
• Names of patient, partner, emergency contact
• Marital status
• Age
• Home address
• Telephone numbers for day, night, emergency
• Education
• Occupation
• Partner's name and occupation
• Pediatrician
• Primary care physician
• Hospital for delivery
• Religion (Jehovah's witness?)
 Initial prenatal social and demographic
assessment

• Date of delivery
• Gestational age at delivery
• Location of delivery
• Sex of child
• Birth weight
• Mode of delivery
• Type of anesthesia
• Length of labor
• Outcome (miscarriage, stillbirth, ectopic, etc.)
• Details (ex., type of cesarean section scar, forceps, etc.)
• Complications (maternal, fetal, child)
Initial prenatal menstrual history
• Last menstrual period (definite or
uncertain?)
• Last normal menstrual period
• Previous menstrual period
• Cycle length
• Recent use of hormonal contraception?
• Menarche
• History of IUD use?_____ Date
removed:_____
 Current pregnancy history
• Medications taken
• Alcohol use
• Cigarette use
• Recreational drug use
• Exposure to radiation
• Vaginal bleeding
• Nausea, vomiting, weight loss
• Infections
• Exposure to toxic substances
• Restricted diet
Prepare the Woman and her Family for
Childbirth
• Counsel on:
*Proper nutrition and self care during pregnancy

*Breastfeeding and family planning

• Birth Plan
❖Where she will deliver, transportation
❖Who will assist her delivery
❖What to expect during labor and delivery
❖What to prepare, estimated cost of delivery
❖Possible blood donors; where will she be
referred in case of emergency
 DANGER SIGNS DURING PREGNANCY
Visual disturbances – blurring, double vision,
or spots
Swelling of the face, fingers or over sacrum
Headaches – severe, frequent, or continuous
Muscular irritability or convulsions
Persistent vomiting – beyond 1st trimester,
severe vomiting at anytime
Fluid discharge from the vagina –
bleeding or amniotic fluid
Signs of infection – chills, fever, burning
on urination, and diarrhea
Pain in abdomen – severe or unusual
Change in fetal movement – absence of
fetal movements after quickening, any
unusual pattern or amount.
 Important Estimates
• Naegele’s Rule – the average duration of
pregnancy calculated from the 1st day of
LMP. Average close to 280 days, 10 lunar
months, or 40 weeks.

Formula : LMP -3 +7 +1
 Age of Gestation (AOG)
Mc Donald’s rule
Formula: age of gestation in weeks = Dx8/7
D = distance in centimetres (symphysis
pubis to the fundus)
K = constant (8/7)
 Estimated Fetal Weight
Johnson’s rule- used clinically to correlate fundic height with fetal
weight.
Formula:
Estimated fetal weight in grams=K(x-n)

• X=fundic height(cm)
• N=11 if the station of the fetal head is below the ischial spine
(engaged)
• = 12 if the presenting part is above the ischial spine
(unengaged)
• K = 155 constant
• Note: for patient greater than 200lbs N is raised by 1.
 Seat work
Compute the following: 1. 14, 2021
1. EDD by Naegle’s rule FH – 24 cms Mwt. 178lbs
2. AOG by Naegle 2. Dec. 31, 2020
3. AOG by Mc Donalds FH – 36cm Mwt. 210lbs
4. Estimated fetal weight 3. May 8, 2021
by Johnson Rule FH – 15 cms Mwt.158lbs
Thank You!