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During the first prenatal visit, the nurse establishes a baseline data that will serve as her
basis for planning health promotion strategies all throughout the woman’s pregnancy. It
begins with obtaining a health history, screening for possible exposure to teratogens (any
factor that may adversely affect the fetus), and identifying problems that the woman
maybe experiencing, which may adversely affect her pregnancy.

An extensive health history, a complete physical assessment (including pelvic

examination) and laboratory work ups are done to evaluate the woman’s health status
and determine possible health risks associated with the pregnancy. Fetal development,
age and possible problems is also determined during the prenatal visits.

Extensive health history is an important measure for screening for danger signs. It includes:

a. Demographic/biographic data

b. Chief concern/complaint

c. History of Past Illnesses/ Past medical and surgical history

d. History of family illnesses

e. Social history

f. Gynecologic History

g. Obstetric history

h. Review of systems

The physical examination includes inspection of major body systems, with emphasis on
the changes that occurs during pregnancy and or that signals the presence of problems.
Physical assessment is usually done in a head-to-toe manner.

Several laboratory studies are also included in the assessment to confirm general health
and rule out sexually transmitted infection that could injure the growing fetus.

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 The following blood studies are usually obtained during the first prenatal visit:

TEST PURPOSE
To detect infection, anemia, or cell
Complete blood count (CBC)
abnormalities
To detect anemia; often checked several
Hemoglobin (Hgb) or hematocrit (Hct) times
during pregnancy
Blood grouping, Rh factor, and
To determine blood type to screen for
antibody
maternal-fetal blood incompatibility
screen
Venereal Disease Research Laboratory
(VDRL) test or rapid plasma reagin To screen for syphilis
(RPR)
Rubella titer To determine immunity
Purified protein derivative (PPD)
To screen for tuberculosis
Tuberculin skin test
Genetic testing (for sickle cell anemia,
Done if there is an increased risk for certain
cystic
genetic
fibrosis, Tay-Sachs disease, and other
conditions
genetic conditions)
To detect presence of antigens in maternal
Hepatitis B screen
blood
Voluntary test encouraged at first visit to
Human immunodeficiency virus (HIV)
detect
screen
HIV antibodies
Urinalysis To detect renal disease or infection
Glucose challenge test To screen for gestational diabetes

Furthermore, there are also diagnostic tests that are available to determine possible
disorders. Before pregnancy, karyotyping of both parents and an already affected child
can provide a picture of the chromosome pattern that can be used to predict
occurrences in future children. Once a woman is pregnant, several other tests may also
be done to help in the prenatal diagnosis of a genetic disorder. These include maternal
serum alpha-fetoprotein (MSAFP), chronic villi sampling (CVS), amniocentesis,
percutaneous umbilical blood sampling (PUBS), ultrasound, and fetoscopy.

Property of and for the exclusive use of SLU. Reproduction, storing in a retrieval system, distributing, uploading or posting online, or
transmitting in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise of any part of this document, without
the prior written permission of SLU, is strictly prohibited. 2