Care of Mother, Child, and Adolescents

PRENATAL CARE TRANS BY: SEAN VINCENT A. RODRIGUEZ

BSN 2-A

OUTLINE
I. PRENATAL CARE
A. Objectives of Prenatal Care
II. DETERMINATION OF ESTIMATED
BIRTHDATE
A. EDC/EDD
B. Age of Gestation (AoG)
i. Traditional Way Based on
LMP
ii. Mc Donald’s Rule
iii. Bartholomew’s Rule
III. FETAL MOVEMENT
A. Sadovsky Method
B. The Cardiff Count-to-Ten chart
Reference: Sande-BUCN-ppt
PRENATAL CARE
• It is the monitoring and managing of a
patient during pregnancy to:
o prevent complications
o promote a healthy outcome for both the
mother and infant
OBJECTIVES OF PRENATAL CARE
• Screening & Prevention of diseases which
may complicate pregnancy
• Education of women on danger and
emergency signs & symptoms
• Birth Preparedness & Complication
readiness of the woman and her family for
childbirth
HOW TO GET THE LMP PROPERLY
Ma’am Sande
● Kailan po ang unang patak ng dugo ng huling
regla mo? (Day 1)
● When was the first drop of your menstrual
blood of your last menstrual period?
Months with 31 in calendar:
1. January
2. March
3. May
4. July
5. August
6. October
7. December
DETERMINATION OF ESTIMATED BIRTHDATE
EDC/EDD
Naegele’s Rule
• Standard method used to predict the length
of pregnancy by determining the Last
Menstrual Period (LMP) of the mother.
• From LMP you deduct 3 months plus 7 days
plus 1 year (April-December).
• From LMP add 9 months and 7 days
(January-March).
EDC Computation:
Patient A: = LMP (April 11, 2021)
1. Less 3 months = January
2. Plus 7 days = 18
3. Plus 1 year = 2022
= EDC is January 18, 2022
Patient B: = LMP (September 27, 2021)
1. Less 3 months = June
2. Plus 7 days = 34 days
a. September has 30 days so add
1 month to June and the
remaining 4 days.
3. Plus 1 year = 2022
= EDC is July 4, 2022
Patient C: = LMP (December 28, 2021)
1. Less 3 months = September
2. Plus 7 days = 35
a. December has 31 days so add
1 month to September and the
remaining 4 days.
3. Plus 1 year = 2022
= EDC is October 4, 2022
AOG (AGE OF GESTATION)
• Age of the unborn child/fetus.
• Gestation = pregnancy (layman’s term)
• Measured in weeks
• 2nd data/information that needs to get
during pre-natal assessment

BSN MAIN 2-A

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 PRENATAL CARE

1. Traditional Way Based on LMP

• Adding the total number of days of the
month from LMP up to the time of visit then
divide by 7 to determine the AOG in weeks.
• AOG is expressed in fraction.
• Note: always add 1 day (e.g., 13 1/7 weeks).

COMPUTE FOR AOG

Situation:
Date of Prenatal Visit: August 24, 2022
LMP: May 25, 2022 (May has 31 days)
Note: Consider the date of LMP as day 1.
• May = 7 days
• June = 30 days
• July = 31 days
• August = 24 days
• Total = 92 days/7
AOG = 13 1/7weeks
The woman is 13 weeks and 1 day
pregnant.
The fetus is 13 weeks and 1 day old.
2. Mc Donald’s Rule
• A method of determining AOG during mid-
pregnancy by measuring fundal height.
• Distance from the fundus to the symphysis
pubis in cm is equal to week of gestation
between the 20th and 31st week of
pregnancy.
• Preparatory steps
o Introduce yourself and identify your client
by getting her full name.
o Explain the procedure
o Provide client’s privacy
o Wash hands
• Implementation
o Let the woman void
o Assist her to lie in supine position
o Drape the client exposing only the
abdomen
o Walk your fingers up the side of the belly.
o Find the top of the uterus (it feels like a
hard ball under the skin).
o You can feel the top by curving your
fingers into the belly
• Using the fundal height measurement to
compute the AOG in weeks/months.
o Length of fundus in cm x8/7 = AOG in
weeks.
o Length of fundus in cm x 2/7 = AOG in
months.
• Becomes inaccurate
o During the 3rd trimester of pregnancy
(fetus is growing more in weight than
height).
o Patients who are obese or with fibroids or
myoma (abnormal growths in the uterus)
Situation:
Date of pre-natal visit: August 1, 2022
• Measurement of Fundal Height: 20 cm
o Get AOG in weeks (20 cm x 8)/7 = 22 6/7
weeks.
o Get AOG in months (20 cm x 2)/7 = 5-6
months
• Implication
o FH greater than this standard suggests:
Computed AOG is wrong
Multiple pregnancy
Polyhydramnios (too much
amniotic fluid)
Motor pregnancy (abnormal form
of pregnancy)

BSN MAIN 2-A

2
 PRENATAL CARE

Pregnancy with myoma or Ovarian 1. Sadovsky Method

Tumor • Mother on left recumbent position after a
meal and record how many fetal movements
she feels over the next hour.

• 2x10 min (average of 10-12x/hour)

• FH much less than suggests: • Less than 5 (call health care provider)
Computed AOG is wrong
Baby is not growing well – Intra-Uterine 2. The Cardiff Count-to-Ten chart:
Growth Restriction (IUGR) • The patient records fetal movements during
Oligohydramnios the course of usual daily activity.
3. Bartholomew’s Rule • Warning Signal:
• To determine age of gestation by fundal • 12 hours without at least 10 perceived
location. movements” patient should be evaluated
and should undergo further testing e.g., NST

------------------------- END OF TRANS -------------------------

Fetal Movement
1. Vary: depends on the sleep cycles of fetus and
mother’s activity during observation time.
2. Quickening: 18th – 20th week.

BSN MAIN 2-A

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