CMCA SL

➢ Minimum 4 visits
Prenatal Care I. As soon as the pregnancy is suspected (for
registration & first checkup)
➢ Periodic and regular supervision including
II. 26 weeks
examination and advice of a woman during
III. 32 weeks
pregnancy.
IV. 36 weeks
➢ Supervision should be of a regular and periodic
(At least one visit at home by health worker)
nature in accordance with the need of the
individual.
Role of the Nurse in Prenatal Care

Aims of Prenatal Care 1. REGISTRATION

➢ To screen high risk
➢ To prevent or detect complications
➢ To ensure continued medical surveillance and
prophylaxis
➢ To educate the mother about the physiology of
pregnancy and labor by demonstrations, charts, and
diagram.
➢ To discuss with the couple the place, time, and
mode of delivery, provision and care of the NB
➢ To motivate the couple about the need of family
planning
➢ To advice the mother about BF, post-natal care and
immunization
Key Aspects in Prenatal Care
1. Early prenatal visits
2. Regular check ups
3. Monitoring fetal development
4. Nutritional guidance
5. Lifestyle recommendations
6. Screening tests
7. Education & counseling
8. Addressing complications
9. Birth planning
10. Post partum care planning
Antenatal Visits
▪ To assess the health status
▪ To identify and manage high risk cases
▪ To estimate EDD accurately
▪ To give the first dose of TT (after 12 weeks)
▪ To help the woman for an early and safe abortion
▪ To start the regular dose of folic acid during the
first trimester
2. PRENATAL SERVICES FOR MOTHERS
▪ Health history
▪ Physical examination
▪ Laboratory examination (urine/stool/blood, pap
test, CXR)
▪ IFA
▪ TT immunization
▪ Health education
▪ Home visit
▪ Referral
TETANUS TOXOID (TT) IMMUNIZATION
 At first contact with woman of reproductive age or
at first antenatal care visit, as early as possible.
[TT1]
 At least 4 weeks after TT1 (at next antenatal care
visit). [TT2]
 At least 6 months after TT2. [TT3]
 At least 1 year after TT3. [TT4]
 At least 1 year after TT4. [TT5]

➢ Ideally 13 visits
• 7 in first 7 months 3. MAINTENANCE OF RECORDS
• 2 in 8th month ▪ Antenatal card
• 4 in 9th month ▪ Antenatal register

BATTAD, A.E.
 CMCA SL

4. ANTENATAL CHECKUP Expected Date of Confinement

▪ History
 To diagnose pregnancy ➢ The expected date of delivery (EDD) in obstetrics,
 To identify any complications during commonly referred to as the due date, is an estimate
previous pregnancies of when a pregnant woman is likely to give birth.
 To identify any medical/obstetrical conditions ➢ It is typically calculated based on the woman’s last
that may complicate pregnancy menstrual period (LMP)
▪ Age of the woman ➢ The EDD is an approximation, and not all
 Complications when less than pregnancies will result in the baby being born on
16/greater than 40 that exact date.
▪ Order of pregnancy
 Primi gravida and multipara Calculating Estimated Date of Delivery
▪ Birth interval
 Less than 3 years ❑ EDC: When is the baby coming
❑ EDB: Estimated/Expected date of birth
5. PREVIOUS PREGNANCIES/OBSTETRIC ❑ EDD: Estimated/Expected date of delivery
HISTORY ❑ Average length of pregnancy:
▪ Number of earlier ➔ Approximately 40 weeks/280 days
pregnancies/abortions/deliveries ➔ 1st Trimester: Weeks 1 – 12
▪ Number of premature ➔ 2nd Trimester: Weeks 13 – 27
births/stillbirths/neonatal deaths ➔ 3rd Trimester: Weeks 28 – 40 (or up to 42
▪ Hypertensive DO of pregnancy weeks)
▪ Prolonged/obstructed labor ➔ Pregnancy ends 2 weeks before or 2 weeks
▪ Malpresentation after the calculated EDD
➔ Naegele’s Rule
6. HISTORY OF ANY SYSTEMIC ILLNESS
▪ Hypertension Procedure: EDC
▪ Diabetes mellitus
▪ Heart disease 1. Determine the last normal menstrual period
▪ Tuberculosis ✓ Normality
▪ Renal disease ✓ Regularity
▪ Convulsions
✓ Character
▪ Asthma 2. Consider the 1st day of the LMP
3. Consider the month in numerical term
Last Menstrual Period 4. Use the Naegele’s formula

 Refers to the date of a woman’s most recent

Naegele’s Rule
menstrual period before she becomes pregnant.
 It is an essential piece of information used to
❑ Is a standard way of calculation the due date for
estimate the gestational age of the pregnancy.
a pregnancy.
 This information is used as a reference point for
❑ The rule estimates the expected date of delivery
prenatal care and monitoring the health and
(EDD) by adding one year, subtracting three
development of both the mother and the fetus.
months, and adding seven days to the first day of
a woman’s last menstrual period (LMP).

BATTAD, A.E.
 CMCA SL

❑ The result is approximately 280 days (40 weeks) ❑ Example:

from the start of the last menstrual period. LMP: Jan 5, 2023
❑ Another method is by adding 9 months and 7 1 5, 2023
days to the first day of the last menstrual period. +9 +7
EDC:10 12, 2023
➢ When solving for an EDD with Naegele’s Rule DOV: Apr 4, 2023
it is important to remember that months that
have 30 days vs. 31 days. AOG:
➢ And of course, February has 28 days. Always Jan – 31 – 5 = 26
give February 28 days (regardless of leap year) Feb – 28
to avoid confusions. Mar – 31
➢ The months with 30 days are September, April, Apr – 4
June, and November while the other months are 89/7 = 12 weeks & 5 days
31 days.
LMP: Sept 12, 2022
9 12, 2022
Note: Use the knuckle trick to easily differentiate
-3 +7 +1
which month are 30 and 31 days! UwU
EDC: 6 19 2023
DOV: Jan 25, 2023
❑ How to calculate the EDD using this rule?
➔ January to March (+9+7) AOG:
➔ April to December (-3+7+1) Sept – 31 – 12 = 18
❑ Example: Oct – 31
LMP – Jan. 05, 2023 Nov – 30
01 05, 2023 Dec – 31
+09 +7 Jan – 25
EDC – 10 12, 2023 135/7 = 19 weeks & 2 days

LMP – Sept. 12, 2023  Try It Out

08 12, 2023 (Use the back of the paper or any paper)
-03 +7 +1 1. LMP: January 5, 2023
EDC – 06 19, 2024 2. LMP: August 12, 2023
3. LMP: February 25, 2023
Age of Gestation (AOG) 4. LMP: May 10, 2023
5. LMP: June 30, 2023
❑ Age of fetus
❑ Step ❑ DOV: September 26, 2023
✓ Determine the 1st day of the LMP
✓ Subtract the total # of days of the calendar
month from the day.
✓ Add the total number of days of the month
following the month of the LMP un to the
present date
✓ Divide into 7

BATTAD, A.E.