ANTEPARTUM CARE

• Refers to the medical and nursing

care given to the pregnant
women between conception and
the onset of labor
FERTILIZATION

• Union of an ovum and a spermatozoon

• Occurs in the AMPULLA
• Ovum is capable of fertilization for only 24-48 hours
• Functional life of a spermatozoa is about 48-72 hours.
IMPLANTATION

•It is the contact between the growing

structure and the uterine endometrium.
•8-10 days after fertilization
• Pregnancy is the carrying
of one or more offspring
in a fetal stage of
development by female
mammals, including
humans, inside their
bodies, between the
stages of conception and
birth.
GESTATION

• 10 LUNAR MONTHS
• 4 weeks each
• 40 weeks of gestation

• 9 CALENDAR MONTHS
• 3 trimesters
• 3 months each trimester
GESTATION

• CONCEPTIONAL AGE (in weeks)

• refers to the time since fertilization

• GESTATIONAL AGE or menstrual age

• refers to the time since the first day of the last menstrual
period (LMP)
• 2 weeks (before fertilization) are added from LMP
Concept of pregnancy

• All maternal body systems are altered by pregnancy. These changes

are normal, inevitable and temporary
Physiologic changes of
pregnancy
• Physiologic changes of pregnancy can be categorized as:
1.Local
2.Systemic
Physiologic changes of
pregnancy
• Reproductive changes
• Uterine changes
• Cervical changes
• Vaginal changes
• Ovarian changes
• Breasts changes
• Systemic Changes
1.Integumentary system
2.Respiratory system
3.Temperature
4.Cardiovascular system
5.Urinary system
6.Skeletal system
7.Endocrine system
8.Immune system
• PREGNACY VIEWED AS A NORMAL PHYSIOLOGIC PROCESS NOT A
DISEASE PROCESS.
• A STATE OF WELLNESS IT IS NOT AN ILLNESS
• THE SIGNS AND SYMPTOMS OF PREGNANCY
1.Presumptive signs of pregnancy
2.Probable signs of pregnancy
3.Positive signs of pregnancy
Presumptive signs of pregnancy

• Breast changes
• Nausea and vomiting
• Amenorrhea
• Frequent urination
• Fatigue
• Uterine enlargement
• Quickening
• Linea nigra
• Melasma
• Striae gravidarum
Presumptive signs of pregnancy

• Breast changes
• Feeling of tenderness, fullness or tingling; enlarging and
darkening of the areola
• The montgomery’s tubercles become pronounced
• Increased vascularity
• 16th week, colostrum can be expelled fom the nipples
Presumptive signs of pregnancy

• Nausea and vomiting

Nausea – sensation often leading to
vomiting
Vomiting – expelling emesis or
vomitus from the stomach
Presumptive signs of pregnancy

• Amenorrhea
• Absence of menstruation
Presumptive signs of pregnancy

• Frequent urination
• Sense of having to void frequently
Presumptive signs of pregnancy

• Fatigue
• General feeling of tiredness
Presumptive signs of pregnancy

• Uterine enlargement
• Uterus can be palpated over symphysis pubis
Presumptive signs of pregnancy

• Quickening
• Fetal movement felt by the mother
Presumptive signs of pregnancy

• Linea nigra
• Line of dark pigment on the abdomen
Presumptive signs of pregnancy

• Melasma
• Dark pigment on face
 Presumptive signs of pregnancy
• Striae gravidarum - red streaks on abdomen
Probable signs of pregnancy

• Serum laboratory tests

• Chadwick’s signs
• Goodel’s sign
• Hegar’s sign
• Sonographic evidence of gestational sac
• Ballottement
• Braxton Hicks contractions
• Fetal outline felt by examiner
Probable signs of pregnancy

• Serum laboratory
tests
• Tests of blood serum
reveal the presence of
human chorionic
gonadotropin
hormone
• Positive: 8-10 days
after fertilization or
3-4 days after
implantation
Probable signs of pregnancy

• Chadwick’s signs
• Chadwick's sign is a bluish (or cyanotic) cervix. It can usually be
observed around 4 weeks gestation by inspecting the cervix.
Probable signs of pregnancy

• Goodell’s sign
• softening of the cervix.
Probable signs of pregnancy

• Hegar’s sign
• Softening of the lower uterine segment
Probable signs of pregnancy

• Sonographic evidence of gestational sac

• Characteristic ring is evident
 Probable signs of pregnancy

• Ballottement
• When lower uterine
segment is tapped on
a bimanual
examination, the
fetus can be felt to
rise against abdominal
wall
Probable signs of pregnancy

• Braxton Hicks contractions

• Periodic uterine tightening occurs
Probable signs of pregnancy

• Fetal outline felt by

examiner
• Fetal outline can be
palpated through
LEOPOLD’S
MANEUVER
Positive Signs of Pregnancy

• Fetal Heart Tone

• Ultrasound
 Care of the Woman During
Antepartum Period
• A. Initial Prenatal Assessment

1. Health History
2. Determination of EDC
3. Assessment of Risk Factors
4. Physical Examination
5. Laboratory and Diagnostic Studies
6. Evaluation of Fetal Well-Being(Doppler- 10-12
weeks; fetoscope-20weeks)
*Includes ultrasound, fundic height, quickening and
other procedures(amniocentesis, fetoscopy,MSAFP)
• B. Subsequent Prenatal Assessment

1.History and Physical Assessment

2. Psychosocial Assessment
3. Dietary Assessment
• C. Assessment of Common Discomforts
1st Trimester
-morning sickness
-nasal stuffiness
-urinary frequency
-breast tenderness
-ptyalism
-leukorrhea
-headaches
• 2nd and 3rd Trimester
-heartburn
-ankle edema
-varicose veins
-hemorrhoids
-constipation
-backache
-leg cramps
-faintness
-SOB
-difficulty in sleeping
-round ligament pain