HEALTH

MAINTAINANCE
IN PREGNANCY
G H I VA R E L A D R I E N S A
PEMELIHARAAN KESEHATAN SAAT
PRENATAL
• Prinsip :
– Mengurangi morbiditas dan mortalitas ibu
– Morbiditas dan peningkatan Kesehatan janin
– Perawatan bayi pada masa perkembangan
– Edukasi mengasuh anak
• Jenis (pemeriksaan Kesehatan berkala)
– Faktor risiko
– Skrining (deteksi dini untuk menemukan masalah dan identifikasi penyakit asimptomatik) = genogram
– Imunisasi
– Kemoprofilaksis (Fe, asam folat)
 ANTENATAL CARE
• Prenatal care should be initiated as soon as there is a reasonable likelihood of pregnancy. Major goals are to:
– Define pregnancy (probable, confirm)
– Define the health status of the mother and fetus
– Estimate the gestational Age
– (3) Initiate a plan for continuing obstetrical care.

• Initial Evaluation
– Prenatal record (GPA, durasi, komplikasi,trimester)
– Previous and current health status (disease which can affect pregnancy conditions)
– Gestational age assessment (LMP, fundal size, doppler, dev. milesones

• Further examinations
– Lingkungan (toxic agents and substance identification)
– Pap smear
– Lesions (if exist) examination
TAMBAHAN PEMERIKSAAN LAB

• 10-13 w : chromosome exam = fetal nuchal translucenct and B=HCG

• 15-20 w : triple (HcG, alfa fetal protein, estriol) /quadruple (triple + inhibin) screening for non-
screening mothers, obstetrical ultrasound
• 24-28 w : glucose challenge testing for gestational diabet, Hb and screen antibody (28 w)
• 35-37 w : Hep B S Ag, HIV, chlamydia, GBStreptococci
 ANTENATAL CARE: CLINICAL
EVALUATION
 Pregnancy Risk Assessment
 ANTENATAL CARE: SUBSEQUENT
PRENATAL VISIT
• Visit interval
– 4-week intervals until 28 weeks
– every 2 weeks until 36 weeks
– weekly thereafter. Women with complicated pregnancies often require return visits at 1- to 2-
week intervals.
 Prenatal surveillance & Subsequent Lab Tests (Similar to initial clinical evaluation)
 Selected Genetic Screening
• Selected screening for certain genetic abnormalities should be offered to those at
increased risk based on family history, ethnic or racial background, or age.
SUMBER

• Williams obstetrics
• Kedokteran keluarga di layanan primer
• WHO guidelines for antenatal care
• Lange’s obstetrics in FM