PRENATAL

CARE
PRESENTED BY: CHARLOTTE MONQIUE M. CAPUA
 PRENATAL CARE

ENSURE UNCOMPLICATED PREGNANCY

AND HEALTHY MOTHER AND NEWBORN

IDENTIFY THOSE AT HIGH RISK FOR

COMMON PREGNANCY COMPLICATIONS
 MOST COMMON PREGNANCY
RELATED COMPLICATIONS

1. GESTATIONAL
DIABETES
4. INTRAUTERINE
GROWTH
RESTRICTION

2. PRE- ECLAMPSIA TRAUMA OR

5. VIOLENCE
PRE-TERM
3. LABOR/DELIVERY
 PRENATAL CARE SCHEDULE

 1ST VISIT AT 6-8 WEEKS

 EVERY 4 WEEKS UNTIL
24 WEEKS
 EVERY 2 WEEKS 26-36
WEEKS
 WEEKLY 36 WEEKS
UNTIL DELIVERY
1ST PRENATAL VISIT

ESTABLISH
GESTATIONAL AGE
IDENTIFY RISK
FACTORS
HISTORY
PHYSICAL EXAM
LABS
 ESTABLISHING
GESTATIONAL AGE

 LAST MENSTRUAL PERIOD (LMP)

 PHYSICAL EXAMINATION
 ULTRASOUND
 INTRAPARTAL CARE

Intrapartum care Intrapartum period

extends from the beginning of
contractions that cause cervical dilatation
to the first 1 to 4 hours after delivery of
the newborn and placenta.
 TRUE AND FALSE LABOR
FALSE LABOR TRUE LABOR

● CONTRACTIONS MAY BE ● REGULAR CONTRACTIONS

IRREGULAR ● PROGRESSIVE FREQUENCY
● DECREASE IN FREQUENCY AND INTENSITY
AND INTENSITY ● SHORTER INTERVAL
● LONGER INTERVAL BETWEEN BETWEEN CONTRACTIONS
CONTRACTIONS ● ACTIVITY INCREASE
● ACTIVITY HAS NO EFFECT OR CONTRACTIONS
DECREASE CONTRACTIONS
FETAL PRESENTATION
 Intrapartum pain experience
overview of pain
 factors affecting perception of intrapartum pain.
 physiologic causes of intrapartum pain.
 uterine anoxia.
 compression of the nerve ganglia in the cervix.
 stretching of the cervix.
 traction on, stretching of the perineum.
 pressure on the urethra, bladder and rectum during fetal
descent.
 distension of the lower uterine segment.
 Intrauterine pain experience
OVERVIEW OF GOALS
● NONE PHARMACOLOGIC PAIN MANAGEMENT
● PHARMACOLOGICAL PAIN MANAGEMENT
● NARCOTIC ANALGESICS
● BARBITURATES
● TRANQUILIZERS
● REGIONAL ANESTHESIA
● GENERAL ANESTHESIA
 POST PARTAL CARE
 More than 60% of maternal
deaths take
place during postpartum period
 First 48 hours are most crucial
 Most maternal and neonatal
complications
occur during this period.
First postpartum visit
First postpartum visit: Mother
 First postpartum visit: Mother
Management / Counseling

1. Postpartum care and hygiene

Advise the mother to
Wash perineum daily and after passing urine and stools
Change perineal pads every 4 - 6 hours
Wash hands frequently and take bath daily
First postpartum visit: Mother
 First postpartum visit: Mother

4. IFA Supplementation
Women with normal Hb are advised to take 1 IFA tablet daily
for 3 months
If Hb below 11 gm%, advise her to take 2 IFA tabs daily and
repeat Hb after 1 month

5. Contraception
Counsel couple regarding contraception
First postpartum visit: Mother
NEWBORN
CARE
 IMMEDIATE BASIC CARE OF
NEWBORN
 AS MAJORITY BABIES CRY AT BIRTH AND TAKE SPONATANEOUS
RESPIRATION, NO RESUSCITATION REQUIRED AT BIRTH IN ABOUT
95-98% NEONATES
 THESE HEALTHY NORMAL NEONATES NEED ONLY WARMTH,
BREASTFEEDING, CLOSE OBSERVATION FOR EARLY DETECTION
OF PROBLEMS AND PROTECTION FROM INFECTIONS AND
INJURIES
 AFTER CUTTING THE UMBILICAL CORD ASEPTICALLY THE BABY
SHOULD BE KEPT DRIED, WRAPPED WITH DRY AND WARM CLOTH,
EXAMINE THOROUGHLY AND QUICKLY TO ASSESS NORMAL
CHARACTERISTICS, TO DETECT CONGENITA MALFORMATION AND
THEN PUT THE MOTHER’S BREAST.
 IMMEDIATE BASIC CARE OF
NEWBORN
 IDENTIFICATION TAG TO BE TIED TO THE MOTHER AND BABY
 RECORDING TO BE DONE ACCURATELY ABOUT THE EVENT OF
THE BIRTH OF THE BABY (ESPECIALLY BIRTH DATE, TIME, SEX,
EXAMINATION FINDINGS OR PRESENCE OF ANY PROBLEM ETC.)
IN THE DELIVERY RECORD SHEET
 THE MOTHER AND BABY SHOULD TRANSFER TO WARD USUALLY
AFTER 1 HOUR OF OBSERVATION IN THE DELIVERY ROOM AND
WHEN THE CONDITION PERMITS
 SICK OR AT RISK NEONATES NEED SPECIAL CARE IN SPECIAL
SETTING
 WARMTH

 WARMTH IS PROVIDED BY KEEPING THE BABY DRY WITH

ADEQUATE CLOTHING
 BABY SHOULD BE KEPT TO THE SIDE OF THE MOTHER, SO THAT
THE MOTHER’S BODY TEMPERATURE CAN KEEP THE BABY WARM
 BABY CAN BE PLACED IN SKIN TO SKIN CONTACT WITH MOTHER
(KANGAROOING) TO MAINTAIN TEMPERATURE OF INFANT AND
FACILITATE BREAST FEEDING
 BATHING AT FIRST DAY IS AVOIDED TO PREVENT HYPOTHERMIA
 BREAST FEEDING

 The baby should be put to mother’s breast within half an hour of

birth as soon as possible .The mother has recovered from exertion
of labour
 Colostrums feeding must be offered.
 Mother should be informing about the importance and techniques
of breast feeding.
 Demand feeding should be encouraged.
 Exclusive breast feeding procedure should be explained to the
mother and family members
 SKIN CARE AND BABY BATH 

 The skin should be cleaned off blood, mucus & meconium by

gentle wiping before he/she is presented to the mother. Baby bath
can be given at the hospital or home by using warm water in a
warm room gently & quickly. First Bath: Once a baby's
temperature has stabilized, the First bath can be given.
 CARE OF UMBILICAL CORD
 The umbilical cord is cut about 2-3 inches from the navel with
aseptic precaution during delivery and tied with cotton thread or
disposable plastic clip.
 The cord must be inspected for bleeding afterwards which
commonly occurs due to shrinkage of cord and loosening of
ligature.
 No dressing should apply and the cord should be kept open and
dry.
 Normally it falls of after 5-10 days.
 Application of triple dye or junction violet is not advocated as a
routine any more.
 CARE OF UMBILICAL CORD
 The umbilical cord is cut about 2-3 inches from the navel with
aseptic precaution during delivery and tied with cotton thread or
disposable plastic clip.
 The cord must be inspected for bleeding afterwards which
commonly occurs due to shrinkage of cord and loosening of
ligature.
 No dressing should apply and the cord should be kept open and
dry.
 Normally it falls of after 5-10 days.
 Application of triple dye or junction violet is not advocated as a
routine any more.
 CARE OF THE EYES
 EYES SHOULD BE
CLEAN AT BIRTH AND
ONCE IN EVERY DAY
USING STERILE
COTTON SWABS
SOAKED IN STERILE
WATER OR NORMAL
SALINE. SEPARATE
SWABS FOR EACH EYE
 GENERAL CARE

ROOMING –IN
GENTLE APPROACH
ASEPTIC TECHNIQUE
SENSORY STIMULATION
TENDER AND LOVING CARE
 ANTHROPOMETRIC
MEASUREMENT

MEASURE WEIGHT
LENGTH
HEAD
CIRCUMFERENCE
CHEST
CIRCUMFERENCE
 WEIGHT

The average daily weight gain for healthy term babies is

about 30gm/day in the first month of life
It is about 20gm/day in second month
10gm per day afterwards during the first year of life.
LENGTH: (from top of head to the heel with the leg
fully extended) Average range: 18-22 inches (46-56
cm)
 HEAD CIRCUMFERENCE

 Average range: 33 to 35 cm (13-14 inches) Normally, 2

cm larger than chest circumference Place tape measure
above eyebrows and stretch around fullest part of
occipital at posterior fontanel.
 CHEST CIRCUMFERENCE
(AT THE NIPPLE LINE)
Average range: 30-33 cm (12-13 inches) Normally, 2
cm smaller than head circumference Stretch tape
measure around scapulae and over nipple line.
Immunization: Newborn should be immunized with
BCG vaccine & ‘0’ dose of ‘OPV’. Hepatitis ‘B’
vaccine can be administered at birth as first dose &
other two doses in one month & 6 months of age.
THANK YOUU!!!!!!