Antenatal Care Systematic supervision of a woman during pregnancy is called antenatal care.

The supervision should be of a regular and periodic nature in accordance with the principles laid down or more frequently according to the need of the individual. It is the education, supervision and treatment to a pregnant woman so that her pregnancy and labour will terminate with delivery of a mature healthy living baby, without injury to the mind or body of the mother. The objective of Antenatal care is to ensure a normal pregnancy with delivery of a healthy baby from a healthy mother. Aims of antenatal care: 1. to monitor the progress of pregnancy in order to ensure maternal health and normal fetal development. . to recognise the deviation from the normal and provide management or treatment as required. !. to ensure that the woman reaches the end of her pregnancy physically and emotionally prepared for her delivery. ". to identify high ris# pregnancy and for their proper management. $. to reduce or prevent maternal and perinatal mortality and morbidity %. to help and support the mother in breast feeding and parenting. &. to offer family welfare advices on parenthood. Antenatal care comprises of: 1. 'egistration of pregnancy . (istory ta#ing !. Antenatal e)aminations *general and obstetrical+ ". (ealth education A. Registration of pregnancy: The registration of pregnancy must be done in an antenatal clinic within 1 wee#s. B. History taking: A complete history of the woman including the following is collected in the first visit. 1. ,emographic data -.ame, age, address, marital status, religion, education, occupation etc/ . 0enstrual history. !. 1ersonal history. ". 1ast medical and surgical history. $. 2amily history. %. (istory of present pregnancy -last menstrual period 301, 4)pected date of delivery 4,,, etc. &. 5bstetrical history -number of pregnancy, any abnormality in previous pregnancies and deliveries/. 6. 7alculation of e)pected date of delivery -4,,/8 4,, is calculated by adding nine calendar months and seven days to the date of first day of the woman9 s last menstrual period, provided the woman has a regular 6:day menstrual cycle. C. Antenatal examination:

A complete general e)aminations of the body is conducted, including 1. Height: The height is carefully recorded, as patients measuring $ feet or less is more li#ely to have a small pelvis that may cause difficulty during delivery. . Weight: ;eight should be regularly ta#en using an accurate weighing machine. 1eriodic and regular weight chec#ing helps in detecting abnormalities. !. Pallor: 7olour of conjuctiva, soft palate, tongue, and nail beds are to be noted. -1aleness indicates anemia/ ". Jaundice: 4yes and mouth are to be observed for yellow discolouration. -yellow discolouration indicates of jaundice/ $. ongue! teeth! gums: 5bserve for signs of infection and malnutrition. %. "egs: 3egs are to be e)amined for oedema. &. Breasts: 4)amination of the breasts is mandatory, to note the presence of pregnancy charges and condition of the nipples -crac#ed < depressed < inverted/. 6. A#dominal and $aginal examinations: 1osition of the uterus is noted in abdominal e)amination. =nless necessary, vaginal e)aminations is not routinely done e)cept for the first time when the woman attends the clinic to confirm pregnancy. "a#oratory in$estigations: %. 7omplete blood count including haemoglobin level, &. >lood grouping and 'h typing. '. >lood for ?,'3 (. =rine e)aminations8 ). =rine should be tested for albumin, sugar, pus cells, 5ne to two doses of tetanus to)oid is given to immuni@e against tetanus infection iron and folic acid supplements is given *u#se+uent $isits: =p to 6 wee# :: the antenatal chec# up should be done at an interval of " wee#s from the first visit. >eyond 6 wee#s, the antenatal chec# up should be done at interval of wee#s upto !% wee# and thereafter wee#ly, till the e)pected date of delivery. At each visit, the findings are to be recorded in the same card for better evaluation. ,. Health education: The antenatal education should include. ,iet The diet during pregnancy should be adequate to provide for a. the maintenance of maternal health. b. the needs of the growing fetus. c. the strength and vitality required during labour and d. the successful lactation. The pregnancy diet should be light, nutritious and easily digestible. It should be rich in protein, minerals vitamins and fibres and of the required calories. ,ietary advice should be given with due consideration to the socio:economic condition, food habits

and taste of the individual. Supplementary iron therapy is needed for all pregnant mothers from A wee#s onwards. Personal hygiene 1. Rest and sleep: The woman may continue her usual activities throughout pregnancy. (ard and strenuous wor# should be avoided. 5n an average, a patient should have 1A hours of sleep -6 hours at night and hours at noon/ . Bo-el: As there is a tendency of constipation during pregnancy, regular bowel movement may be facilitated by regulation of diet ta#ing plenty of fluids, vegetables and mil#. !. Bathing: ,aily baths and preferably twice a day are advised. ". Clothing: The patient should wear loose but comfortable dresses. (igh heel shoes are better avoided. $. ,ental hygiene: The dentist should be consulted at the earliest, if necessary. %. Care of the #reasts: 7leanliness of the breasts is maintained. If anatomical defects are present advise to see# medical help. &. Coitus: 7ontact with the husband to be avoided during the first trimester and last % wee#s. 6. ra$el: 3ong distance travel better to be avoided. 'ail route is preferable. B. *moking and alcohol: Smo#ing and alcohol are to be avoided totally during pregnancy as both cause variable injuries to the fetus. 1A. ,rugs8 The pregnant women should avoid over:the counter drugs -drugs without medical prescription/. The drugs may have teratogenic effects on the growing fetus especially during the first trimester -The first three months is the period of organogenesis. Teratogens will cause gross malformation or defects to the fetus. The common teratogens are drugs caffeine, e)posure to ):rays, alcohol, nicotine, etc/. .eneral ad$ice The patient should be persuaded to attend for antenatal chec#up positively on the scheduled date of visit. She is instructed to report to the doctor even at an early date and if the following untoward -warning signs and symptoms/ symptoms arise8 intense persistent headache severe oedema disturbed sleep with restlessness low urine output -less than $AA ml per day/ epigastric pain persistent vomiting painful uterine contractions sudden gush of watery fluid per vaginum active vaginal bleeding, etc.