CHAPTER

Preventive Obstetrics,
8 Paediatrics and Geriatrics
MCH
I
Ante-natal and Post-natal Visits (RCH Program) Minimum recommended ante-
natal visitsQ: 4
• Ideal recommended ante-natal visitsQ: 13 – 14
Period of gestation Frequency of visitQ
0 – 7 months Once every month
8th month Twice a month
9th month onwards Once a week

• Minimum recommended ante-natal visitsQ: 4

Visit Period of gestationQ
First AN visit Early registration
Second AN visit 14-26 weeks POG
Third AN visit 28-34 weeks POG
Fourth AN visit 36 weeks POG - Term
• Minimum recommended post-natal visits : 3 Q I
Minimum recommended post-
Visit Period of gestation natal visitsQ: 3
First PN visit <3 days
Second PN visit 1 week
Third PN visit 8 weeks

At Risk Approach

• At risk approach: Central purpose is to identify high risk cases (as early as possible)
from a large group of all antenatal mothers/infants, and provide specialized care to
them, while continuing to provide appropriate care to all antenatal mothers/infantsQ
• At risk infants: Contribute to perinatal, neonatal and infant mortality; so they have
to be provided with special intensive care; Basic criteria for identifying these
babies includeQ:
– Birth weight < 2.5 kg (low birth weight)
– Twins
– Birth order > 5
– Artificial feeding
– Weight < 70% of expected (II and III degrees of malnutrition)
– Failure to thrive (failure to gain weight in 3 successive months)
– Children with PEM, diarrhea
– Working mother/single parent
• At risk mothersQ: Basic criteria for identifying these mothers include:
– Elderly primi (> 30 years) Q
– Short statured primi (< 140 cms) Q
– Malpresentations (breech, transverse lie, etc.)
– Antepartum hemorrhage, threatened abortion
– Preeclampsia, Eclampsia
– Anemia
– Twins, hydramnios
– Previous still birth, IUD, manual removal of placenta
– Elderly grandmultipara (> 5 parity) Q