Antenatal And Post-Natal Care For Normal Pregnancy PDF

Summary of ANTENATAL AND POST-NATAL CARE FOR NORMAL PREGNANCY (Prof P O Nkwo) Outline: o Introduction o Components of antenatal care services o First trimester o Second trimester o Third trimester o Post-natal care Introduction Skilled Birth Attendants (SBAs) are p...

Summary of ANTENATAL AND POST-NATAL CARE FOR NORMAL PREGNANCY (Prof P O Nkwo) Outline: o Introduction o Components of antenatal care services o First trimester o Second trimester o Third trimester o Post-natal care Introduction Skilled Birth Attendants (SBAs) are professionals who are trained to provide the acceptable level of care to women and their babies during pregnancy, labor and delivery, and the first 6 weeks following delivery. Components of Antenatal Care Services o Antenatal assessment:  History taking  Physical exam:  BP, temperature, pulse rate  General appearance, hotness, jaundice, pallor  Oral hygiene, oral hydration, capillary refill time, leg edema  Abdominal contour, movement with respiration, umbilical status, linea nigrae, striae gravidarum  Location of xiphisternum, identifying superior surface of pubic symphysis, symphysio-fundal height  Leopold maneuver, fetal heart sound etc.  Investigations:  Urinalysis for proteinuria and glucosuria  PCV, Hb genotype, blood group and Rhesus factor  Viral screening: HbsAg, HCV, HIV  VDRL for syphilis  Fasting blood sugar and 2h post-prandial   USS  Relevant treatment and counselling o Health promotion:  Counsel woman on the need for screening for HIV and other mother-to- child transmissible diseases  Nutrition, immunization and exercise  Information on breastfeeding and family planning o Birth preparedness and emergency readiness:  Done from 36 – 40 weeks GA  Involves gathering all the materials needed for the mother and baby, as well as transportation arrangement, arrangement for blood if needed  Teaching the mother and partner / birth supporters the signs and symptoms of labor  Collect relevant contact information and procure immunoglobulins (e.g. Rhogam) and vaccines (e.g. HBV vaccine) o Delivery plan:  Starts from 36 weeks GA  Route of delivery must be documented  Factors that decide the route of delivery are:  Maternal factors: parity, age, past obs history, co-morbidities etc.  Fetal factors: placentation, lie, fetal number, congenital anomalies etc. First Trimester (first 12 weeks) o First routine visit should be within first 11 weeks o Antenatal assessment should be done o First trimester USS is necessary for accurate dating of pregnancy Second Trimester (13 – 27 weeks) o Second routine visit should be between 18 and 22 weeks o It’s the best period for anomaly USS o IPT for malaria is commenced here o Screening for pregnancy-associated diseases like pregnancy-induced hypertension and gestational DM o Health information and education Third Trimester (28 – 40 weeks) o Feto-maternal assessment, health education and appropriate interventions o Prevent premature birth o Decide route of delivery o Birth preparedness and emergency readiness Post-natal Care (8 hours – 6 weeks post-partum) o First visit should be within first 7 days of life if the mother and baby were discharged within 24 hours of birth o Second visit is at 6th week o Aims include:  To identify morbidity and treat early  To initiate or continue health promotion from the antenatal period