Transcript antenatal care

Title: antenatal care
05 April 2017
Learning question: What is antenatal care and why is it
important?
Homework:
Aims from specification
(d) outline the programme of antenatal care in the United Kingdom, with
reference to pre-conceptual care (to include immune status with regard to
rubella and the use of folic acid supplements) and routine post-conceptual
care;
(e) state the dietary changes recommended during pregnancy with reference
to DRV values for energy, protein, calcium, iron, vitamin A, vitamin C and folic
acid and the reasons for the changes with respect to the role of these
nutrients;
(f) describe how human fetal growth can be measured using ultrasound to
measure biparietal diameter of cranium and crown-rump length of back;
(g) describe how alcohol and nicotine can affect the growth and development
of the fetus (HSW6a, 6b, 7b, 7c);
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Care before conception
• Preconceptual care – the care that a mother
should take before she is even pregnant
• Health of expectant mother is essential as the
baby will live in the uterus for nine months!
Smoking
• Giving up smoking before
pregnancy is important –
can cause serious harm to
developing fetus
• Men should also give up too
– evidence shows sperm are
healthier in non-smokers
• Passive smoking can have
serious effects on baby also.
Effects of smoking on developing baby
• Lower the amount of oxygen available to you and your growing
baby – carbon monoxide combines with haemoglobin, lowering O2
carrying capacity
• Nicotine causes vasoconstriction of arteries
• Increase your baby's heart rate
• Increase the chances of miscarriage and stillbirth
• Increase the risk that your baby is born prematurely and/or born
with low birth weight
• Increase your baby's risk of developing respiratory (lung) problems
Drinking
• Alcohol can cause serious
problems in developing
baby
• Consuming more than two
units of alcohol per day can
lead to:
– Language difficulty
– Attention disorders
– Hyperactivity disorders
• Best to give up altogether,
but no more than 1-2 units
per week are the guidelines
Foetal Alcohol Syndrome (FAS)
• Children with FAS have distinct facial features including:
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small and narrow eyes
small head
smooth area between the nose and the lips and
thin upper lip.
Hearing and ear problems
Mouth, teeth and facial problems
Weak immune system
Epilepsy
Liver damage
Kidney and heart defects
Cerebral palsy and other muscular problems
Height and weight issues
Hormonal disorders
Immunity
• Rubella (German measles) is a virus an expectant mother must be
immunised against
• Can cause problems in unborn baby such as:
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hearing loss
brain damage
heart defects
cataracts
• Vaccinations contain the live virus, so pregnancy for 3 months after
immunisation should be avoided
• Tests to check if you are immunised can be carried out by your GP
and involves a blood test
Toxoplasmosis
• A parasitic infection found in cats that
can spread to humans via cat faeces
• If caught during pregnancy, high risk
of passing it on to baby, which is
serious
• Can cause brain damage, hearing and
eyesight problems, epilepsy and in
extreme cases, still birth
• Can be avoided by taking care while
gardening and avoiding cat litter trays
Food poisoning
• Listeria - common in soft, unpasteurised cheeses and ready
meals
• Salmonella – present in raw, uncooked meat and eggs
• Cooking food thoroughly and only consuming pasteurised
products helps to avoid these bacteria
• Fish such as shark and swordfish contain high levels of
mercury and should be avoided also
• Tuna can be eaten in small doses
9 marks
Care after conception
• Care received after a woman becomes pregnant is described as
antenatal care
• At 11-12 weeks, medical staff ask about general health and any
history of pregnancy to decide if any special care is needed
• Advice on diet and exercise and services available are given
• Urine in screened for presence of glucose and protein – checks
kidney function and signs of gestational diabetes
• Height, weight and blood pressure taken – a high BP is indicative of
pre-eclampasia, which can cause maternal and infant deaths
Later appointments
• After the 12 week mark, expectant mothers have check ups every 4
weeks, then every 2 weeks at 32 week mark
• Can take place at hospital, local clinic or even the woman’s own
home
• Checks include:
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Height, weight and BP (as before)
Abdomen check for baby growth rate (normal/abnormal)
Listen to baby’s heartbeat
Check baby’s movements
Mother’s emotional state
Check for swelling of arms, legs or face – signs of pre-eclampasia
Diet during pregnancy
• Weight gain of 10-15kg is normal – NO dieting/weight gain
avoidance during this time
• Nutrients for developing baby are essential for normal development
• The following is recommended for daily consumption of pregnant
women:
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4-6 portions of carbohydrates per day
5 portions of fruit and vegetables
3 portions of protein
1 portion of dairy
2 litres of fluid – gets rid of toxins and waste products and prevent
constipation
Diet during pregnancy
• Folic acid – reduces risk of problems with baby’s spine and
brain, such as spina bifida
• Green leafy vegetables, bread and breakfast cereals contain
lots of folic acid. These foods also contain lots of iron, which
can help to prevent anaemia
Tests during pregnancy
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Blood group – in case transfusion is required during pregnancy
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Mother’s Rhesus blood group – Rh- mothers need an injection after first baby’s
birth to protect the second baby from a serious kind of anaemia if the baby is Rh+
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Check for the virus that causes hepatitis
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Check whether the mother has HIV, the virus that causes AIDS. Pregnant women
can pass the virus to unborn baby, although medical treatment can reduce risk
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Check whether mother has syphilis
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Check whether the mother is immune to rubella
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Ultrasound carried out as well as tests to check for genetic defects