Transcript Prenatal Care .

Prenatal Care
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Prenatal Care - Introduction
Prenatal care focuses on prevention
Majority of pregnant females will deliver
without major complications
Goal of prenatal care is to select females at
risk for development of major complications
and early prevention/intervention in order to
affect improved outcome
Prenatal Care
Decide who will provide care
– Obstetrician-Dr. who specializes in the care of the
female and her child
– Certified nurse-midwife- advanced practical nurse
who specializes in prenatal care and deliveries
Where will birth take place?
– Hospital- most common
– Birthing Center- facility in which low-risk women can
deliver their babies in a more home like setting
– Home
Gestational Age
Outcome in pregnancy is gestational age dependant
Calculation of gestational age is made using a
variety
of methods:
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Patient history
Initial pelvic exam/biochemical test of pregnancy
Fetal heart auscultation (10-11 or 18-19 weeks)
Serial fundal height measurement (at umbilicus - 20 weeks)
Ultrasound estimation of gestational age
Dating (U.S.) best based upon MENSTRUAL
DATING (Last normal menstrual period to estimate
date of confinement 40 7-day weeks
Ultrasound
Real time images produced on computer
screen using sound waves
Used to monitor fetus in uterus
Determines how well the fetus is
developing including organ development
ULTRASOUND VIDEO
Laboratory Tests
Blood typically drawn each Dr. Visit
– Hemoglobin/hematocrit
– Urinalysis
– Glucose testing (gestational Diabetes)
– Blood Type
– Test for STD’s
– Numerous other tests
Additional Testing
High risk pregnancies at risk for fetal loss
receive antenatal testingat least once per
week:
– Non Stress testing
– Contraction stress testing
– Other tests as ordered by Dr.
– AMNIOCENTESIS VIDEO
Visit Interval - Pregnancy
(Uncomplicated Patient)
• Conception until 26-28 weeks gestational age Every 4 weeks (Pelvic exam on first visit)
28-36 weeks gestational age - Every 2 weeks
• 36-40 weeks gestation - Every week (Pelvic exam at
least by term)
High risk pregnancy may alter visit intervals
Preterm labor risk may alter pelvic exam interval
Possible Concerns
Bleeding
Decrease in fetal movement
Swelling
Headache
Visual Disturbance
Contractions
Leakage of Fluid
Weight Gain
It is normal for female to gain between 2040 lbs during pregnancy
Too much = increased risk of gestational
diabetes
Gestational Diabetes
Too little = risks for fetus
Health of Fetus
Females must be very careful about what
they take into their body
– Everything she takes baby does too!
Tobacco
Smoking is estimated to count for up to:
– 30% of low birth weight babies
– 14% of premature birth
– 10% of all infant deaths
Studies also suggest that smoking during
pregnancy can affect growth, mental
development, and behavior
Females exposed to secondhand smoke
can also have increased risks
Alcohol
ANY alcohol consumed during pregnancy
quickly passes through the umbilical cord
to the fetus. Alcohol breaks down much
more slowly in a fetus then in an adult,
therefore fetus may have much higher
BAC then mother and it will stay higher
for longer.
Alcohol and Pregnancy
Fetal Alcohol Syndrome- group of alcohol
related birth defects that can cause both
physical and mental problems
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Mental retardation
Learning disabilities
Serious behavior problems
Slowed Growth
Physical deformities
Heart defects
FAS is entirely preventable by avoiding alcohol
completely during pregnancy as well as for
those considering pregnancy
Medicines and other drugs during
Pregnancy
Using drugs while pregnant can have
serious consequences even OTC
medications
Babies can be born addicted to the drug
mother used while pregnant
ALL MEDICINES should be discussed
with Dr. before taken
Environmental Hazards- some
environmental substances can be harmful to fetus when
exposed to mother
Lead- linked to miscarriages, mental disabilities,
and behavior problems
Smog- linked to birth defects, low birth weight,
premature births, stillbirth, and infant death
Radiation- x-rays can affect fetal growth and
cause mental retardation
Cat litter- may contain parasite which can cause
Toxoplasmosis which can result in miscarriage,
premature labor, and health problems in a
newborn.
As a pregnant mother you are your
unborn childs lifeline. You are
solely responsible for the health
of your baby for the next 9 months
he or she is in you