Prenatal Care .

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: 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 20-40 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 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 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