1. PRENATAL CARE DR CHIPPY DR CHIPPY

2. DEFINITION Prenatal care is defined as a comprehensive antenatal care programme that involves a coordinated approach to medical care and psychosocial support that optimally begins before conception and extends throughout the antenatal period. Prenatal care is defined as a comprehensive antenatal care programme that involves a coordinated approach to medical care and psychosocial support that optimally begins before conception and extends throughout the antenatal period.

3. AIMS Screen high risk cases Screen high risk cases Detect and treat complications Detect and treat complications Educate mother Educate mother Interact/discuss with the couple Interact/discuss with the couple Motivate the need of family planning Motivate the need of family planning

4. PRECONCEPTIONAL CARE Preventive Preventive Counselled to prevent unwanted pregnancy Counselled to prevent unwanted pregnancy Thorough medical exam to identify medical, reproductive,genetic, social and nutritional risk factors Thorough medical exam to identify medical, reproductive,genetic, social and nutritional risk factors

5. First prenatal visit First prenatal visit-as soon as there is a chance of pregnancy/not later than the 2 nd missed period. First prenatal visit-as soon as there is a chance of pregnancy/not later than the 2 nd missed period.GOALS 1. To identify risk factors for pregnancy 2. GA 3. Plan prenatal care

6. GENERAL HISTORY Name/age /parity/SES/medical diseases/hereditary diseases ( dm / htn /-rick / rf/ renal) Name/age /parity/SES/medical diseases/hereditary diseases ( dm / htn /-rick / rf/ renal) Occupation Occupation Husbands occupation Husbands occupation OCP OCP Drugs Drugs

7. OBSTETRIC HISTORY PARITY /GRAVIDA PARITY /GRAVIDANULLIPARA/NULLIGRAVIDAPRIMIPARA/PRIMIGRAVIDAMULTIPARA/MULTIGRAVIDAPARTURIENTPUERPERA Duration of marriage Duration of marriage Details of deliveries Details of deliveries Consanguinity Consanguinity Spacing Spacing

8. Other details Complaints Complaints h/o present pregnancy h/o present pregnancy First tm/second tm/last tm

9. Contd.. Menstrual history Menstrual history LMP/EDD - Naegele’s rule POG Past medical/surgical history Past medical/surgical history Family history Family history Personal history Personal history

10. Examination General exam General examBuilt/nutrition/height/weightPallor/jaundice/mouthNeck/edema(5) Pulse/bp /breasts Obstetric exam Obstetric exam

11. Investigations Investigations Routine Routine Blood-Hb (28th/36 th ) Urine Special Special Hepatitis B /rubella/MSAFP/HIV/group B sc USG USG

12. SUBSEQUENT VISITS 4 weekly up to 28weeks.2weekly till 36weeks and then weekly till EDD. WHO at least 3 visits: 16-20weeks 28-32 weeks 36 weeks objectives

13. ANTENATAL ADVICE Diet /drugs Diet /drugs Rest and sleep Rest and sleep Exercise Exercise Bowel Bowel Bathing Bathing Clothes Clothes Dental care Dental care Breast care Breast care Coitus Coitus Smoking/alcohol Smoking/alcohol Immunization Immunization travel travel

14. DIET Recommended nutrients pregna ncy lactatio n kcal+300+700 protein6070gm Ca1000mg1500 Fe40mg30mg Folic acid 1 mg 1mg

15. Minor ailments in pregnancy Nausea/vomiting Nausea/vomiting Backache Backache Constipation Constipation Leg cramps Leg cramps Acidity Acidity Varicosities Varicosities Edema Edema Vaginal discharge Vaginal discharge

16. Pre conceptional care -