1. Dr. MSc. Raul Hernandez Canete
ANTENATAL CARE
Dr. MSc. Raul Hernandez Canete

2. Is the clinical assessment of mother and fetus during pregnancy for the purpose of obtaining the best possible outcome for both mother and the child

3. The aims of Antenatal Care
Assessment and management of maternal risk and symptoms
Assessment of fetal risk
Prenatal diagnosis and management of fetal abnormality
Diagnosis and management of perinatal complications
Decision regarding timing and mode of delivery
Parental education regarding pregnancy and childbirth
Parental education regarding child-rearing.

4. The first visit: should be done between 8- 14 weeks
Schedule of key antenatal visits:
-Preconception clinic visit
8-14 weeks visit
20-24 weeks visit
36-38 weeks visit
41-42 weeks visit

5. 8-14 weeks: Booking visit
The main purpose is to obtain a comprehensive history, establish the gestational age, and identify maternal and fetal risk factors.
Baseline investigation
Vaginal examination
USG

6. Baseline investigation
Hb,
FBC,
FBS,
VDRL,
HIV,
Hemoglobin electrophoresis
Urine test
Vaginal swab
Pap smear
Group and Rh

7. 20-24 weeks visit: The mid-trimester risk assessment visit
Moment to review the result of the test and ultrasound scan
Physical Exam: Mucosa, BP, Weight, Abdomen, Check oedema, Vaginal exam (if consider necessary)
Investigations: Hb, Urine test, vaginal swab if necessary, Ultrasound scan.
IPT and Immunization with TT.

8. 36-38 weeks: with hospital team
To anticipate any problems regarding the prospective delivery
For suggest the best place to delivery
To finalize de discussions on planned contraception after delivery
Physical Exam: Mucosa, BP, Weight, Abdomen( Symphysis-fundal height, presentation, lie, engagement, fetal heart auscultation), check for oedema.
Investigation: Hb, Urine test

9. 41-42 weeks: Postdates visit
It is a true postdate pregnancy?
YES
A joint decision should be taken as to whether induction of labour is appropriate
Two methods of induction could be used:
- Amniotomy
- Medical methods using prostaglandin or oxytocin

10. Other model of antenatal care
Booking visit
1 visit monthly until 32 weeks of gestation
1 visit every 2 weeks until 36 weeks
1 visit weekly until delivery

11. IPT
Should be provide to all pregnant women at regular schedule clinic visits after 16 weeks of gestation.
All pregnant women should receive 2 doses of SP (Sulfadoxine 500mg and Pyrimethamine 25mg) under directly observed therapy strategy.
The interval between the 1st and 2nd dose should be 4 weeks
Regimen for IPT:
-1st dose: 16 – 27 weeks 3 tablets
-2nd dose: 28 – 34 weeks 3 tablets

12. Why is important check the pregnant weight?
Excessive weight gained is associated with Hypertensive disorder, fetal macrosomia, dystocia.
Low weight gained is associated with anemia, IUGR, prematurity
A woman should gain during pregnancy 8 to 12 kg, it mean +/- 0,5kg per week

13. Health Education during the Antenatal Care
Diet
Medication
Toxic habit
Rest and exercise
Immunization and prevention of Malaria
Dental care
Information about: Infections, bleeding per vagina, abdominal pain, drain of liquid, headache, collapse or convulsions, fever.
Preparation for breastfeeding
Post delivery care