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Dr Parul Jain



Antenatal Checkup



antenetal


Antenatal care is the complete supervision of women during pregnancy to monitor fetal growth progress and to determine the well-being of the mother and the fetus. An appropriate antenatal check-up provides necessary care to the mother. It helps in identifying any complications of pregnancy, such as pre-eclampsia, anemia, and hypertension, etc. in the mother and incomplete or slow growth of the fetus. Antenatal care allows for the timely management of complications by referring to an appropriate facility for further treatment. It also gives a better chance to prepare a birth plan and recognize the facility for delivery and referral in case of any difficulties

Antenatal check-ups Schedule

Four antenatal check-ups are recommended for every pregnant woman. It should be taken care that this is only a minimum requirement, and more visits may be necessary, depending on the woman's condition and needs. The schedule suggested for antenatal visits is as follows. The first visit/registration timing- As soon as the pregnancy is suspected, the first visit or registration of a pregnant woman for ANC should take place. The first visit should take place within 12 weeks, ideally.

Second Visit - Between 14 and 26 weeks

Third Visit - Between 28 and 34 weeks

Fourth Visit - Between 36 weeks and term

Antenatal check-up components

Taking the complete history of woman

A detailed history of the woman needed to be taken:

  • Any current medical/surgical or obstetric condition(s) that may complicate the present pregnancy need to be identified.
  • The Expected Date of Delivery should be calculated using menstrual history.
  • Enquire about Nausea and vomiting / Constipation / Heartburn / Increased frequency of urination
  • Unusual vaginal discharge/itching
  • Easy fatigability
  • Obtain information about any Recurrent early abortion/ Post-abortion complications /Hypertension, pre-eclampsia or eclampsia / Ante-Partum Hemorrhage (APH) / Breech or transverse presentation / Obstructed labor, including dystocia / Perineal injuries/tears / Excessive bleeding after delivery / Puerperal sepsis during previous pregnancies.
  • History of blood transfusions should be noted.
  • For pregnancy confirmation (first visit only)

Physical Examination

General examination pulse

  • Respiratory rate
  • Oedema
  • Blood pressure
  • Weight
  • Breast examination

General examination

  • Fundal height to be measured
  • Listening of the Fetal Heart Sounds
  • Inspecting any other relevant abdominal findings.

Laboratory Investigations

  • Haemoglobin estimation and blood grouping including Rh factor using Blood investigations
  • To assess the presence of sugar and proteins using the urine test
  • Rapid test for malaria and syphilis

Interventions

  • Supplementation of Iron Folic Acid (IFA) along with counselling about the necessity of taking IFA and the dangers associated with anemia
  • Administration of two doses of TT injection for prevention of maternal and neonatal tetanus (tetanus of the newborn).
  • Micro-Birth Planning and Counseling
  • To keep a record registration of pregnant women and fill-up of the Maternal and Child Protection Card and JSY card/below poverty line (BPL) certificates/necessary proofs or certificates should be done.
  • The woman needs to be informed about the dates of antenatal visits, schedule for TT injections, and the Expected Date of Delivery.
  • The place of delivery and the person who would conduct the delivery need to be identified.
  • A referral facility and the mode of referral need to be identified.

What are the benefits of antenatal?

Antenatal – Antenatal means during pregnancy and before birth. When you are pregnant, having regular antenatal check-ups is important to detect abnormalities and preventable illnesses in both the mother and the child. The antenatal healthcare team comprises of your gynaecologist and obstetrician, midwife, paediatrician, and other support staff.

Even though you're feeling good, antenatal check-ups are important to stay healthy as well as making sure your baby is healthy. Antenatal care helps the mums to get the best physical and psychological care. Here are a few benefits summarized :

  • Regular check-ups
    The regular check-ups help detect complications such as the heart rate of the mother and baby, diabetes, hypertension, etc. Early detection of any complications means regular monitoring as well as proper treatment.
  • Supplements
    Along with a healthy diet, a mum to be will need regular supplements. Additional nutrients like folic acid, calcium zinc, and multivitamins help the baby's development.
  • Talk about Issues
    Antenatal care will give you a chance to talk about any issues you are unsure about, like any pain, aches, or any discomfort you are undergoing. You can note down the points before your antenatal check-up and discuss the same with your doctor.
  • Antenatal Exercises
    Your antenatal care will also include the exercise you can do during your pregnancy. These exercises make your back and your pelvic muscles strong, improves circulation, can help in promoting better sleep, and can also help in speeding during labour.
    Antenatal care not only gives you friendly support but also educates you for a better pregnancy and childbirth.

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