Prenatal care 

The care given to the women starting from preconception counselling till the delivery is called prenatal care it is characterized by systematic supervision on a regular and according to the need of the women. 

The aims of prenatal care are 

Detect high-risk pregnancy and prevent or treat it at the earliest if any untoward complication is present 

Promote, protect, and maintain the health and nutritional status of the woman during pregnancy by ensuring continuous medical servillains and prophylaxis.

Ensure that the mother receives the best available care during her pregnancy. 

Educate the mother regarding the physiology of pregnancy and labor so that fear is removed and Psychology is improved good rapport builds the trust of the mother with health personnel. Motivate the couple about the need and benefits of family planning. Reduce Infant and maternal mortality and morbidity. Delivery of the baby, healthy and at gestational age 38 to 40 weeks from a healthy mother with a fetus of more than 2.5 kilograms. Teach the mother how to look after her own health and newborn baby.

History taking and examination

General as well as obstetrics being the most important aspect of the prenatal it should be discussed in detail 

Personal history

Prenatal care starts with Personal history along with its records 

Name, age, address, occupation religion date, and place of examination are also recorded. personal history also includes the history of any pre-existing disease, she has recovered from such as tuberculosis, anemia, malnutrition, STD, Kidney Disease, diabetes, or any other disease 

This aspect aims at the assessment of the health of the mother and fetus to rule out risks in pregnancy and plan for subsequent management. marital History Duration of marriage, 

Family history 

The health of the husband, his occupation, economical status, age number of present children, and their health status play an important role in pregnancy care, presence of any illness in the family is noted carefully.

Environmental history 

The type of house, source of water, type of diet consumed, personal and domestic hygiene, and hereditary illness are recorded carefully. 

General examination 

Vital signs, weight, pallor, jaundice, tongue, teeth, gums, tonsils, neck veins, thyroid glands, and lymph glands are examined for abnormality. Edema of the legs should be examined whether it is physiological or pathological along with this examination heart, lungs, and spleen is also examined.In pregnancy care, breast examination is mandatory to rule out inverted nipples, flat nipples, and depressed nipple skin conditions in order to correct well in time. 

Obstetric examination 

Abdominal tone, muscle, and skin condition, to check the height of the fundus, other examinations include PV examination, per speculum examination bimanual examination to rule out the exact duration of pregnancy, lie of the fetus, presentation of fetus, if there are multiple pregnancies (twins or triplet) and other abnormalities are considered in this examination of prenatal care 

Routine examination

 investigations:

Blood grouping, hemoglobin %, VDRL HIV, HBsAg, blood glucose level,

Urine Examination, maternal serum Alpha protein you Rule out neural tube defect, Ultrasonography: first-trimester 

Ultrasonography, fetal Doppler to evaluate the exact age of the fetus, number of fetuses, structural abnormalities in the fetus and monitor proper growth and development of the fetus in the uterus. 

Calculation of the expected due date

 from the first day of the menstrual cycle pregnancy last an average of 280 days that is 9 months and seven days pregnancy care is provided by prenatal clinics in urban areas where registration is done and prenatal cards are prepared along with prenatal examination includes mental preparation, health education, and mother craft services 

Pregnancy advice

 it's a major component of pregnancy care as the mother is concerning more about herself and the baby she is receptive hence the health talk should cover all the aspects related to pregnancy 

Diet in pregnancy 

As we all know expected mother gains weight about 10 to 12 KG during pregnancy it should be lite easily digestible and rich in protein, minerals, and vitamins because good maternal health is a pre-requisite of a healthy growing fetus, strength and vitality during labor and successful lactation along with maintenance of good maternal health. 

Water being the most important ingredient daily requirement is increased. Calories 2500 to 3300 kcal per day, proteins 60 to 65 grams per day, calcium 1 gram per day, Iron 40 MG per day, vitamin A 6000 International units per day, vitamin D 400 international units per day thiamin 1.5mg/day, folic acid 1MG (double of the nonpregnant woman) everyday vitamin C 60 mg per day is required.

Personal hygiene in pregnant women 

Apart from cleanliness bowel habits should be regular by increasing green leafy vegetable fruits in her daily diet my laxatives if required can be added. Rest and sleep are of tremendous importance 8 hours of night sleep and two hours rest after a mid-day meal. Family planning and other advice Pre-natal duration are said to be the best time for explaining family planning methods of spacing and permanent sterilization methods. 

The expected mother should not undergo an x-ray 4 months of pregnancy. if it is unavoidable should be done under great precaution. Immunization of pregnant women with tetanus toxoid first dose at 16 to 20 weeks and second dose four weeks apart. 

Instructions regarding warning signs

Pregnant women should report immediately if 

Swelling on feet does not subside on rest

Fits 

Headache 

Blooding of vision 

Bleeding 

Sudden gush of watery fluid PV 

Restlessness 

pain in abdomen 

scanty urination

urinary trouble.

Values of prenatal care and minor elements in pregnancy will be discussed in next blog 

Thank you

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