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| Anc antenatal care |
Anc antenatal care
Systematic supervision (examination and care ) of a women during pregnacy is called antenatal careanc comprie of
careful history taking and examination (general and obstretical)
advice given to pregnant women
procedure at first visit
history taking
gravida -denotes pregnant state both present and past irrespective of period of gestation
parity -denotes previous pregnancy beyond the period of viability
EDD
naegeles formula -by adding 9 calender months and 7 days to first day of the last normal (28 days) periodgeneral examination
built, nutrition, hight, weighit, pallor, laundice, tongue, gums, teeth, oedema of legsbp -disappeasence of sounds rather than muffling of sound is best representation of distolic pressure during pregnancy
heart lungs liver spleen
breasts
obstetrical examination
abdominalvaginal -done when pt attends clinic for first time before 12 weeks
ultrasound exam.
routine exam.
1 exam. Of bloodfor -Hb , ABO ,Rh grouping and VDRL
screening for blood glucose in selected pt
2 urine
for- proteins sugar and pus cells
clean catch specimen of midstream urine is collected
3 cervical cytology study by papanicolau stain has become a routine in many clinics
special investigation
ultrasound exam. -first trimester scan either transabdominal or transvaginal helps to detect -1 early pregnancy 2 accurate dating 3number of fetuses 4 gross fetal anomalies 5 any uterine pathology
b) Serological tests for rubella and hepatitis
c) maternal serum alpha feto proteine
repeatation of investigations
1 Hb estimation is repeated at 28 and 36 week2 urine is tested for protein and sugar at every anc visit
schedule
generally check up is done at interval of 4 weeks upto 28 weeksat interval of 2 weeks upto 36 weeks and thereafter weekly till expected date of delivery
w h o recommendation
the visits may curtailed to at least 4 visits
fist in 2 trimester around 16 weeks
second between 24-28 weeks
third at 32 weeks
fourth at 36 weeks
subsequent visits
history - 1 appearence of new complaints 2 date of quickninggeneral exam. 1 weight 2 pallor 3 oedema of legs 4 blood pressure
abdominal exam
antenatal device
1 dietsupplementsy nutritional therapy -supplementsy iron therapy is needed for all pregnant women from 16 weeks onwards
above 10gm% hb 1 tab of ferrous sulphate containing 60 mg of elemental iron is enough
anc hygine
following advices are given
rest and sleep . Bowl . Bathing . Clothing .dental care .care of breasts . Coitus travel . Smoking and alchohol . Drugs
immunisation
tetanusimmunisation against tetanus not only protects the mother but also fetus
0.5 ml tetanus toxide i m at 6 weeks interval for 2 such first 16-24 Weeks
women who immunised in past a booster dose of 0.5 ml is given in the last trimester
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