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Antenatal Care Flashcards

(59 cards)

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1
Q

Define Antenatal Care.

A

It is the systematic supervision (examination and advice) of a woman during pregnancy.

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2
Q

State the aim of Antenatal Care.

A

To ensure a normal pregnancy with the delivery of a healthy baby from a healthy mother.

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3
Q

State the objectives of Antenatal Care.

A
  1. Confirm the pregnancy date and rule out early complications
  2. Identify high risk pregnancies (Risk scoring)
  3. Monitor foetal growth
  4. Prevention, screening, early diagnosis and management of minor problems
  5. Education and counselling
  6. Supplements and immunization
  7. Planning
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4
Q

What is the schedule for Antenatal Care?

A

First, every 4 weeks till 28 weeks. Then, every 2 weeks till 36 weeks. Then, every week till 40 weeks, at which the mother will be hospitalized.

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5
Q

When is the ideal time for the 1st Antenatal Visit?

A

Before the 2nd missed period

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6
Q

What is the purpose of the 1st Antenatal Visit?

A

For diagnosis of pregnancy and detection of risk factors and complications

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7
Q

What is the standard procedure of the 1st Antenatal Visit?

A
  1. Obtain a detailed history
  2. Examination
  3. Investigations
  4. Advice
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8
Q

What are the important details required in the antenatal history taking?

A
  1. Patient Profile
  2. Parity Index
  3. E.D.D. and L.M.P.
  4. Gestational Period
  5. Presenting complaints
  6. H.O.P.P.
  7. Obstetric History
  8. Menstrual History
  9. Past Medical and Surgical History
  10. Family and Social History
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9
Q

What examinations are required in the antenatal examination?

A
  1. General examination : Height, Weight, BMI, Nutrition, Pallor, Icterus, Pedal Oedema
  2. Vital Signs : Pulse, BP
  3. Systemic Examination : CVS, RS, CNS
  4. Breast examination
  5. Thyroid glands examination
  6. Obstetric examination : Per abdomen, Per speculum, Vaginal examination
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10
Q

How do you confirm a pregnancy?

A

By conducting an Ultrasound scan.

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11
Q

What investigations would you carry out during the 1st Antenatal Visit?

A
  1. Blood Tests

2. Urine Tests

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12
Q

What blood tests would you carry out?

A
  1. Haemoglobin levels
  2. Identify the Blood group
  3. Rh typing
  4. VDRL test
  5. HIV test
  6. HBsAg test
  7. RBS/Glycogen HB test
  8. TSH levels
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13
Q

What urine tests would you carry out?

A
  1. Protein levels
  2. Sugar levels
  3. Presence of pus cells
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14
Q

What is the purpose of carrying out a transvaginal ultrasound scan in the 1st trimester?

A

To identify :

  • Site of foetus
  • Number of foetus
  • Viability of the embryo
  • For accurate dating
  • Adnexal pathology, if present
  • Molar pregnancy
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15
Q

What is the standard procedure of the 2nd Trimester Antenatal Visits?

A
  1. Continue medical surveillance (History, Examination, Investigations)
  2. Screen for high risk cases
  3. Detect, treat and advice regarding minor problems encountered
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16
Q

What details would you ask for in the history for 2nd Trimester Antenatal Visits?

A
  1. Any new complaints

2. Quickening

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17
Q

What examination findings do you expect in a 2nd Trimester Antenatal Examination?

A
  1. 0.5 kg weight gain per week
  2. Vital signs (pulse, BP)
  3. Presence of pallor, pedal oedema
  4. CVS, RS, CNS examination
  5. Per abdomen, Per speculum, Vaginal examination
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18
Q

How do you carry out and what is observed in a Per Abdomen examination in the 2nd Trimester?

A
  1. Inspection - Observe for abdominal enlargement, pregnancy marks
  2. Palpitation - Fundal height (measure SFH), External ballotement, foetal movement and foetal parts
  3. Auscultation - Foetal Heart Sounds
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19
Q

When is a Per Speculum/Vaginal examination conducted in the 2nd Trimester?

A

In the presence of vaginal bleeding or discharge

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20
Q

What scans would you like to conduct and when in the 2nd Trimester?

A
  1. Nuchal Transparency Scan - 11 to 14 weeks

2. Anomaly Scan - 20 weeks

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21
Q

What investigations and when would you carry out in the 2nd Trimester?

A
  1. Dual Test - 11 to 14 weeks
  2. Triple/Quadruple Test - 16 weeks
  3. Amniocentesis (if indicated) - 14 to 16 weeks
  4. Non-Invasive Prenatal Diagnostic Test (N.I.P.T)
  5. Haemoglobin and Urine Analysis
  6. Glucose Tolerance Test (75g GTT) or
  7. Glucose Challenge Test (50g GCT), followed by 100g GTT, if abnormal.
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22
Q

What details would you ask for in the history for 3rd Trimester Antenatal Visits?

A
  1. Any new complaints (Vaginal discharge, Bleeding, Labor pains, Urinary symptoms)
  2. Foetal movements
  3. Lightening
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23
Q

What examination findings do you expect in a 3rd Trimester Antenatal Examination?

A
  1. Measure the weight of mother
  2. Vital signs (pulse, BP)
  3. Presence of pallor, pedal oedema
  4. CVS, RS, CNS examination
  5. Per abdomen, Per speculum, Vaginal examination
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24
Q

How do you carry out and what is observed in a Per Abdomen examination in the 3rd Trimester?

Study These Flashcards
A
  1. Inspection - Observe for abdominal enlargement, pregnancy marks
  2. Palpitation - Fundal height (measure SFH), Foetal lie, presentation, position, growth liquor
  3. Auscultation - Foetal Heart Rate
25
When is a Per Speculum/Vaginal examination conducted in the 3rd Trimester?
When the patient complains of labour pains and at 40 weeks, for Bishop Score and pelvic examination
26
What investigations and when would you carry out in the 3rd Trimester?
1. GTT - 34 Weeks 2. Haemoglobin and platelet count - 36 weeks 3. Growth scan to observe foetal growth, liquor and placenta
27
What would you advice the mother on in the Antenatal period?
1. Regular check-ups 2. Improve her diet 3. Drugs 4. Hygiene 5. Education and psychological support 6. Sleep and her daily activities 7. Bowel and bladder habits
28
What are the goals in giving dietary advice to a pregnant mother?
To maintain maternal health, to meet demands of growing foetus and to ensure a successful labour and lactation.
29
A pregnancy diet should be ........... ?
Balanced, light, nutritious and easily digestible. (rich in proteins, minerals and vitamins)
30
What are the daily dietary allowances in pregnancy?
1. Calories : + 300 kcal 2. Proteins : 60 mg 3. Iron : 40 mg 4. Calcium : 1000 mg 5. Folic Acid : 400 mcg 6. Vitamins and minerals
31
What are the daily dietary allowances when a mother is lactating?
1. Calories : + 400 kcal 2. Proteins : 65 mg 3. Iron : 30 mg 4. Calcium : 1500 mg 5. Folic Acid : 400 mcg 6. Vitamins and minerals
32
What is the optimum weight gain during pregnancy?
10 kg - 12 kg
33
What supplementation and when would you prescribe it to a pregnant mother?
1. Folic Acid (5 mg) - 1st Trimester 2. Elemental Iron (60 mg) - 2nd Trimester till lactation 3. Calcium (500 mg - 1000 mg / day) - depending on her diet.
34
What advice would you give a pregnant mother on her sleep and daily activities?
1. Continue to do usual activities, just avoid strenuous work during the 1st Trim and the last 4 weeks. 2. Get an average of 8 hours of sleep at night and 2 hours at night. The lateral posture is the most comfortable. 3. Some light exercises is helpgul
35
What advice would you give a pregnant mother on her bowel and bladder habits?
1. Bowel : There is a tendency to constipate, hence, diet regulation with plenty of fluids, vegetables and milk is adviced. 2. Practice regular emptying and drink plenty of fluids.
36
What advice would you give a pregnant mother on her dental hygiene?
In case of caries, consult the dentist at the earliest. Any dental procedure is best done in the 2nd Trimester or after delivery.
37
What advice would you give a pregnant mother on her breasts?
Keep them clean and if there's a retracted nipple, it can be corrected by manipulation.
38
What advice would you give a pregnant mother on her clothing?
Wear loose, comfortable garments and avoid high-heeled shoes.
39
What advice would you give a pregnant mother on coitus?
It is better avoided during 1st Trim and the last 6 weeks as it may increase risk of abortion or pre-term labour.
40
What advice would you give a pregnant mother on travelling?
It is better to avoid travelling during the 1st Trim and the last 6 weeks.
41
What advice would you give a pregnant mother on consumption of alcohol, smoking and drugs?
1. Stop smoking and drinking as it may lead to I.U.G.R. 2. Any drugs should be considered potentially harmful to the foetus and should be prescribed, only if absolutely necessary.
42
What immunization would you give to a pregnant mother?
2 shots of Tetanus Toxoid : 0.5 ml I.M. (4-6 weeks apart), 1st Dose between 16 - 24 weeks. *live viral vaccines is contraindicated
43
What are the warning symptoms in a pregnant woman?
1. Bleeding per vaginum 2. Abdominal pain, backache and pelvic pain 3. Vaginal discharge 4. Blurring of vision 5. Swelling of face and limbs 6. Decreased foetal movements
44
Is nausea and vomiting common in a pregnant woman?
It is common in primigravida women, especially in the morning, in the 1st Trimester.
45
What advice would you give a pregnant mother that has nausea and vomiting?
1. Offer reassurance 2. Advice to avoid fatty, odorous foods 3. Drink plenty of fluids 4. Have small, frequent meals 5. If still no relief, prescribe anti-emetics 6. If dehydration is present, admit her and administer urine ketones/IV fluids/Anti-emetics
46
Is backache common in a pregnant woman?
It is common in the later months. It is mainly due to relaxation of pelvic joints, faulty posture, uncomfortable shoes, muscle spasm, U.T.I. or constipation.
47
What advice would you give a pregnant mother with backache?
1. Improve your posture 2. Ensure adequate rest 3. If still no relief, prescribe analgesics
48
What are the reasons behind constipation in a pregnant women?
1. Progesterone (atonicity of the gut) 2. Diminished physical activity 3. Pressure of a gravid uterus on the Pelvic colon
49
What advice would you give a pregnant mother with constipation?
1. Regulate diet with plenty of fluids, fruits and vegetables
50
What are the reasons behind leg cramps in a pregnant women?
Calcium deficiency
51
What advice would you give a pregnant mother with leg cramps?
Provide supplementary calcium therapy, massages, local heat applications and multivitamins.
52
What are the reasons behind pyrosis (heart burns) in a pregnant women?
1. Increased gastric emptying time | 2. Pressure by a gravid uterus
53
What advice would you give a pregnant mother with pyrosis?
1. Avoid spicy foods 2. Sleep in semi-reclining position 3. Prescribe antacids
54
What are the reasons behind ankle oedema in a pregnant women?
1. Pressure by gravid uterus | 2. Pre-eclampsia
55
What advice would you give a pregnant mother with ankle oedema?
Rest with limb elevation
56
What are the reasons behind vaginal discharge in a pregnant women?
1. Physiological discharge | 2. Infections - Trichomonas, Candida, Bacterial Vaginosis
57
What advice would you give a pregnant mother with vaginal discharge?
1. Provide reassurance 2. Advice to take care of local hygiene 3. Prescribe vaginal antifungal tablets
58
What are the reasons behind varicose veins in a pregnant women?
A gravid uterus might obstruct venous return.
59
What advice would you give a pregnant mother with varicose veins?
1. Rest with limb elevation 2. Wrap with elastic crepe bandages 3. Avoid surgical therapy

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