Obstetrics and gynaecology

Antenatal care: For a healthy mom and a baby

What is antenatal care?

Did you miss your period? Are you worried you might be pregnant? You can be sure you are pregnant in just a few minutes. You can check your pregnancy by a pregnancy testing kit. If you are pregnant then congratulations. For a pregnant woman, it is a must to know about antenatal care. Let’s know all detail about antenatal care or prenatal care.

The health care of the mother during pregnancy is known as antenatal care (ANC).  ANC is also called pregnancy care or maternity care or prenatal care.  The advice for antenatal care is offered from midwife or gynaecologist.

Objectives of the antenatal care: Ultimately goal to have a healthy child and mother before deliver

  • To promote, protect and maintain the health of the mother during the pregnancy.
  • To identify the high risk of the pregnancy so that special attention may be given to them.
  • To foresee the complication and to prevent them.
  • To remove the anxiety and dread of the mother associated with delivery.
  • To reduce infant and maternal mortality and morbidity.
  • To educate the mother regarding child care, nutrition, personal hygiene etc.
  • To sensitize the mother regarding family planning.

Antenatal visit

There are three types of antenatal visit:

  1. Standard or ideal visit
  2. Intermediate visit
  3. Minimum visit

Standard visit: 14 in number

  • Once in a month during first 7 months of pregnancy -7
  • Twice in next month-2
  • Then once in week -5

Intermediate visit: 5 in number

  • First visit: 12 weeks
  • Second visit: 20-22 weeks
  • Third visit: 28-32 weeks
  • Fourth visit: 34-38 weeks
  • Fifth visit: 38 weeks

Minimum visit: 3 in number

  • First visit: 20 weeks  (as soon as pregnancy is known)
  • Second visit: 28-32 weeks
  • Third visit: 36-38 weeks

Activities of a doctor during the first antenatal visit

  1. Registration
  2. History taking
  3. Examination
  4. Investigation
  5. Advice
  6. Others

Registration

The name of the pregnant women is enlisted in the registered during the first antenatal visit. A registration card is given to the women with a registration number. She will be told that she should take this card to every visit. So, the present findings may be compared with the patient.

History taking

  • Brief menstrual history including the last menstruation period (LMP).
  • Present and past obstetrical history.
  • Family history- Diabetes Mellitus, Hypertension, bronchial asthma.
  • Drug history with allergy
  • Social history- education, occupation, economic condition.

Antenatal Examination

General examination

  • Height
  • Weight
  • Anemia
  • Oedema
  • Jaundice
  • Pulse
  • Bp

Local examination

  • Height of uterus
  • Lie of baby
  • Presentation (Head of the baby towards the lower end of the uterus)
  • Fetal heart sound

Investigation

Essential investigation

  1. Urine for routine examination
  2. Blood for hemoglobin (Hb)
  • Sugar: if present, then gestational diabetes
  • Pus cell: if more than 3, then UTI (urinary tract infections).
  • Albumin in urine: if present, eclampsia toxemia

Other investigations

  1. Blood for grouping with Rh factor
  2. Random blood sugar (RBS)
  3. HBsAg (hepatitis B)
  4. VDRL (Syphilis)
  5. Ultrasonography

Advice during antenatal care

Pregnant women should be given the following advice.

Diet

The nutritional diet should be taken during the antenatal period. Nutritional diet includes milk, egg, meat, fish, yogurt, and cheese. (Usually, a pregnant woman gets 12 kg weight more during pregnancy). These dietary foods are good sources of protein, vitamin D and calcium.

In addition, the pregnant mother should also take prenatal vitamins which are hard to get from foods such as folic acid and iron. The foods that are rich with iron are baked potatoes, beans, spinach, cashews and whole grains. the foods that are rich with folic acids are broccoli, cabbage, peas, chickpeas, and cereals.

Foods to avoid during antenatal periods

Here are the list of some foods that should be avoided during the antenatal period:

  • High mercury fish: Fish that contains a high amount of mercury are king mackerel, marlin, orange roughy, shark, ahi tuna and bigeye tuna.
  • undercooked or raw fish
  • undercooked or raw meat
  • caffeine
  • raw eggs
  • organ meat
  • Alcohol

Personal habit

  1. Personal hygiene: eg: daily bath, clean cloth, oral hygiene.
  2. Rest and sleep: eight hours sleep at night and two hours sleep at day time.
  3. Bowel: constipation should be avoided.
  4. Work: Normal household work is allowed. Physical manual labours may affect the baby.
  5. Smoking: Smoking is one of the important causes of LBW (low birth weight). the weight of a baby of a smoking mother is about 170 gm less than that of a non-smoking mother. (Nicotine causes vasoconstriction, that’s why weight is less).
  6. Sexual intercourse: This should be restricted during the last semester that may affect the baby.
  7. Drugs: There are some drugs that should not be taken during pregnancy because these drugs may affect the baby. The drugs are enlisted below:
  • Thalidomide
  • Tetraogenic
  • Hypnotics
  • Analgesic or painkiller like aspirin and ibuprofen and naproxen.
  • Cough and cold medicines that contain guaifenesin. You can also read about cough medicine for kids.
  • Bismuth subsalicylate

8. Radiology/Xray: Xray should not be done during the first four-month of pregnancy.

Warning signs

The mother should be advised that if she observed any one of the following signs, she should report to her doctor:

  • Severe headache
  • Fit or convulsion
  • Swelling of feets
  • Excessive bleeding
  • The blurring of a vision
  • Any unusual symptoms

Summary

Every pregnant mother must have some knowledge about antenatal care. Ultimately, prenatal care is going to promote, protect and maintain the health of every mother during the pregnancy period.  We have discussed all the detail about maternity care in the principle article. If you do have any queries about pregnancy care please do let us know by commenting below in the comment section.

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