Definition of "Antenatal care"

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Antenatal care are regular check-ups that allwo doctors and midwives to Dx, Tx, and prevent potential health problems througout the course of pregnancy. The sessions also provide an opportunity to promote healthy lifestyles, receive medical information rearding maternal physiological changes during pregnancy, nutritional requirements (including vitamins).

Fetus is a child before birth. Neonate (from Latin "neonatus" meaning "newborn" is a child in their first 28 days of birth. Infant is a child between 1 month-1 year old.

Schedule
  • Initial visit, in trimester 1 (weeks 1-12) → blood group and antibodies, FBC, syphilis, rubella, hepatitis B, hepatitis C, HIV, offer papsmear (if last had >2 years), smoking/alcohol cessation counselling, urine dipstick (MSU), pre-pregnancy weight/height/BMI, chromosomal abnormality screen (free beta-hCG, PAPP A), confirm, pregnancy, Trimester 1 U/S
  • Monthly visits, in trimester 2 (weeks 13-27), at:
    • Week 12 → Early morphology U/S (see page), CVS (see page) (if required)
    • Week 16 → Amniocentesis (if required), EDS
    • Week 20 → Morphology U/S
    • Week 24 → Rhesus antibody screen, GCT
  • Fortnightly visits, in trimester 3 (weeks 28-39), at:
    • Week 26
    • Week 28 → anti-D
    • Week 30
    • Week 32
    • Week 34 → anti-D, EDS
    • Week 36
    • Week 38
  • Weekly visits, after term, at (weeks 40+):
    • Week 40
    • Week 41 → offer IOL for 42 weeks
  • Postnatal visits (see page), at:
    • Home visit service
    • 6-8 week check → EPDS

Source: QLD Health

Method
  • After the initial antenatal visit, and with the aid of a checklist, the pregnant woman will be classified into "Normal" or "High" risk
  • Calculate gestational age
  • Prenatal screens and/or Dx, which is testing for disease/conditions in a fetus before it is born. It includes screening for:
    • Down syndrome
  • Hx (contractions/pains, vaginal bleeding, 1st passing of urine following delivery should be within 6 hours)
  • Monitoring the mother's health, including:
    • Mother's medical Hx, including:
      • Maternal drinking
      • Maternal smoking
    • Checking the mother's BP → maternal HTN
    • Mother's height and weight
    • Pelvic exam
    • Mother's blood and urine tests → maternal proteinuria
    • Screening tests, including:
      • Rh status → give anti-D @ 28 and 34 weeks, and as required during sensitizing events
      • Nuchal scan → early morphology (nuchal translucency) @ 10-14 weeks, and morphology (nuchal fold) @ 18-20 weeks
      • Down syndrome Dx test → CVS @11-13 weeks, or amniocentesis @ 16-18 weeks, if indicated
      • Conduct or book papsmear → <12 weeks
      • GDM → 50g GCT @ week 24. If at high risk of GDM, a 75g GTT is done at 12 weeks gestation, to be repeated at 24 weeks gestation
      • Postnatal depression → EDS @ week 12 and 34
  • Monitoring prenatal development, including:
    • Doppler fetal heart rate monitoring
    • Assess fundal height
    • Assess uterine contraction
  • Advisorial discussion
  • Obstetric U/S → trimester 1 scan @ <12 weeks, early morphology @ 10-14 weeks, morphology @ 18-20 weeks, growth scans >24 weeks (if necessary), week 36 scan (if necessary)

Source: QLD Health

Epidemiology
  • Availability of routine antenatal care has reduced maternal death, miscarriages, birth defects, low birth weight
See also

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Definition of Antenatal care | Autoprac


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