2 Prenatal Care - Introduction Prenatal care focuses on preventionMajority of pregnant females will deliverwithout major complicationsGoal of prenatal care is to select females atrisk for development of major complicationsand early prevention/intervention in order toaffect improved outcome
3 Prenatal Care Decide who will provide care Obstetrician-Dr. who specializes in the care of the female and her childCertified nurse-midwife- advanced practical nurse who specializes in prenatal care and deliveriesWhere will birth take place?Hospital- most commonBirthing Center- facility in which low-risk women can deliver their babies in a more home like settingHome
4 Gestational Age Outcome in pregnancy is gestational age dependant Calculation of gestational age is made using a varietyof methods:Patient historyInitial pelvic exam/biochemical test of pregnancyFetal heart auscultation (10-11 or weeks)Serial fundal height measurement (at umbilicus - 20 weeks)Ultrasound estimation of gestational ageDating (U.S.) best based upon MENSTRUALDATING (Last normal menstrual period to estimate date of confinement 40 7-day weeks
5 UltrasoundReal time images produced on computer screen using sound wavesUsed to monitor fetus in uterusDetermines how well the fetus is developing including organ developmentULTRASOUND VIDEO
6 Laboratory Tests Blood typically drawn each Dr. Visit Hemoglobin/hematocritUrinalysisGlucose testing (gestational Diabetes)Blood TypeTest for STD’sNumerous other tests
7 Additional TestingHigh risk pregnancies at risk for fetal loss receive antenatal testingat least once per week:Non Stress testingContraction stress testingOther tests as ordered by Dr.AMNIOCENTESIS VIDEO
8 Visit Interval - Pregnancy (Uncomplicated Patient) • Conception until weeks gestational age - Every 4 weeks (Pelvic exam on first visit)28-36 weeks gestational age - Every 2 weeks• weeks gestation - Every week (Pelvic exam at least by term)High risk pregnancy may alter visit intervalsPreterm labor risk may alter pelvic exam interval
9 Possible Concerns Bleeding Decrease in fetal movement Swelling HeadacheVisual DisturbanceContractionsLeakage of Fluid
10 Weight GainIt is normal for female to gain between lbs during pregnancyToo much = increased risk of gestational diabetesGestational DiabetesToo little = risks for fetus
11 Health of FetusFemales must be very careful about what they take into their bodyEverything she takes baby does too!
12 Tobacco Smoking is estimated to count for up to: 30% of low birth weight babies14% of premature birth10% of all infant deathsStudies also suggest that smoking during pregnancy can affect growth, mental development, and behaviorFemales exposed to secondhand smoke can also have increased risks
13 AlcoholANY alcohol consumed during pregnancy quickly passes through the umbilical cord to the fetus. Alcohol breaks down much more slowly in a fetus then in an adult, therefore fetus may have much higher BAC then mother and it will stay higher for longer.
14 Alcohol and PregnancyFetal Alcohol Syndrome- group of alcohol related birth defects that can cause both physical and mental problemsMental retardationLearning disabilitiesSerious behavior problemsSlowed GrowthPhysical deformitiesHeart defectsFAS is entirely preventable by avoiding alcohol completely during pregnancy as well as for those considering pregnancy
15 Medicines and other drugs during Pregnancy Using drugs while pregnant can have serious consequences even OTC medicationsBabies can be born addicted to the drug mother used while pregnantALL MEDICINES should be discussed with Dr. before taken
16 Environmental Hazards- some environmental substances can be harmful to fetus when exposed to mother Lead- linked to miscarriages, mental disabilities, and behavior problemsSmog- linked to birth defects, low birth weight, premature births, stillbirth, and infant deathRadiation- x-rays can affect fetal growth and cause mental retardationCat litter- may contain parasite which can cause Toxoplasmosis which can result in miscarriage, premature labor, and health problems in a newborn.
17 As a pregnant mother you are your unborn childs lifeline As a pregnant mother you are your unborn childs lifeline. You are solely responsible for the health of your baby for the next 9 months he or she is in you