1. First Antenatal Assessment
Lab one

2. Antepartum Assessment and Care: Objective
Antepartum care is to ensure that pregnancy ends in the birth of a healthy infant without impairing the health of the mother.
Copyright © 2014, 2010, 2006, 2002, 1998, 1994, by Saunders, an imprint of Elsevier Inc.

3. Antepartum Assessment and Care benefits
Ideally before conception
Identify problems
Provide education to help achieve a healthy pregnancy
History, vital signs, and physical examination
Screening
Medications and nutrition
Copyright © 2014, 2010, 2006, 2002, 1998, 1994, by Saunders, an imprint of Elsevier Inc.

4. Antepartum Assessment and Care: Initial Prenatal Visit goals
Establish trust and rapport with family.
Verify or rule out pregnancy.
Evaluate woman’s physical health.
Assess the growth and health of the fetus.
Establish baseline data.
Evaluate the psychosocial needs.
Assess the need for counseling or teaching.
Negotiate a plan of care.
Copyright © 2014, 2010, 2006, 2002, 1998, 1994, by Saunders, an imprint of Elsevier Inc.

5. First Antenatal Assessment
It is a Comprehensive health history.
Is taken during the initial visit, including:
Demographic data
Menstrual history
Pregnancy History
Prior obstetric history
Prior Gynecologic History
Past medical and surgical/psychological history
Family history
Genetic screening

6. First Antenatal Assessment
9. Medications 10. History of exposure to infections (STDs) (Use the prenatal history form is the best way to document these data)

7. First Antenatal Assessment form
1- Reason for seeking care
-When she missed her menstrual period or had a positive pregnancy test at home, she will seek for a care.
- Ask the women about her last menstrual period (LMP), any probable signs of pregnancy and hCG (Human Chrionic Gonadotropin) is made to confirm pregnancy.

8. First Antenatal Assessment
2- Past health history
Past medical and surgical history
Urinary tract infections.
Chronic diseases like Diabetes mellitus, heart diseases, hypertension,
History of allergies from medications, foods, or environmental substances.
Mental health problems like depressions and anxiety

9. 3. Personal history
Occupation
Possible exposure to teratogens
Exercise and activity level
Recreational patterns (alcohol, tobacco, and drugs)
Sleep patterns
Nutritional habits, and general lifestyle.

10. First Antenatal Assessment
4. Reproductive History
a- Menstrual history
Describe the menstrual cycle including the her age at menarche.
Number of days in her cycle
Typical flow characteristics
Any associated discomforts
last time she used the contraception.
Ask the LMP to estimate the EDD (Expected Date of Delivery) Nagele's rule (Subtract 3 months and then add 7 days to the first day of LMP. Then add 1 to the year. The margin error is plus or minus 2 weeks.
e.g., 14 October 2014 LMP
EDD is 21 July 2015.

11. First Antenatal Assessment
b- Obstetric history past pregnancies
Any problems encountered in during past pregnancies, labors, deliveries.
G and P is used, G means Gravida-number of pregnancy, P means Para means number of deliveries.
c- Gynecologic history
Reproductive tract surgeries
Tubal pregnancy, polyps,
Papilloma, endometriosis…etc.

12. Follow-up visits
-Continuous prenatal care is important for a successful pregnancy outcome.
-Recommended follow-up visit schedule for healthy pregnant women is:
*Every 4 weeks up to 28th weeks (7 months)
*Every 2 weeks from 29th till 36th week
*Every week from 37th to birth.

13. Follow-up visits Physical exam Vital signs Weight and blood pressure
Urine test for protein, sugar, ketones.
Fundal height measurement to assess fetal growth-A distance measured by a tape from pubic bone till top of uterus(fundus) while she is in supine position -McDonald's method.
Assessment the quickening/fetal movements to determine fetal well- being. Usually perceived between 16th and 20th week of gestation.
Assessment of fetal heart rate (Normal is bpm)

14. Copyright © 2014, 2010, 2006, 2002, 1998, 1994, by Saunders, an imprint of Elsevier Inc.

15. Fundal height

18. Lab Activity
History Taking practice.
Follow up visit assessment.

19. Reference
“Foundations of Maternal-Newborn and Women's Health Nursing” by Sharon Murray, Emily McKinney, 6th Edition; Saunders