Presumptive indications :
•Amenorrhea
•Nausea and vomiting
•Fatigue
•Urinary frequency
•Breast and skin changes
•Cervical color changes
•Quickening
Probable indications :
•Abdominal enlargement
•Cervical softening
•Ballottement
•Braxton hicks contraction
•Palpation of fetal out line
•Pregnancy tests in blood
and urine
Positive indications :
•Auscultation of fetal heart
beats
•Feeling the fetal movements
by examiner
•Ultrasound visualization of
The conception
1st 12 weeks :
•Amenorrhea
•Morning sickness
•Breast changes
•Change appetite
•Sleepy and depressed
13-28 weeks :
•Amenorrhea
•Breast changes
•Morning sickness
•Braxton hicks contraction
•ballottement
29- 40 weeks :
•Palpation of fetal parts
•Fetal movements
•FHS
•Umbilical souffle
•Seeing of fetal movement
•Seeing of fetal skeleton
by sonar
•Breast sensitivity
•Secretion of cholestrum
•Softening of uterus
•Cervix ,vagina changes
•hCG in :
•Urine : one week after
missed period
•Blood : before one week
of missed period
(After implantation ).
Definitions :
•Ante : before
Natal : delivery
Antenatal : before delivery
•Antenatal care : comprehensive health supervision
of pregnant woman.
•Gravida : refers the number of pregnancies regardless
of duration of the pregnancy
•Para: refers to the number of pregnancies that end at
20 weeks or more.
To reduce maternal mortality and morbidity rate
Improve women and children health
Prepare woman for labor, lactation and care of her infant
Early detection and early treatment of complicated conditions .
Antenatal Room :
Preparation :
1.
2.
3.
4.
5.
6.
7.
Trays :VS , Immunization , medication
Furniture
Stationary
Visual display
Weighting room
Nursing
roles
:
Scales
1. Welcoming
Urine traces
2. Privacy
3. History
4. Physical examination
History
Personal Hx:
•Name
•Address
•Age
•Education
•Occupation
•Duration
•of marriage
•Religion
•Finance
M&S Hx:
•Immunization
•Chronic illness
•Infection
•STD
•Anemia
•Smoking
•Allergies
•Drug sensitivity
•Gynecological
•Elimination
•Blood transfusion
Obstetric Hx:
Family Hx:
•Chronic disease
TB,HB
• Genetic/
congenital
abnormalities
•Smoking
•Rh factor
Obstetric Hx:
(GTPAL) for pregnancy out come
•
•
•
•
•
•
•
•
•
•
•
1.
2.
3.
4.
Gravida ,Para , abortion ,living births
Weight of infant at birth
Length of gestation of previous pregnancy
Previous child sex
Labor experience , type , location ,name of care giver
Type of anesthesia
Maternal /fetal complication (DM, HTN, bleeding ,infection)
Feeding of infant
Date of last delivery
Contraceptive history /complication
Menstrual history :
Age of menarche
Regularity ,Duration and frequency of MP
Any previous treatment of MP or infertility
LMP /EDD
Naagele’s rule:
1st day :add 7 days
Month : subtract 3
Year : add one year (adjusted )
Group one (5STU):
Mrs. H . newly notice that here
manse is absent for two weeks ago ,
she want to confirm that she is
pregnant or not ,
• what will you advice her to do ?
•What other changes you will ask about?
•Could you look for positive sign for
Pregnancy at this time in case of Mrs. H?
Group 2 (5STUD)
Positive hCG in the urine , categories
in which pregnancy indications?
what others related indication you could look for ?
If Mrs. H is not accurate about the date of her LMP ,
What other investigations could help in determine
Pregnancy age - later on ?
If she is pregnant give her antenatal visits
schedule ?
Case two :
Alma has 2males children and 3 females ,
one of her sun born at 39 weeks , the other is
term but is handicap .
two of her daughters born as preterm twins
at 36weeks.
She delivered one dead baby two years ago,
and she have 2abortins .now she is
pregnant for 14weeks .
Group 3 (5STUD)
Report complete obstetric history ?
Add extra question if you need ?
Classify gravida and Para ?
Group4 (4STUD)
If you told by this client that LMP is : 2/1/2009
Calculate EDD?
Group5 (4STUD)
If you told by this client that LMP is : 1/12/2008
Calculate EDD?
Group6 (4STUD)
If you told by this client that LMP is : 31/ 1/2009
Calculate EDD?