ANTEPARTUM TERMINOLOGY

1
ANTEPARTUM TERMINOLOGY
2

• Gestation the number of weeks of pregnancy since
  the first day of the last menstrual period
• Abortion birth that occurs before the end of 20
  weeks gestation
• Term the normal duration of pregnancy (38 to 42
  weeks gestation)
• Antepartum time between conception and the onset
  of labor usually used to describe the period
  during which a woman is pregnant used
  interchangeably with prenatal

3

• Intrapartum time from the onset of true labor
  until the birth of the infant and placenta
• Postpartum time from the delivery of the
  placenta and membranes until the womans body
  returns to a nonpregnant condition
• Preterm or premature labor labor that occurs
  after 20 weeks but before completion of 37
  weeks gestation
• Postterm labor labor that occurs after 42 weeks
  gestation

4

• GRAVIDA any pregnancy, regardless of duration,
  including present pregnancy
• Nulligravida a woman who has never been pregnant
• Primigravida a woman who is pregnant for the
  first time
• Multigravida a woman who is in her second or any
  subsequent pregnancy

5

• PARA birth after 20 weeks gestation regardless
  of whether the infant is born alive or dead
• Nullipara a woman who has had no births at more
  than 20 weeks gestation
• Primipara a woman who has had one birth at more
  than 20 weeks gestation, regardless of whether
  the infant was born alive or dead
• Multipara a woman who has had two or more births
  at more than 20 weeks gestation
• Stillbirth an infant born dead after 20 weeks
  gestation

6

• TPAL/GPA
• T--NUMBER OF TERM PREGNANCIES
• P--NUMBER OF BIRTHS AFTER 20 WEEKS
• ANUMBER OF ABORTIONS
• LNUMBER OF LIVING CHILDREN

7
(No Transcript)
8
ANTEPARTUM PHYSICAL AND PSYCHO-SOCIAL ASSESSMENT
9
ANTEPARTUM PHYSICAL AND PSYCHOSOCIAL ASSESSMENT
CULTURE
FINDINGS RELATED TO PREGNANCY
PHYSICAL ASSESSMENT
RISK FACTORS
CLIENT PROFILE
ECONOMICS ENVIRONMENT SUPPORT SYSTEM
FAMILY FUNCTION
EDUCATIONAL NEEDS
10
CULTURAL BELIEFS AND PRACTICE ASSESSMENT IN
ANTEPARTUM PERIOD

• HOME REMEDIES
• NUTRITION
• ALTERNATIVE HEALTH CARE PROVIDERS
• FAMILY SUPPORT
• EXERCISE
• SPIRITUALITY

11
CULTURAL CONSIDERATIONS/ASSESSMENT IN ANTEPARTUM
PERIOD

• VIEW OF PREGNANCY
• SELF CARE PRACTICES
• PAIN
• CHILDBIRTH PRACTICES
• CARE OF THE NEWBORN
• POST PARTUM

12
(No Transcript)
13
SIGNS OF PREGNANCY

• SUBJECTIVE (PRESUMPTIVE)
• OBJECTIVE (PROBABLE)
• DIAGNOSTIC (POSITIVE)

14
DUE DATE

• EDB
• NAEGLES RULESUBTRACT 3 MONTHS FROM FIRST DAY OF
  LAST MENSTRUAL PERIOD AND ADD 7 DAYS
• EXAMPLE LMP OCT. 12EDB---JULY 19

15
CLIENT PROFILE

• CURRENT PREGNANCY
• PAST PREGNANCY
• CURRENT MEDICAL/SUGICAL HISTORY
• GYN HISTORY
• FAMILY MEDICAL HISTORY
• RELIGIOUS, SPIRITUAL, CULTURAL HISTORY
• OCCUPATIONAL HISTORY
• PERSONAL INFORMATION(PSYCHOSOCIAL)

16
ANTEPARTUM RISK FACTORS

• FACTORS RELATED TO
• ECONOMICS
• ENVIRONMENT
• CURRENT HEALTH STATUS/PRACTICES
• AGE
• NUTRITION
• CHILDBIRTH HISTORY
• SOCIAL ISSUES
• PYSCHOLOGICAL STATUS

17
PSYCHO-SOCIAL ANTEPARTUM ASSESSMENT

• CULTURE
• PSYCHOLOGIC STATUS
• EDUCATIONAL NEEDS
• SUPPORT SYSTEMS
• FUNCTIONING OF FAMILY
• ECONOMIC STATUS
• ENVIRONMENT

18
ANTEPARTUM PHYSICAL ASSESSMENT

• VS, WEIGHT UTERUS
• SKIN, NOSE EXTERNAL GENITALS
• MOUTH, EARS, NECK CERVIX, VAGINA
• CHEST AND LUNGS ANUS AND RECTUM
• BREASTS LAB EVALUATION
• HEART
• ABDOMEN
• EXTREMITIES
• REFLEXES
• SPINE

19
MATERNAL NUTRITION

• AVERAGE WEIGHT GAIN
• PATTERN OF WEIGHT GAIN
• NUTRITIONAL REQUIREMENTS
• CALORIES
• PROTEIN

20
MATERNAL NUTRITION

• FAT
• CARBS
• VITAMINS
• MINERALS
• CULTURAL CONSIDERATIONS

21
MATERNAL NUTRITION

• VEGETARIANISM
• LACTOSE DEFICIENCY
• EATING DISORDERS
• PICA
• ADOLESCENT
• WHAT TEACHING WOULD YOU DO FOR THESE ALTERATIONS/
  CHANGES IN NUTRITION?

22
(No Transcript)
23
(No Transcript)
24
LAB EVALUATIONS INITIAL ANTEPARTUM VISIT

• SCREENING TESTS
• CBC
• ABO AND Rh TYPING
• WBC WITH DIFFERENTIAL
• FIRST TRIMESTER ANEUPLOIDY
• STD SCREENING, HIV
• GLUCOSE
• RUBELLA TITER
• HEPATITS B
• SICKLE CELL
• PAP SMEAR

25
ANTEPARTUM ASSESSMENTFETAL DEVELOPMENT

• FUNDAL HEIGHT
• QUICKENING fetal movement felt by mother gtgt 20
  weeks gestation
• FETAL HEART BEAT Doppler gtgt 8 - 12 weeksgest,
  fetoscope gtgt 16 weeks (early), mostly 19 or 20
  weeksgest
• ULTRASOUND gestational sac gtgt5-6 weeks after the
  LMP, FHR by 6-7 weeks, fetal breathing movement
  by 10-11 weeks of pregnancy

26
FUNDAL HEIGHT
Figure 83 A cross-sectional view of fetal
position when McDonalds method is used to assess
fundal height.
27
Figure 75 Approximate height of the fundus at
various weeks of pregnancy.
28
DANGERS IN PREGNANCY
29
DANGER SIGNS OF PREGNANCY

• VAGINAL BLEEDING
• LEAKAGE OF FLUID FROM VAGINA
• ABDOMINAL PAIN
• TEMP gt 38
• DIZZINESS, BLURRING OF VISION
• SEVERE HEADACHE
• EDEMA OF HANDS, FACE, FEET

30
DANGER SIGNS OF PREGNANCY

• PERSISTENT VOMITING
• MUSCULAR IRRITABILITY
• EPIGASTRIC PAIN
• OLIGURIA
• DYSURIA
• ABSENCE OF FETAL MOVEMENT

31
SELF CARE PROMOTION

• DENTAL CARE
• IMMUNIZATIONS
• SEXUAL ACTIVITY
• COMPLEMENTARY ALTERNATIVE THERAPIES
• ABSTINENCE FROM ALCOHOL, TOBACCO, DRUGS
• PSYCHO-SOCIALSUPPORT

32
ANTEPARTAL VISITS

• The recommended frequency of antepartal visits in
  an uncomplicated pregnancy is as follows
• Every 4 weeks for the first 28 weeks gestation
• Every 2 weeks until 36 weeks gestation
• After week 36, every week until childbirth

33
THANK YOU!