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Antenatal Care

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Title: Antenatal Care


1
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Antenatal Care
3
ANTENATAL CARE
Antenatal care means "care before birth (During
pregnancy) Antenatal care aims to monitor and
promote the wellbeing of a mother and her
developing baby, and to provide information,
advice and reassurance as well as monitoring,
screening and treatment where necessary.
4
Who provides antenatal care?
5
Antenatal education
  • It takes the form of programmed course in the
    third trimester.
  • Each team member reinforce the role of the others
    and this requires good communication with regular
    contact to operate an effective referral system

6
Aims of adequate antenatal care
  • To detect and treat any physical or psychological
    defect.
  • Prepare the parents for the birth of the baby.
  • Give confidence to the women in her own abilities
    through an understanding of how her body
    functions and various changes occurring during
    pregnancy and birth.

7
Psychological preparation for pregnant women
  • primigravidae and large number of multigravidae
    experience an increase in anxiety during
    pregnancy and have fears about childbirth due to
  • Baby will die in uterus.
  • Baby will not be born normally.
  • Baby will not be healthy.
  • Childbirth will be traumatic and pain relief
    will not be provided.
  • Drugs taken during pregnancy may cause birth
    defects .
  • Birth-child will alter the relationship between
    the woman and her husband.

8
  • The greater the anxiety, the greater the chance
    that labour will be more difficult.
  • So the pregnant women should talk about their
    anxieties. Doctors and other team members must
    describe to them, the changes which are occurring
    in their bodies and explain the purpose of
    investigation they make.

9
Physical preparation for pregnant woman
  • Physical plane should be given to help a young
    women through phases of childbearing cycle.
  • This plane should include certain anatomical
    structure of
  • The bony pelvis, its size and shape.
  • Its position in the body in relation
    to
  • posture.
  • The attachment of pelvic inlet and
    outlet.
  • The attachment of the muscle of the
    pelvic floor.
  • The development of muscles, ligaments,
    joints.
  • The role of pelvic floor muscles and
    abdominal muscles
  • during labour.
  • A selected number of illustration will greatly
    assist the information given by spoken word

10
Physical therapy program for normal pregnant
woman
  • Experienced Physical therapist conduct courses
    and give intensive training in physical, mental
    preparation and care of pregnant woman in small
    classes to
  • Allow meeting between pregnant woman with
    another at the same state of pregnancy.
  • Emphasize that pregnancy is physiological
    process.
  • Date of starting physical therapy program
  • depends on the medical advisor and should be
    before the woman increases her weight.

11
Role of physiotherapy during pregnancy
  • Assess physical health and identify any
    musculoskeletal or neuromuscular problems.
  • Advise on back care and lifting, back strain is
    minimized when the spin is held in its normal
    curves, so postural correction exercises are
    practiced from different positions (standing,
    sitting, lying position, crock lying positions(
  • Lifting advices (from height and from ground)

12
  • The principles for the pregnant woman to
    follow when lifting objects are
  • The foot should be apart to increase the base of
    support.
  • Any object to be lifted should be close to the
    body.
  • Objects lifted from ground should be light
    enough.
  • Objects lifted from height should be close to
    the body and its
  • height should be easy reached.
  • Teach methods for controlling tension and pain
    during labour e.g.
  • Relaxation technique.
  • Breathing exercises. (to preserve energy.)

13
  • Treat any problem with appropriate physiotherapy
    skills e.g.
  • Pubic pain.
  • Lumber pain.
  • Cramps.
  • Teach positions that may be used for labour
    (crock lying position)

14
Physical therapy skills
  • Leg exercises to prevent varicose veins.
  • Abdominal contractions from different positions.
  • Pelvic tilting and postural correction.
  • Pelvic floor contractions are taught in stride
    sitting with elbow resting on the knees.
  • Relaxation techniques.
  • Breathing exercises.
  • Walking and lining forward exercises.
  • TENS to relive pain.
  • Pelvic support ( firm elastic corset which
    modified and fitted under the main pubic when
    pubic pain is related to rectus abdominal muscles
    diastasis.0

15
Model of physical therapy program for normal
pregnant woman
  • From 4th month of pregnancy not before that time
    to avoid abortion.
  • The physical therapy program includes
  • Breathing exercises (deep breathing).
  • Relaxation ? in any comfortable position chosen
    by mother, room must be calm, quite, warm, no
    air draft, no direct light, light music assist
    physical and menta relaxation.
  • Postural correction ? to avoid postural
    problems.

16
  • From the end of 6th month till the end of 8th
    month of pregnancy.
  • Deep breathing exercises.
  • Relaxation training.
  • Pelvic rocking exercises (upward, backward)
  • Leg exercises
  • Pelvic floor contraction.
  • Abdominal exercises.
  • Arm exercises for preparation of lactation and to
    allow free flow of milk.

17
  • During the last month of pregnancy
  • Instruction about onset of labour.
  • Stages of labour.
  • Breathing exercises.
  • Explanation for TENS and its effect in
  • relieving pain.

18
Medical antenatal care for normal pregnant woman
  • The objectives of antenatal care are
  • 1) Regular observation for early detection and if
    possible prevention of complications of
    pregnancy. E.g. toxemia or hemorrhage.
  • 2) Detection and management of any complicating
    general diseases .e.g. anemia and diabetes.
  • 3) Detection of complications which affect labour
    such as mal-presentation.
  • 4) Instruct the patient about hygiene and diet.
  • 5) Laboratory studies as blood group, Rh typing,
    serological examination to detect the conditions
    which may affect the fetus.

19
Frequency of examination
  • Every month until the7th month and every 2 weeks
    until the last month and every week in the last
    month.
  • The 1st visit includes history taken, general
    abdominal and vaginal examination, urine analysis
    for albumin and sugar, blood examination for
    hemoglobin and blood group.
  • Return visits ask about warning symptoms, weight
    the mother, look for edema and measure blood
    pressure, do abdominal examination and urine
    analysis for albumin and sugar.

20
REassurance and Advices
  • Exercises and traveling
  • Avoid vigorous exercises e.g. swimming,
    tennis and
  • cycling.
  • Avoid traveling on hard roads and for long
    distances
  • specially during last month.
  • Sleep and rest.
  • Breast care washing, massage the nipple with a
    mixture of glycerin and alcohol to reduce the
    incidence of cracking.
  • Bowel habits avoid constipation (cause piles
    and genital prolapse).
  • Closes should be loose, comfortable, avoid tight
    breast support. The shoes should be easily
    fitting with low heels.

21
Thank you
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