Title: Antenatal Care
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2Antenatal Care
3ANTENATAL 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.
4Who provides antenatal care?
5Antenatal 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
6Aims 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.
7Psychological 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.
9Physical 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 -
10Physical 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. -
11Role 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)
14Physical 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
15Model 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.
18Medical 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. -
19Frequency 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.
20REassurance 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.
21Thank you