prenatal visits / check – up → for confirmation; missed menstrual period = usual reason
First Prenatal Visit
occurs as soon as the woman thinks she might be pregnant
the longest period
Objectives:
to confirm or rule out pregnancy
to ascertain risk factors
to determine the due date (using Naegele's rule)
to provide education on maintaining a healthy pregnancy
Components:
1. History – most important element
- written questionnaire or by face-to-face interview
Parts of History Taking:
a. Chief complaint → amenorrhea
b. Reproductive history → LMP, GTPAL (gravida, term, para, abortion, living children), menarche, length of menstrual cycle
c. Medical – surgical → ooectomy, breast augmentation, colicystectomy
d. Family History → hypertension, diabetes
e. Social History → occupation
2. Physical Examination – covers all body system
- head-to-toe examination
- vaginal speculum examination
> Papanicolaou Test / Pap Smear → for early detection of cervical cancer
3. Laboratory Assessment
CBC → to determine hemoglobin level (if low – affect O2 of fetus)
Blood Type and Antibody Screen
Rubella Titer
Urine Culture
TB Screening → Purified Protein Derivative (PPD)
Ultrasound
Subsequent Visits:
o Schedule
Week
Number of Visits
01 – 32 - once/month
32 - 36 - 2x/month
36 - delivery - Every week
Include Specific Assessments:
Weight → 3 -12 – 12 (to avoid striae gravidarum)
BP
Urine protein and glucose
Fetal Heart Rate → ultrasound in 2nd trimester
Danger signs of pregnancy
Fetal movement
Contractions → for cases of miscarriage in 1st trimester
Membrane rupture
Fundal Height
Danger Signs of Pregnancy
Fevere or severe vomiting
Severe or continuous headache
Blurred vision or spots before the eyes
Pain in the epigastric or abdominal area
Sudden weight gain or sudden onset of edema
Vaginal bleeding
Painful urination
Sudden gush or constant, uncontrollable leaking of fluid from the vagina
Decreased fetal movement
Signs of Pre-term Labor
** Labor – series of events that end in the product of conception
Uterine Contractions → regular, painful
Lower, dull backache → due to crowning or engagement
Pelvic pressure → engagement
Menstrual-like cramps → uterine contractions
Increase vaginal discharge → SHOW – bloody mucoid vaginal discharges; ROM
A feeling that something is not right
