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ANTEPARTUM CARE. CARE AND MANAGEMENT OF ANTEPARTAL WOMEN. I. OBSTETRIC AND GYNECOLOGIC HISTORY. II. GENERAL PRENATAL CARE AND PHYSICAL ASSESSMENT Tetanus immunization Physical examination Estimation of gestational age 1. Naegele’s rule 2. Mc Donald’s rule
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CARE AND MANAGEMENT OF ANTEPARTAL WOMEN I. OBSTETRIC AND GYNECOLOGIC HISTORY
II. GENERAL PRENATAL CARE AND PHYSICAL ASSESSMENT • Tetanus immunization • Physical examination • Estimation of gestational age 1. Naegele’s rule 2. Mc Donald’s rule 3. Bartholomew’s rule 4. Haase’s rule • Pelvic Examination • Leopold’s Maneuver
III. ANTEPARTUM FETAL SURVEILLANCE A. Daily Fetal Movement Counting (DFMC) B. Non-Stress test C. Contraction Stress Test or Oxytocin Challenge test (OCT) D. Biophysical Profile
IV. HEALTH TEACHING ABOUT PREGNANCY A. Frequency of Pre-Natal Visits • Danger Signs of Pregnancy • 1. Swelling or edema of the upper extremities – • preeclampsia. • 2. Chills and fever – signs of infection
3. Abdominal pain – “epigastric pain is an aura of an impending convulsion. 4. Board-like abdomen – abruptio placenta 5. Sudden gush of fluid – premature rupture of membranes; predisposes the mother and the fetus to infection.
C. Nutrition 1. All pregnant women should be encouraged to eat a well-balanced diet. 2. Folic acid is recommended in the pre conceptional and early prenatal period to prevent neural tube defects. 3. Nutritional recommendations for pregnant women are based upon the pregnancy body mass index. 4. Conduct nutritional assessment and emphasize knowledge on the food guide pyramid . 5. Calories: a. Non-pregnant: 2200 b. Pregnant: +300=2500 c. Lactation: +500=2700
D. Sexual Activity 1. Principles 2. Contraindication 3. Sexual Appetite E. Exercise - to strengthen muscles that will be used during the delivery process; done in moderation and must be individualized 1. Walking – best form of exercise. 2. Squatting – to strengthen perineal muscles and increase circulation to perineum
3. Tailor Sitting – same purpose as squatting; done by placing one leg in front of the other. 4. Kegel’s exercise – strengthens pubococcygeal muscle. 5. Abdominal Exercise – strengthen muscle of abdomen 6. Shoulder Circling – strengthen muscle of chest. 7. Pelvic Rocking or Pelvic Tilt – relieves low back pain and maintains good posture.
F. Childbirth Preparation 1. Overall goal: to prepare parents physically and psychologically while promoting wellness behavior that can be used by parents and family thus, helping them achieve satisfying and enjoying childbirth experience. 2. Types a. Psychophysical b. Psychosexual c. Psychoprophylaxis (prevention of pain through the mind
G. Different Methods of Delivery 1. Birthing Chair:semi-fowler’s position 2. Birthing bed: dorsal recumbent 3. Squatting position: facilitate descent and relieves low back pain. 4. Leboyer’s method: to prevent trauma to the baby. 5. Birth under water – common practice in US, Latin America, Japan and Scandinavian region.