PRENATAL CARE : “Periodic and regular supervision including examination and advice of a

woman during pregnancy is called Antenatal care”

→The supervision should be of a regular and periodic nature in accordance with the need of the
individual.

AIMS : The aims are-

• To screen the high risk cases

• To prevent or detect or treat at the any earliest complication

• To ensure continued medical surveillance and prophylaxis

• To educate the mother about the physiology of pregnancy and labor by demonstrations, charts and
diagrams so that fear is removed and psychology is improved

• To discuss with the couple about the place, time and mode of the delivery, provisionally and care of
the newborn

• To motivate the couple about the need of family planning

• To advice the mother about breast-feeding, post-natal care and immunization

 OBJECTIVES :

To ensure a normal pregnancy with delivery of a healthy baby from a healthy mother

PRENATAL CARE :

Prenatal care is the health care a woman gets during pregnancy. Prenatal care should begin as soon as a
woman knows or thinks she is pregnant. Early and regular prenatal visits are important for the health of
both the mother and the fetus.

Research shows that prenatal care makes a difference for a healthy pregnancy. Women who do not seek
prenatal care are three times as likely to deliver a low birth weight infant. Lack of prenatal care can also
increase the risk of infant death.

IMPORTANCE OF PRENATAL CARE :

→ Having a healthy pregnancy is one of the best ways to promote a healthy birth. Getting early and

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regular prenatal care improves the chances of a healthy pregnancy. This care can begin even before
pregnancy with a pre-pregnancy care visit to a health care provider.

→Women who suspect they may be pregnant should schedule a visit to their health care provider to
begin prenatal care.

 Prenatal visits to a health care provider usually include a physical exam, weight checks, and
providing a urine sample. Depending on the stage of the pregnancy, health care providers may
also do blood tests and imaging tests, such as ultrasound exams. These visits also include
discussions about the mother's health, the fetus's health, and any questions about the pregnancy.
 Prenatal care can helps to prevent complications and to inform women about important steps
they can take to protect their infant and ensure a healthy pregnancy. With regular prenatal care
women can:
 Reduce the risk of pregnancy complications. Following a healthy, safe diet; getting regular
exercise as advised by a health care provider; and avoiding exposure to potentially harmful
substances such as lead and radiation can help reduce the risk for problems during pregnancy
and promote fetal health and development.
 Controlling existing conditions, such as high blood pressure and diabetes, is important to
prevent serious complications and their effects.
 Reduce the fetus's and infant's risk for complications. Tobacco smoke and alcohol use during
pregnancy have been shown to increase the risk for Sudden Infant Death Syndrome.
 Alcohol use also increases the risk for fetal alcohol spectrum disorders, which can cause a
variety of problems such as abnormal facial features, having a small head, poor coordination,
poor memory, intellectual disability, and problems with the heart, kidneys, or bones.
 According to one recent study supported by the NIH, these and other long-term problems can
occur even with low levels of prenatal alcohol exposure.
 In addition, taking 400 micrograms of folic acid daily reduces the risk for neural tube defects by
70%.
 Most prenatal vitamins contain the recommended 400 micrograms of folic acid as well as other
vitamins that pregnant women and their developing fetus need.
 Folic acid has been added to foods like cereals, breads, pasta, and other grain-based foods.
Although a related form (called folate) is present in orange juice and leafy, green vegetables
(such as kale and spinach), folate is not absorbed as well as folic acid.
 Help ensure the medications women take are safe. Women should not take certain medications,
including some acne treatments and dietary and herbal supplements, during pregnancy because

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 they can harm the fetus.
 Monitor baby's movement
After 28 weeks, it’s advised to keep track of baby's movement. This will to notice if the
fetus is moving less than normal, which could be a sign that your fetus is in distress. Count
your baby's movements every day so you know what is normal for you. If the count is less
than 10 movements within two hours or if you notice the baby is moving less than normal.
If your baby is not moving at all its advised that the mother should go to the nearest
hospital.
 Helps to reduce risk of miscarriages. Noticed when a fetal heart beat is missing, an
ultrasound is advised to be positive.
 Helps to reduce rate of premature birth. Birth before 37weeks is considered preterm. The
U.S experienced a 20% increase in premature birth from 1990-2006. Women who have
little or no prenatal care or obese women and those who have had preterm labor before are
at increased risk. Preterm birth is the leading cause of newborn death and disability.
 Babies who survive often have lifetime health complications for example breathing
problems due incomplete formation of the lungs, Cerebral palsy and intellectualdisabilities.
 Helps in monitoring high risk pregnancies.

ROLE OF A PEDIATRIC NURSE IN PRENATAL CARE :

1.REGISTRATION-

The nurse has to do registration of the prenatal mother. so that to assess the following condition-

 To assess the health status

 To identify and manage high risk cases

 To estimate EDD more accurately

 To give the first dose of TT (after 12 weeks)

 To help the woman for an early and safe abortion (MTP) if it is required by her

 To start the regular dose of folic acid during the first trimester.

2.PRENATAL SERVICES FOR MOTHERS

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  Health history
 Physical examination
 Laboratory Examination
• Urine/Stool/Blood(Count)/Hb/Serological/Blood group(Rh also)
• Pap test(if facilities)/ Chest X-Ray and Gonorrhea test(if needed)
 High risk approach
 IFA and necessary medications
 TT Immunization
 Health education
 Home visit
 Referrel ( if needed )

3. MAINTENANCE OF RECORDS :

Antenatal Card
_ Antenatal register

4. ANTENATAL CHECKUP HISTORY :

(I) To diagnose pregnancy

(ii) To identify any complications during previous pregnancies

(Iii) To identify any medical/obstetric condition(s) that may complicate this pregnancy

Calculation of EDD :

• Ask for the first day of the last menstrual cycle (LMP)

• Ask for the date when the foetal movements were first felt(quickening)

• Also assess the fundal height to estimate the gestational age

• Ask for any test done to confirm pregnancy EDD= LMP + 9 months + 7 days

Age of the woman

• Complications when <16 years/>40 year

Order of the pregnancy

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• Primigravida and multipara are at risk

Birth interval

• Ideally should be >3 years

5.SYMPTOMS DURING THE PRESENT PREGNANCY :

• Symptoms indicating discomfort :

nausea and vomiting

Heart burn
Constipation
Frequency of urination

• Symptoms indicating that a complication may be arising :

Fever
Vaginal discharge /bleeding
Palpitations
Breathlessness at rest
Generalized swelling of the body ;puffiness of the face
Oliguria
Decreased or absent foetal movements

6. PREVIOUS PREGNANCIES/OBSTETRIC HISTORY :

Number of earlier pregnancies/ abortions/ delivers

Number of premature births/still birth /neonatal deaths
Hypertensive disorders of pregnancy (history of convulsions)
Prolonged /obstructed labour
Malpresentation
APH/PPH
Modes of deliveries(normal/assisted/caesarean section)
Birth weight of the previous baby
Any surgery on the reproductive tract
Iso-immunization (Rh-ve) in the previous pregnancy (Any costly inj. Given to her within 72
hours of her previous delivery.

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7. HISTORY OF ANY SYSTEMIC ILLNESS:

 Hypertension
 Diabetes
 Heart disease
 Tuberculosis
 Renal disease
 Convulsions
 Asthma
 Rashes
 Jaundice
 Thalassemia
 Delivery of twins or delivery of an infant with congenital malformations
 History of drug intake or allergies
 History of intake of habit-forming substances (tobacco, alcohol)

8. INVESTIGATION :

The nurse should undergo following investigation-

• CBC

• Blood grouping & Rh typing

• Urine R/E

• RBS

• VDRL

• HBS Ag

•Ultrasound

Ultrasound early pregnancy (preferably at 10-13 weeks) to:

• Determine gestational age

• Detect multiple pregnancies

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 • Help with later screening for Down's syndrome

● At 11-14 weeks: offer nuchal translucency screening for Down's syndrome, with other tests if
available.

● At 18-20 weeks: offer screening with ultrasound for congenital anomalies.

● At 36 weeks: for foetal maturity, placenta praevia.

 9.ANTENATAL ADVICE

1.DIET

Diet should be:

1. Nutritious

2. Balanced

3. Light

4. Easily digestible

5. Rich in protein, mineral and vitamin with woman’s choice

6. Iron & folic acid supplementation.

10.REST & SLEEP

 Night 8 hours ,Day 2 hours (Lt side)

 Avoid heavy work (especially lifting heavy weights)
 Avoid the supine position (especially in late pregnancy, if it is necessary, a small pillow under
the lower back at the level of the pelvis should be used)

11. BOWEL :

• Regular bowel movement may be facilitated by regulation of diet, taking plenty fluid, vegetable and
milk

12. ABSISTENCE :

Should be avoided in

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• 1st trimester

• last 6 weeks

13. TRAVELLING :

Should be avoided in

• 1st trimester

• last 6 weeks

Air travelling is contraindicated in

• Placenta praevia

• Preeclampsia

• Severe anemia

14. IMMUNIZATION

Indicated-

• TT • HAV • HBV • Rabies

Contraindicated-

• Live virus vaccine (rubella measles, mumps, Varicella)

15. PERSONAL HYGIENE

• The nurse should advice the mother regarding the personal hygiene and its importance.

16. RADIATION

• The nurse should advice the mother to avoid the X-rays.

17. DRUGS

• Sedative , Anticoagulant, Antithyrodism, Hormones& Antibiotics Should Be Avoided .

18. OCCUPATIONAL HAZARDS

Lead, mercury, X ray s& ethylene oxide.

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19 .DANGER/WARNING SIGNS

• High fever with/without abd. pain, feels too weak to get out of bed

• Fast/difficult breathing

• Decreased or absent foetal movements

• Excessive vomiting (woman is unable to take food/fluids)

• Any bleeding P/V during pregnancy

• Heavy (>500 ml) vaginal bleeding during and following delivery

• Severe headache with blurred vision

• Convulsions or loss of consciousness

• Labour lasting longer than 12 hours

• Failure of the placenta to come out within 30 minutes of delivery

• Preterm labour

• Premature or prelabour rupture of membranes (PROM)

• Continuous severe abdominal pain

20. HEALTH EDUCATION

The nurse should educate the mother regarding-

• Breast feeding

• Nutrition

• Family planning

• Postnatal exercises

• Child care

• Dental care

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• Clothing, shoes and belt

• Care of breast

• Smoking and alcohol

• Birth plan

• Mental preparation

• Diet

• Sleep and rest

• To avoid stressor

• Minor ailments.

Summary :
Till now we have discussed about definition ,aims ,objectives of prenatal care,importance of
prenatal care and role of pediatric nurse in prenatal care .
Conclusion :
By the end of the class student’s gained knowledge regarding the Importance of prenatal care
and role of pediatric nurse.
Bibliography :
→ www.slideshare.com

SEMINAR
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 ON
IMPORTANCE OF PRENATAL
CARE AND ROLE OF

PEDIATRIC NURSE

SUBMITTED TO : SUBMITTED BY :
MRS.ARCHANA MADAM M.JYOTHSNA
ASSISTANT PROFESSOR M.SC (N) 1ST YEAR
DEPARTMENT OF CHILD HEALTH NURSING. JAYA COLLEGE OF NURSING
JAYA COLLEGE OF NURSING.

OBJECTIVES

General objectives :
By the end of the class the group will be able to gain adequate knowledge regarding
Importance of prenatal care and role of pediatric nurse.

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Specific objectives :
By the end of the class the group will be able to
→ define Prenatal care.
→explain the Aims and Objectives of prenatal care.
→ explain the Importance of prenatal care.
→discuss the Role of pediatric nurse in prenatal care.

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