Dr.

Hanan Tork, RN, PhD

Outlines:
1. Maternity terminology

2. Prenatal Care
-Goals of Prenatal Care
-Healthcare Prior to Conception
-Prenatal Visits
Definitions
• Gravida: indicates the number of times the mother has
been pregnant, regardless of whether these pregnancies
were carried to term
• Nulligravida: A ♀ who has not been pregnant
• Primigravida: a woman pregnant for the first time
• Multigravida: a woman who has been pregnant more
than once
• Para: indicates the number of times the mother has been
delivered
• Nullipara: A woman who has not given birth to a viable child
• Primipara: unipara; a female which has had one pregnancy
that resulted in viable offspring
• Multipara: a woman who has delivered more than one viable
infant
• Abortion: is the termination of pregnancy by the removal or
expulsion from the uterus of a fetus or embryo prior to viability.
• Gestational age: relates to the age of an embryo or fetus.
Trimesters

• Three trimesters: each one 3 months periods

– Each with unique developmental stages
Prenatal Care
• Phases of Pregnancy
– Antepartum
– Intrapartum
– Postpartum
• Nursing Involvement in Prenatal Care
– Education
Goals of Prenatal Care
• Safe birth for mother and child
– Promoting good health habits & reducing risk factors
• Client education
• Provide physical care
• Prepare client for motherhood
Healthcare Prior to Conception
• Accurate Health History
• Physical Examination
Advantage
– Permits diagnosis and treatment of maternal
disorders
1st Prenatal Visit
• Should begin with a positive pregnancy test
• Baseline data
 Complete history

 Baseline vital signs, height, and weight

 Nutritional status

 Psychosocial situation
Prenatal Visits
• Establishment of Estimated Expected Date of
Delivery (EDD)
• Lab tests
• Scheduled appointments
Routine Visits
• Review of history
• Vital Signs
• Weight
• Urine Analysis
• Fundal height
• Fetal position
• Fetal heart rate
• Nutrition screening
• Complications
 Signs of Pregnancy
I. Presumptive Signs
• Amenorrhea
• Nausea
• Breast tenderness
• Deepening pigmentation
• Urinary frequency
Signs of Pregnancy
II. Probable Signs
• Goodell’s sign: Goodell's sign is an indication of pregnancy. It is
a significant softening of the vaginal portion of the cervix from
increased vascularization
•Chadwick’s sign: is a bluish discoloration of the vagina, cervix,
and labia caused by the hormone estrogen which results in venous
congestion
•Abdominal enlargement
•Braxton-Hicks contractions sometimes start around six weeks of
pregnancy. However, they are not usually felt until the second or
third trimester.
Signs of Pregnancy

III. Positive signs

• Audible fetal heartbeat
• Fetal movement felt by examiner
• Ultrasound visualization of fetus
Nutrition for Pregnancy
• Nutritional education
• Good nutrition is vital for healthy growth and
development
– Encourage
• healthy food choices
• Protein versus sugary foods
Nutritional Requirements
• Increase intake which should include:
– Protein—60 g/day
– Calcium—1200 mg/day
– Iron—30 mg/day
– Folic acid—400 mcg (0.4 mg)/day
Special Nutritional Considerations

• Pregnant adolescent
• Sodium intake
• Vegetarian
• Pica
• Lactose intolerance
• Gestational diabetes mellitus
Exercise During Pregnancy
• Maternal cardiac status and fetoplacental reserve should be the
basis for determining exercise levels during all trimesters of
pregnancy
• It is important to assess the exercise practices of the woman
• Goal of exercise during pregnancy should be maintenance of
fitness, not improvement of fitness or weight loss
Common Discomforts during Pregnancy

• Fatigue • Vaginal discharge

• Nasal stuffiness • Backache
• Nausea • Varicose veins
• Heartburn • Leg cramps
• Constipation • Edema of the lower
• extremities
Hemorrhoids
Psychological Adaptations to Pregnancy

• Identifying and managing psychosocial problems is

essential to the positive outcome of pregnancy

• Manage psychological disturbance during each

trimester
Prenatal Education
• Should progress according to the nursing process:

 Assess the history and cultural needs

 Diagnose the knowledge deficit
 Plan the goals and priorities
 Impelementation
 Outcome identification
Thank you