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perinatal maternal.

Prevent
risks and
potentials
Applic detectpreco
routine exams.
ation disorders
ciousl
of occurred.
y
Facilitate the
identification of high- More appropriate
risk pregnancies. obstetric care.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition. // Prenatal control guide, normal pregnancy. 2009.
Dr. Casini, Sergio et al.
 Prenatal control
1. Provide educational content for the health of the mother, family and child.

2. Monitor fetal growth and vitality.

Goals
3. Relieve minor discomfort and symptoms of pregnancy.

4. Prepare the pregnant woman for the birth and upbringing of the newborn.

5. Prevent, diagnose and treat pregnancy complications.

6. Detect alterations in maternal and fetal health.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition // Prenatal control guide, normal pregnancy. 2009.
Dr. Casini, Sergio et al..
 Prenatal control
Characteristics:

1- Precoze
It should be started as soon as the pregnancy has been diagnosed, to enable
prevention and health promotion actions and detect risk factors.

Minimum: 1st control from 12 to 20 SG.

Optimal: 1st control before week 12.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al. 2:100)
 Prenatal control
Characteristics

2- Comprehensive:
Actions for promotion, protection and
health recovery.
 Prenatal control
Promotion:
1 .- Pregnancy monitoring and care.
2 .- Assessment of the
edo. Nutritional.
3 .- Education
sanitary.

Protection: Recovery:
1.- Vaccination. Depending on
2.- the existing
Environmental morbidity.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.
 Prenatal control
Characteristics

3-Newspaper:
Attend your regularly scheduled consultations.

• Minimum: 6 controls.
1st C: Course of the first 13
2nd C: Between 3-6 p.m. weeks
3rd C: Between 22-24 weeks.
4th C: between 27-29 weeks.
5th C: Between 33-35 weeks. gust

6th C: Between 38-40 weeks.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.
 Prenatal control
Characteristics

3-Newspaper:
Optimal: 10 controls.
Up to 36 weeks: every 4-6
weeks.
– From 37 to 40 weeks: every 1 week.
– From week 40: 1 times a week.

Medical or obstetric complications may require closer monitoring.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.
 Prenatal
Prenatal control
control
Characteristics:

Positive impact on maternal and

child mortality and morbidity.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., // Prenatal control et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
guide,normal pregnancy. 2009. Dr. Casini, Sergio et al.
 First Consultation
1. Confirmation of pregnancy. Rule of
2. Preparation of the Perinatal Clinical Naegele:
History. FUR= +7/ -3/
3. Carry out the risk approach.
4. Clinic history:
• Anamnesis:
Filiation.
Family background.
Personal history.
Gynecological History. FUR and FPP (Naegele rule).
Obstetric History.
Sociodemographic conditions.
Symptoms associated with the current pregnancy.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.
 I
Prenatal control
Prenatal control
First Consultation:
4 - Clinic history:
 V Physical V Exploration
Examination Gynecological
Weight. Breast examination.
Size. Axillary and
TA. supraclavicular
Fur. examination.
Neck. Genital inspection
Oral cavity. Vaginal touch.
Cardiopulmonary. Cytology (one shot).
Abdomen: AU, Fetal
Statics, Mov. fetal FCF.
Extremities.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.
 Prenatal control
First Consultation

5 .- Complementary Exams:

1. Blood test
• Blood group and Rh. (Indirect Coombs test)
• Hemogram:
• Biochemistry. Liver and kidney profile, Basal glycemia.
• Serologies. rubella, syphilis, HIV, VDRL, Chagas, Toxoplasmosis and
Hepatitis B.

2. Urine analysis: V4
• Urinalysis and Urine Culture (I trimester) Ev(e- -
• Proteinuria, glucosuria and ketonuria. kgne6i:
“41*
Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.
 Prenatal control
First Consultation
6.- Ultrasound Examination:
Table 3. Ultrasound examination of the first trimester of pregnancy.

Modality Basic obstetric ultrasound examination.

Age (week)
Goals
11-12 weeks.
• Identify the number of embryos.
1st
• In the case of twin pregnancy, diagnosis of
zygosity. 11-12
• Identify the embryonic heartbeat.
• Estimate gestation age.
• Detect and measure nape translucency!
GS
(marker of fetal chromosomes).
• Observation of embryonic morphology.
• Identify the existence of pathology of the uterus
and adnexa.

Content • Study of the gestational sac and embryo:

- Number of embryos and/or gestational sacs.
- Presence or absence of embryo.
- Evaluation of embryonic vitality:
- Cardiac movement.
- embryonic movement.
- Measurement of craniocaudal length and
estimation of gestation age.
- Neck translucency measurement!
- Location and characteristic of the trophoblast.
- Observation of the morphology of the embryo.
• Study of the uterus and adnexa.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.
 Prenatal control
First Consultation
7.- Screening for Congenital Defects:
Identify pregnancies at high risk of fetal u )5
congenital defects.
II

Congenital defects susceptible to prenatal

12

»4 hi M o !,
screening are: 13 l J 15 r YO
)
18
•l 11
15

Anomalies structural:
20

•
*Yo
?

Ultrasound examinations (10-13th and 20-

22nd SG)
• Chromosomopathies: study of
fetal cls.
• Hereditary monogenic diseases:
molecular genetic techniques before the start
of pregnancy.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al..
 Prenatal control
First Consultation

8.- Complementary Interconsultations:

-Dental office.
- Cervical Pathology Clinic.
- Breast Pathology Clinic.
- Cardiology Office.
- Interconsultation with the corresponding specialty according to
each particular case.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.
 Prenatal control
Successive Consultations

They will carry out informative and health promoting actions.

Update the perinatal risk classification. Review of the perinatal clinical history and
perinatal card.
Review of diet and prescriptions.
Calculation of the EG and FPP.
Comprehensive physical examination: breasts, edema, BP, weight gain.
Abdomen: AU, FHR, Fetal statics, Fetal movements.
Gynecological examination : speculoscopy and vaginal examination.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.
 Prenatal control
Successive
Consultations
Paraclinical:
■ Interpretation of exams already requested. Around
24-28 and 35-37 GS: blood count, coagulation tests
■ (III T), blood glucose, glycosuria, proteinuria,
ketonuria,
urine sediment and culture.
Serologies: HbsAg, syphilis and antibodies
■ against HIV if the patient belongs to a high-risk
group.
Vaginal and rectal culture of streptococcus
■ agalactiae (35-37 weeks).

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.
Prenatal control
 Prenatal control
Determination of plasma glycemia 60 min after ingestion of 50 g. of glucose.
It will be requested 24-28 SG.
Repeat in the Third Trimester when risk factors exist.
Positive: (glycemia >O= 140 mg/dl, the OGTT (with 75 g) will be requested to
establish a diagnosis of glucose intolerance (1 pathological value) or
gestational diabetes (2 or more abnormal values).
 I Prenatal control
Successive
Subsequent Consultations:
Consultations
2nd.
18-20 GS
Table 4. Ultrasound examination of the second trimester of pregnancy.

Congenital Defect Screening:

abla S. Ultrasound examination of the third trimester of pregnancy.

Modality Ultrasound examination for prenatal diagnosis. Modality Basic obstetric ultrasound examination.
Age (week) 32-36 weeks.
Age (week) 18-20 weeks. Goals
• Goals
If it has not been done during the I trimester.
• Diagnosis of structural anomalies and markers
• Identify fetal static.
• Quantify •αIfofyou
chromosomopathies.
-fetoprotein and β -hCG between weeks
have not had the basic level ultrasound in
14-17.
• Identify the fetal heartbeat.
• Estimate fetal growth and diagnose restricted

• Performingtheultrasound
first trimester, it includes its objectives.
(measuring the nuchal fold).
uterine growth or fetal macrosomia.
• Diagnose anomalies in the location of the
Content • Evaluation of embryonic vitality: placenta (placenta previa).
• Obtain the risk
- Cardiac calculation.
movement.
Content
• Diagnose amniotic fluid volume anomalies.
• Evaluation of fetal statics.
- embryonic movement.
• Assessment of fetal vitality:
• Fetal biometry: - Cardiac movement.
- Biparietal diameter. - Fetal movement.
- Head circumference (CC). • Estimation of fetal growth with the
measurement of:
- Mean abdominal diameter (MAD).
- Biparietal diameter.
- Abdominal circumference (AC). - Head circumference (CC).
- DC/AC ratio. - Abdominal circumference (AC).
- Femur length. - Mean abdominal diameter (MAD).
- DC/AC ratio.
• Evaluation of fetal anatomy'.
- Femur length.
• Location and characteristics (gradation) of the
• Location and characteristics (gradation) of the
placenta and umbilical cord (number of placenta and umbilical cord.
vessels). • Estimation of amniotic fluid volume.
• Estimation of amniotic fluid volume. • Observation of fetal anatomy.

fppt.com
 Prenatal control
Successive Consultations

Clinical Examinations of the Pelvis:

Third trimester.
Evaluates the prognosis of the vaginal route.
Characteristics of the pelvis (internal
pelvimetry).
Neck maturity (Bishop's test).

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical
Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.
 Prenatal control

Nutritional supplement

activities during prenatal care

1. Folic acid administration.

Count it 60 Tablets <fe 0.7R
Net content 42 g °

Iron supplementation.
2. The use of multivitamins and calcium is
recommended.
3.
4. Vaccination:
•
Recommended vaccines: tetanus and
influenza.
In cases of high risk of exposure:
Antihepatitis A and B, Vaccine against rabies,
against Pneumococcus and Meningococcus.
HmK
38
Prenatal control
Prenatal control
Subsequent Consultations:

When presenting any abnormal symptoms

 Frequency and intensity of fetal movements.

• Start of Labor.

Fundamentals of Obstetrics (SEGO). 2007. Bajo Arenas, JM., et al . // Practical Obstetrics. Uranga, F. 1985. Intermedical Publishing. 5th Edition.
// Prenatal control guide, normal pregnancy. 2009. Dr. Casini, Sergio et al.

• Genital
discharge.
Thank you