INTRODUCTION

In India one women dies every five minutes from pregnancy related causes.
Most of these deaths can be prevented or can be prevented if preventive
measures are taken and adequate care is available. Maternal death is
tragedy for the individual women family and community. In developed
countries the maternal mortality is 27 maternal deaths per 1 lakh live births
and in developing country the ratio is nearly 20 times i.e 480 maternal
deaths per lakh live births. To reduce the maternal mortality antenatal care
can play a very important role.

OBJECTIVES

Explain the procedure of antenatal registration and collect necessary

information?
Perform antenatal examination;
Identityfy normal and abnormal changes during antenatal
examination;
Conduct physical and abdominal examination;
Identify women at risk during antenatal examination; and
Assess health education needs of women and conduct need based
health education.
 Definition

Antenatal care is defined as the systematic examination and advices

given to the pregnant women at regular and periodic intervals based on
the individual needs starting from the beginning of pregnancy till
delivery.

Components of Antenantal Care

History Taking
Registration. The women should be registered after
confirming that she is pregnent. Afterwards midwife will
carryout the following :-
Identification Data.
History Taking.
(a) Surgical History
(b) Family History
(c) Personal History
(d) Menstrual History
(e) Obsterical History.
Investigations

Urine Test.
Blood Test.
HIV Test.
TOURCH Test.
Physical Examination
Height- Average height of indian woman is 145-150cms.
Weight- average weight in the age group of 25-30 is 60kgs.
Blood pressure- any reading 140/90 should be reported
HEAD TO TOE EXAMINATION
I. Hair & scalp- healthy or infected.
II. Eye- observe the colour of conjunctiva.
III. Mouth- healthy or infected.
IV. Ear, nose, and throat- healthy, enlargement or infected.
V. Breast changes-normal changes during pregnancy.
VI. Abdomen- palpate for liver and spleen enlargement.
VII. Skin- observe for any infection.
VIII. Back and spine- observe for any deformity.

ABDOMINAL EXAMINATION
INSPECTION- observation of shape, size, contour, skin changes, foetal
movement.
PALPATION- It should be done between 16-20wks of onwards, when
foetal part are palpated.
a) Fundal height- measurement is done by using the tape. Measures
the distance between the symphysis pubis and the fundal curve
using tape measures.it is applicable beyond 24 wks of pregnancy.
b) Abdominal girth- abdominal circumference is measures with help of
tape .
c) Grip use in abdominal palapation-
Fundal grip- by facing the the patients head use the tip of the
finger of the both hand to palpate the uterine fundus. When foetal
head is in the fundus, it will be felt as a smothhard, globular, mobile
and ballotable mass.
LATERAL GRIP- It also by facing the patients head & place hands on
either side of the abdomen.steady the uterus with your hand on
one side & palpate the opposite side to determine the location of
the foetal back. The back area will be feel firm.
 DEEP PELVIC PALPATION-During this grip will feel the patients
face. Gently move your fingers downthe side of the abdomen
towards the pelvis until the fingers of one hand encounter the bony
prominence. If the prominence on the opposite side of the back, it
is the babys brow and the head is flexed.
PAWLICK GRIP-Place the tips of the first three finger of each hand
on the either side of the abdomen just above the symphysis pubis &
ask the patient to take deep breath & exhale. This grip will help you
to identify the presenting part.
AUACULTATION
Itis done to monitor the foetal heart sound.
IDENTIFICATION OF HIGH RISK FACTOR
Height- short stature woman.
Age- less than 20 or more than 35
Parity- multiparty or more than five
Education- illiterate or below primary level
Socio economic status- low
Wieght gain during pregnancy- more or less than normal range
Previous pregnancy- bad obstetrical history, previous caesarian
Present pregnancy- any medical problem
Bleeding per vagina
Rh negative pregnancy
Anaemia
Foetal distress
Abnormal presentation.