Antenatal clinics: care and examinations
Table of contents
- Tasks of antenatal clinics evd
- Periodic medical examination during weeks 13–18 (extensive examination)
- Periodic medical examination of late pregnancy during weeks 35–36
- Discretionary additional medical examinations
- Postnatal examination 5–12 weeks after delivery evd
- Antenatal screening programmes
- Infections during pregnancy
- Pregnancy nausea evd
- Treatment guidelines for other common ailments of pregnancy
- Nutrition, smoking and substance abuse, lifestyle
- References
Extract
- The tasks of antenatal clinics are listed below.
- Provide the expectant mother with information and guidance regarding the pregnancy, childbirth and care of the newborn.
- Offer a wide range of psychosocial support and identify the need of such support;
attention should be paid to
- the life situation and well-being of the parents and the whole family, as well as factors contributing to or possibly decreasing the quality of life
- the changes in family relations and resources brought about by the baby.
- Identify any health risks to the foetus or mother so that any problems can be duly attended to, either at the antenatal clinic or by specialist intervention.
- Provide routine care of various illnesses and complaints.
- Identify situations which require specialist health care.
- See also Antenatal clinics and specialist care: consultations, referrals, treatment guidelines1.
- Co-operation between the physician and midwife/nurse, and a mutually agreed workload division, is important in the provision of antenatal care. When appropriate, the following tasks associated with medical examinations can be carried out by the nurse.
- Visits to an antenatal clinic are divided into scheduled periodic visits (basic visits)
and discretionary additional visits.
- The basic schedule of periodic health examinations includes a minimum amount of check-up visits that are planned for normally progressing low-risk pregnancies.
- Two of the basic visits should be to a doctor, one in early and one in late pregnancy.
- Additional visits are appointed either to a nurse or a doctor as needed. About one quarter of the resources of an antenatal clinic are estimated to be needed for the additional visits.
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Linked evidence summaries
- Ultrasound in early pregnancy appears to be effective for early detection of multiple pregnancies and for improved gestational dating.B
- In high-income countries, routine digital cervical examination is not effective for identifying women at risk of preterm labour compared with no examination unless medically indicated.A
- Infection screening and treatment programs in pregnant women may reduce preterm birth and preterm low birthweights, but it is unclear to which component of the screening program the effect can be attributed.C
- Intrapartum antibiotic prophylaxis for known maternal group B streptococcal colonization appears to reduce early onset group B streptococcus disease in the newborn.B
- Gestational diabetes mellitus increases the future risk of diabetes up to 10-fold.A↑↑
- Low-dose aspirin is effective in prevention of pre-eclampsia. Proteinuric pre-eclampsia is reduced by 18%, fetal or neonatal deaths are reduced by 14%, number of small-for-gestational age babies by 10% and number of preterm births by 9%.A
- A diet based on vegetables, fruits, whole grains, and low fat dairy started early in pregnancy is effective for preventing gestational diabetes.A
- Fetal movement counting compared with no instruction may not be associated with a clear improvement in foetal outcomes. There may be more operational deliveries in the movement counting group. .C
- Antibiotics are effective in the treatment of bacterial vaginosis in pregnancy but do not prevent preterm birth before 37 weeks.A
- After previous preterm birth, antibiotics in pregnancy may possibly reduce the risk of preterm prelabour rupture of membranes and low birthweight in women with bacterial vaginosis.D
- Antibiotic treatment appears to reduce the risk of pyelonephritis in pregnancy and appears to reduce the incidence of preterm delivery and low birthweight babies compared to placebo or no treatment.B
- Antacid, ranitidine, alginate acid , and sucralfate appear to be effective for heartburn in pregnancy.B
- Dietary supplements of fibre in the form of bran or wheat fibre may help women experiencing constipation in pregnancy.C
- There is insufficient evidence on the effect of oral magnesium, calcium, vitmin D, or vitamin B for leg cramps in pregnancy compared to placebo or no treatment.D
- There is insufficient evidence of the effect of psychosocial and psychological interventions for treating antenatal depression.D
- Routine oral iron supplementation during pregnancy may be effective for maternal anaemia but not for infant outcomes.C
- Higher maternal folate levels and folic acid supplementation during pregnancy may decrease the risk of preterm birth .C
- Periconceptional folate supplementation is effective for preventing neural tube defects.A↑↑
- Calcium supplementation during pregnancy appears to reduce the risk of pre-eclampsia, hypertension, and the composite outcome maternal death or severe morbidity especially among women at high risk and those with a low calcium intake.B
- Regular aerobic exercise during pregnancy improves (or maintain) physical fitness and prevents excessive gestational weight gain. .A
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