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Antenatal Assessment:

Antenatal Assessment Presented byMaj Ajitha K

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Everything grows rounder and wider and weirder, and I sit here in the middle of it all and wonder who in the world youwill turn out to be. - Carrie Fisher

History Taking:

History Taking General information Name, age, gravidity, parity, edn qualification, occupation, income, religion,marital status Husband - age, edn , occupation, income, religion Current problem/ complaint History of currentcomplaint

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Menstrual H istory - Age at menarche Cycle, duration Amount of Flow Dysmenorrhea Intermenstrual bleeding LMPand EDD Marital History - years of marriage, consanguineous marriage, late marriage Contraceptive H istory - useand type of devices

Past Obstetrics History:

Past Obstetrics History Pregnancy Gestational age at time of delivery Outcome of pregnancy Labour/delivery Normalvaginal delivery, C-section Labor- Normal, prolonged Length of labor D & E D & C Place of delivery (at home or at thehospital) Any other complications

Past Obstetric History:

Puerperium Any complications Baby Gender of baby Age of baby Breast fed, l ength of breast feeding Birth weightPast Obstetric History

Present obstetric history:

Present obstetric history Date of booking No of antenatal visits 1 st Trimester Ask about nausea, vomiting Otherassociated symptoms such as fever Abdominal/pelvic/back pain, b urning micturition Vaginal discharge Bleeding pervagina Use of folic acid tablets (small yellow colored pills) Was an ultrasound done at 6 or 7wks (Dating scan)

Present obstetric history:

2 nd Trimester Ask about regular use of folic acid, iron and calcium supplements Ultrasound at 18-22wks (Anomalyscan ) Quickening: fetal movements (normally felt around 20 weeks gestation) Fever, rash , abdominal pain 3 rd

Trimester Tetanus toxoid vaccine at 28 wks & 32 wks Regular doctor checkups Ultrasound Present obstetric history

Obstetric history:

General - Any history of diseaseHyperemesis Bleeding , dizziness,urinary complications Head ache,visualdisturbances, constipation, edema, abdominal pain, indigestion History of drugs ,radiation Total weight gain Obstetrichistory

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Past History Past medical: HTN , Diabetes, TB, Seizures, Asthma , heart disease, malaria, kidney disease, syphilisPast Surgical - pelvic surgeries, abdominal surgeries, caesarian, lower genital tract infections Blood TransfusionsVaccination up-to-date Family History :- heart disease, hypertension, DM , TB History of breast cancer, ovariancancer, uterine cancer History of obstetrical disorders, twin pregnancy, abortion

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Personal History Appetite Sleep Bowel Micturition Recent weight gain/weight loss History of any addictions (such assmoking, alcoholism , tobacco chewing etc..) History of any allergies to foods or medicines Dietetic History Veg/ nonveg, meal pattern, food fads, habits, likes, dislikes for food, pica, cultural beliefs

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Social History Family members Earning members Approximate income Living condition Psychosocial History

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Aspects of Antenatal Assessment Head to toe examination Breast examination Abdominal palpation

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Physical Examination:

General Examination Height Weight Temperature, Pulse, Respiration Blood Pressure Physical Examination

Physical Examination:

General Appearance Build Pallor Jaundice Gait Physical Examination

Physical Examination:

Head and Scalp Scalp, infection , infestation Hair Quality Tongue Teeth Gums Tonsils Thyroid Physical Examination

Physical Examination:

Physical Examination Breasts Pregnancy c hanges Size Nipples Inverted Flat Retracted Cracked

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Skin Colour changes Texture Striae Gravida Linea Nigra Physical Examination

Physical Examination:

Abdomen Size: Liver, Spleen Shape: Scaphoid, Pendulous Umbilicus: Protuberant, Dimpled Extremities OedemaVaricosities Deformities Physical Examination

Physical Examination:

Perineum Oedema of v ulva Discharge Soreness of v ulva Vaginal bleeding Bartholins cyst Perineal hygienePhysical Examination

Abdominal Examination:

Aim observe signs of pregnancy assess foetal size and growth assess foetal health diagnose the location of foetalparts detect any deviation from normal Abdominal Examination

Investigations:

Investigations ABO blood group, Rh typing Haemoglobin and haematocrit Blood sugarfasting, postprandial VDRLHIV Rubella immune status Urinalysis Ultrasonography

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A baby is something you carry inside you for nine months, in your arms for three years and in your heart till the dayyou die. - Mary Mason