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Antenatal Care

Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

Antenatal care is the routine care that all healthy women can expect to receive during their pregnancy.

The aim is to monitor the progress of pregnancy in order to support maternal health and normal fetal development. The midwife critically evaluates the physical, psychological and sociological effects of pregnancy on the woman and her family, by: Developing a partnership with the woman Providing a holistic approach to the woman's care that meets her individual needs Promoting awareness of public health issues for the woman and her family Exchanging information with the woman and her family and enabling them to make choices about pregnancy and birth Being an advocate for the woman and her family during pregnancy Recognising the complications of pregnancy and appropriately referring the woman within the multidisciplinary team Assisting the woman and her family in their preparations to meet the demands of birth, and making a birth plan Assisting the woman in making an informed choice about methods of infant feeding and giving appropriate and sensitive advice to support her decision Offering education for parenthood within a planned programme or on an individual basis Working in partnership with other pertinent organisations The National Institute for Health and Care Excellence (NICE) (2008) recommends pregnant women should be offered information based on current available evidence together with support to enable them to make informed decisions about their care, including where they will be seen and who will undertake their care.

Ongoing antenatal care

 

 

16 weeks

 

  • Review, discuss and document results of screening tests undertaken
  • Investigate haemoglobin level below 11 g/dl and consider iron supplementation (See Anaemia)
  • Measure blood pressure
  • Urinalysis for proteinuria
  • Information exchange and review of care plan

18-20 weeks

  • Ultrasound scan to detect fetal anomalies

25 weeks

  • Measure fundal height
  • Measure blood pressure
  • Urinalysis for proteinuria
  • Information exchange and review of care plan

     

28 weeks

  • Offer repeat screening for anaemia and atypical red-cell alloantibodies
  • Investigate haemoglobin level below 10.5 g/dl and consider iron supplementation (See Anaemia)
  • Offer anti-D to Rhesus-negative women
  • Measure fundal height
  • Measure blood pressure
  • Urinalysis for proteinuria
  • Information exchange and review of care plan

31 weeks (nulliparous women)

  • Measure fundal height
  • Measure blood pressure
  • Urinalysis for proteinuria
  • Review, discuss and document results of screening tests undertaken at 28-week assessment
  • Information exchange and review of care plan

34 weeks

  • Offer a second dose of anti-D to Rhesus negative women
  • Measure fundal height
  • Measure blood pressure
  • Urinalysis for proteinuria
  • Multiparous women - review, discuss and document results of screening tests undertaken at 28-week assessment
  • Information exchange and review of care plan

36 weeks

  • Measure blood pressure
  • Urinalysis for proteinuria
  • Measure fundal height
  • Check presentation of fetus: refer to obstetrician if breech
  • Information exchange and review of care plan

38 weeks

  • Measure blood pressure
  • Urinalysis for proteinuria
  • Measure fundal height
  • Information exchange and review of care plan

40 weeks (nulliparous women)

  • Measure blood pressure
  • Urinalysis for proteinuria
  • Measure fundal height
  • Information exchange and review of care plan

41 weeks

  • Measure blood pressure
  • Urinalysis for proteinuria
  • Measure fundal height
  • Information exchange and review of care plan
  • Offer a membrane sweep
  • Offer induction of labour

Resources

National Institute for Health and Clinical Excellence (NICE) (2008) Antenatal care for uncomplicated pregnancies. Clinical guideline 62. https://www.nice.org.uk/guidance/cg62

 

 

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