ANTEPARTUM CARE

 Refers to the medical

and nursing care
given to the pregnant
women between
conception and the
onset of labor
 FERTILIZATION
 Union of an ovum and a spermatozoon
 Occurs in the AMPULLA
 Ovum is capable of fertilization for only 24-48
hours
 Functional life of a spermatozoa is about 48-72
hours.
 IMPLANTATION
 It is the contact between the growing
structure and the uterine endometrium.
 8-10 days after fertilization
 Pregnancy is the
carrying of one or more
offspring in a fetal stage
of development by
female mammals,
including humans,
inside their bodies,
between the stages of
conception and birth.
 GESTATION
 10 LUNAR MONTHS
 4 weeks each
 40 weeks of gestation

 9 CALENDAR MONTHS
 3 trimesters
 3 months each trimester
 GESTATION
 CONCEPTIONAL AGE (in weeks)
 refers to the time since fertilization

 GESTATIONAL AGE or menstrual

age
 refers to the time since the first day of
the last menstrual period (LMP)
 2 weeks (before fertilization) are added
from LMP
 Concept of pregnancy
 All maternal body systems are altered by
pregnancy. These changes are normal,
inevitable and temporary
 Physiologic changes of
pregnancy
 Physiologic changes of pregnancy can
be categorized as:
1. Local
2. Systemic
 Physiologic changes of
pregnancy
 Reproductive changes
 Uterine changes
 Cervical changes
 Vaginal changes
 Ovarian changes
 Breasts changes
 Systemic Changes
1. Integumentary system
2. Respiratory system
3. Temperature
4. Cardiovascular system
5. Urinary system
6. Skeletal system
7. Endocrine system
8. Immune system
 PREGNACY VIEWED AS A NORMAL
PHYSIOLOGIC PROCESS NOT A DISEASE
PROCESS.
 A STATE OF WELLNESS IT IS NOT AN
ILLNESS
 THE SIGNS AND SYMPTOMS OF
PREGNANCY
1. Presumptive signs of pregnancy
2. Probable signs of pregnancy
3. Positive signs of pregnancy
 Presumptive signs of
pregnancy
 Breast changes
 Nausea and vomiting
 Amenorrhea
 Frequent urination
 Fatigue
 Uterine enlargement
 Quickening
 Linea nigra
 Melasma
 Striae gravidarum
 Presumptive signs of
pregnancy
 Breast changes
 Feeling of tenderness, fullness or tingling;
enlarging and darkening of the areola
 The montgomery’s tubercles become
pronounced
 Increased vascularity
 16th week, colostrum can be expelled fom
the nipples
 Presumptive signs of
pregnancy
 Nausea and vomiting
Nausea – sensation often leading to
vomiting
Vomiting – expelling emesis or vomitus
from the stomach
 Presumptive signs of
pregnancy
 Amenorrhea
 Absence of menstruation
 Presumptive signs of
pregnancy
 Frequent urination
 Sense of having to void frequently
 Presumptive signs of
pregnancy
 Fatigue
 General feeling of tiredness
 Presumptive signs of
pregnancy
 Uterine enlargement
 Uterus can be palpated over symphysis
pubis
 Presumptive signs of
pregnancy
 Quickening
 Fetal movement felt by the mother
 Presumptive signs of
pregnancy
 Linea nigra
 Line of dark pigment on the abdomen
 Presumptive signs of
pregnancy
 Melasma
 Dark pigment on face
 Presumptive signs of
pregnancy
 Striae gravidarum - red streaks on
abdomen
 Probable signs of pregnancy
 Serum laboratory tests
 Chadwick’s signs
 Goodel’s sign
 Hegar’s sign
 Sonographic evidence of gestational
sac
 Ballottement
 Braxton Hicks contractions
 Fetal outline felt by examiner
 Probable signs of pregnancy
 Serum laboratory
tests
 Tests of blood
serum reveal the
presence of human
chorionic
gonadotropin
hormone
 Positive: 8-10 days
after fertilization or
3-4 days after
implantation
 Probable signs of pregnancy
 Chadwick’s signs
 Chadwick's sign is a bluish (or cyanotic)
cervix. It can usually be observed around
4 weeks gestation by inspecting the
cervix.
 Probable signs of pregnancy
 Goodell’s sign
 softening of the cervix.
 Probable signs of pregnancy
 Hegar’s sign
 Softening of the lower uterine segment
 Probable signs of pregnancy
 Sonographic evidence of gestational
sac
 Characteristic ring is evident
 Probable signs of pregnancy
 Ballottement
 When lower uterine
segment is tapped
on a bimanual
examination, the
fetus can be felt to
rise against
abdominal wall
 Probable signs of pregnancy
 Braxton Hicks contractions
 Periodic uterine tightening occurs
 Probable signs of pregnancy
 Fetal outline felt by
examiner
 Fetal outline can be
palpated through
LEOPOLD’S
MANEUVER
 Positive Signs of Pregnancy
 Fetal Heart Tone
 Ultrasound
 Care of the Woman During
Antepartum Period
 A. Initial Prenatal Assessment

1. Health History
2. Determination of EDC
3. Assessment of Risk Factors
4. Physical Examination
5. Laboratory and Diagnostic Studies
6. Evaluation of Fetal Well-Being(Doppler- 10-12
weeks; fetoscope-20weeks)
*Includes ultrasound, fundic height, quickening
and other procedures(amniocentesis,
fetoscopy,MSAFP)
 B. Subsequent Prenatal Assessment

1.History and Physical Assessment

2. Psychosocial Assessment
3. Dietary Assessment
 C. Assessment of Common Discomforts
1st Trimester
-morning sickness
-nasal stuffiness
-urinary frequency
-breast tenderness
-ptyalism
-leukorrhea
-headaches
 2nd and 3rd Trimester
-heartburn
-ankle edema
-varicose veins
-hemorrhoids
-constipation
-backache
-leg cramps
-faintness
-SOB
-difficulty in sleeping
-round ligament pain
Ma’am BANG