Antenatal Care

What is antenatal care?

Antenatal care also known as prenatal care, , is a type of preventive healthcare. Its goal is to provide regular check-ups that allow doctors to treat and prevent potential health problems throughout the course of the pregnancy and to promote healthy lifestyles that benefit both mother and child. During check-ups, pregnant women receive medical information over maternal physiological changes in pregnancy, biological changes, and prenatal nutrition including prenatal vitamins. Recommendations on management and healthy lifestyle changes are also made during regular check-ups. The availability of routine prenatal care, including prenatal screening and diagnosis, has played a part in reducing the frequency of maternal death, miscarriages, birth defects, low birth weight, neonatal infections and other preventable health problems.

Frequency of antenatal care visits

Traditional prenatal care in high-income countries generally consists of:

  • monthly visits during the first 7 months (from the 1st week to the 28th week)
  • fortnightly visits from the 28th week to the 36th week of pregnancy (every 2 weeks)
  • weekly visits after 36th week to the delivery

It has been suggested that women who have low-risk pregnancies should have a less antenatal visits. However, when this was tested, women with less visits had babies who were much more likely to be admitted to neonatal intensive care and stay there for longer (though this could down to chance results). 14% more babies died compared with those whose mothers had a standard number of visits. Women who had less antenatal visits were not as satisfied with the care they received compared with women who had the standard number of visits

What is group antenatal care ?

In group antenatal care, the women have more hours of care as a group than on their own. Only small studies have been conducted looking at group care but they have found that mothers’ knew more about pregnancy, birth and parenting in the group setting. The mothers reported liking the group care and the review found no difference between how the pregnancies developed between the group and individual setting

What happens in antenatal care visits?

At the initial antenatal care visit and with the aid of a special booking checklist the pregnant women become classified into either normal risk or high risk.

Women are given a summary of their case notes including important background information about their pregnancy for example their medical history, growth charts and any scan reports. If the mother goes to a different hospital for care or to give birth the summary of her case notes can be used by the other doctors until her hospital notes arrive.

Prenatal diagnosis or prenatal screening (note that “Prenatal Diagnosis” and “Prenatal Screening” refer to two different types of tests) is testing for diseases or conditions in a fetus or embryo before it is born.

Physical examinations generally consist of:

  • Collection of (mother’s) medical history
  • Checking (mother’s) blood pressure
  • (Mother’s) height and weight
  • Pelvic exam
  • Doppler fetal heart rate monitoring
  • (Mother’s) blood and urine tests
  • Discussion with caregive

Antenatal Ultrasound

Obstetric ultrasounds are most commonly performed throughout the pregnancy. Ultrasounds are considered relatively safe and have been used for over 35 years for monitoring pregnancy.

Among other things, ultrasounds are used to:

  • Diagnose pregnancy (uncommon)
  • Check for multiple fetuses
  • Assess possible risks to the mother (e.g., miscarriage, blighted ovum, ectopic pregnancy, or a molar pregnancy condition)
  • Check for fetal malformation (e.g., club foot, spina bifida, cleft palate, clenched fists)
  • Determine if an intrauterine growth retardation condition exists
  • Note the development of fetal body parts (e.g., heart, brain, liver, stomach, skull, other bones)
  • Check the amniotic fluid and umbilical cord for possible problems
  • Determine due date (based on measurements and relative developmental progress)

Generally the most important ultrasound is ordered whenever an abnormality is suspected or along a schedule similar to the following:

  • 7 weeks : to confirm pregnancy, exclude molar or ectopic, determine due date
  • 13–14 weeks: to evaluate the possibility of Down syndrome
  • 18–20 weeks: to see the expanded list above
  • 34 weeks: to evaluate size, verify placental position

Early scans mean that multiple pregnancies can be detected at an early stage of pregnancy and also gives more accurate due dates so that less women are induced who do not need to be.

Parents can see the screen and are given a detailed description of what they can see with the findings being discussed at the end and the parents are given a picture of the ultrasound. The different ways of giving feedback affect how much the parents worry and the mother’s health behavior.

Women experiencing a complicated pregnancy may have a test called a Doppler ultrasound to look at the blood flow to their unborn baby. This is performed to detect signs that the baby is not getting a normal blood flow and therefore is ‘at risk’.

Also, you can retain of the happiest memories of pregnancy through ultrasound videos during pregnancy

Press this link to read more about ultrasound

Cardio-tocographgy (CTG)

Sample of CTG trace
  • This device can monitor the fetal health status through a maternal abdominal probe which draws a diagram of the fetal pulse.
  • This device also can measure the rate and strength of the uterine contractions during normal labor, and thus it enable us to recognize the preterm labor contractions.