By Francis Kamwendo Nkhotakota Definition Health Evidence Network Antenatal care is all the care that a pregnant woman receives from organized health services The primary aims of this care are to ID: 210370
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Slide1
Antenatal Care (ANC)
By
Francis
Kamwendo
@
Nkhota-kotaSlide2
Definition
(
Health Evidence Network)
Antenatal care is all the care that a pregnant
woman receives from organized health services.
The primary aims of this care are to:
• detect early factors that may heighten the perinatal risk of both individual pregnancies and
members of vulnerable groups;
• intervene to improve outcomes;
• educate all who provide or receive care; and
• help make pregnancy and birth a positive life experience.Slide3
Antenatal care activities found to be effective
The basic activities of antenatal care fall
withinthree
general areas
:
Screening
for health and socioeconomic conditions likely to increase the possibility of
specific
adverse outcomes;
2. providing therapeutic interventions known to be beneficial; and
3.
Educating
pregnant women about planning for safe birth, emergencies during pregnancy
and
how to deal with them.Slide4
Antenatal interventions known to be effective
Condition/stage
Test/treatment
Effect
Reduced number of antenatal visits
Reduced to 4-5 include proven effect interventions
Similar maternal results
Delivering antenatal visits
Midwife/GP managed care compared wit Obstet./Gynaecol. Led shared care
Similar clinical effectiveness
Prevention of anaemia
Routine iron & folate supplementation + Malaria Chemoprophylaxes
Reduces or prevents fall in Hgb, reduces % of anaemic women
Detection and investigation of anaemia
Blood tests
Diagnosis and type of anaemia → correct treatment
Treatment of iron deficiency anaemia
Oral iron and folate/IM or IV iron
Packed cell transfusion
Raises Hgb prenatally
Detection and investigation of HDP
Measurement of blood pressure with sphygmomanometer using 2nd & 5th Korotkoff sound
Urine analysis of clean catch urine
Detects Hypertention
Detects proteinuria. Indicative of pre-eclampsia in presence of hypertentionSlide5
Antenatal interventions known to be effective
Condition/stage
Test/treatment
Effect
Detection and investigation of HDP
Measurement of BP
Urine analysis of clean catch urine
Detects Hypertention
Detects proteinuria. Indicative of pre-eclampsia in the presence of hypertention
Treatment of severe pre-eclampsia
Transfer to first referal level for expert care
Control of disease. Reduces case fatality
Treatment of eclampsia
Supportive first aid maintaining airway and preventing injury during fit
Magnesium sulphate (IM or IV).
Recognition and speedy transfer to fully equiped facility.
Expedited delivery
Reduces case fatality
Reduces recurrent convulsions and maternal mortality.
Reduces
case fatality.
Only definite treatment.
Prevention of obstructed labour
External cephalic version at term
Reduces Ceasarean Section
Screening for infection
Serological screening and treatment for Syphylis
Microbiological screening for gonorrhoea
Detects asymptomatic disease. Coupled with effective treatment, contact tracing and follow-up, reduces fetal loss and maternal and infant morbidity
Detects asymptomatic disease. Coupled with effective treatment, contact tracing and follow-up, reduces fetal loss and maternal and infant morbiditySlide6
Antenatal interventions known to be effective
Condition/stage
Test/treatment
Effect
Screening for infection
Screening for bacteriuria with quantitative culture of urine
Detects asymptomatic disease. Coupled with effective treatment prevents pyelonephritis and pre-term delivery/low birth weight
Prevention of infection
Tetanus immunization in pregnancy and/or women of child bearing age
Induction of labour in uncomplecated prelabour rupture of membranes
Prevents maternal and neonatal Tetanus
Prevents maternal infection