Tuesday 6 March 2012

Antenatal care of a pregnancy without high risk factors - counseling before pregnancy

Antenatal care is an important element in the pregnancy outcome. 

It is having a major role in decreasing the maternal and neonatal mortality. 

Actually antenatal care starts before the woman becomes pregnant. 

Preparing the woman for the pregnancy is also a part of prenatal care. 

The woman who want to become pregnant should consult a medical professional before pregnancy to take suggestions. 

In counseling a women regarding becoming pregnant following factors to be considered: 

The age of the patient: 

The woman should be above 19 years, in young age patients many complications like pregnancy induced hypertension, increased chance of operative delivery etc complications can occur. 

In women above the age of 31 years also can prone to complications like hypertension, gestational diabetes, prone to operative deliveries etc. 


Number of pregnancies: 

From third pregnancy onwards many problems can occur to woman like increased chance of becoming anemic, chances of uterine rupture in neglected cases etc can occur. 


Mode of previous delivery: 

In previous caesarean section case proper care to be taken and at least 2 years gap to be maintained from previous delivery. 


Health status of the woman: 

The woman should be healthy to bear the burden of pregnancy and to deliver a healthy baby. 

So, in preconceptional counseling testing for the general health of the woman is important. 


Previous history of miscarriages or intrauterine deaths: 

In case of any untoward outcome in the previous pregnancy to be evaluated. 

Previous reports to be studied. 

In case of consanguineous marriage the level of consanguinity to be noted. 

Family history of any anomalous babies to be enquired. 

In case of infertility: In case of infertile couple both to be investigated and the treatment they have taken to be enquired.

And the chances of getting pregnancy to be discussed frankly and alternatives to be suggested if needed. 


Preparedness of the family: Enquiring about the preparedness of the family for pregnancy and for the new comer is important. 

The members in the house especially the husband to be instructed the care he has to taken. 


The medication to be taken: 

The woman should be advised to take folic acid tablets 0.5mg per day from before one month of conception. 

And she has to stop habits like cigarette smoking, excessive coffee intake etc. 

If she is on drugs like anti convulsants etc she has to consult the respected doctor and take suggestion regarding stoppage of drugs.

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