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What is Ante Natal Care – Doctor Visits, Education & Training?

What is Ante Natal Care – Doctor Visits, Education & Training?

by: Dr. Surinder Kaur Gambhir
Sr. Consultant - Obstetrics & Gynecology

The purpose of ante natal care is

  • To maintain mother and foetus in the best possible state of health.
  • To recognize abnormalities and complications at an early stage.
  • To educate the mother about the physiology of pregnancy.

This usually begins with the patient’s doctor and involves the specialist, the midwife and the health visitor. The earlier in pregnancy the women comes under the medical supervision of the doctor, the better is the outcome of the pregnancy.

Average pregnancy lasts for about 40 weeks from the last menstrual period that is first day of menses. Full pregnancy is divided into three trimesters. Antenatal visit is monthly up-to 24 weeks, fortnightly 24 to 36 weeks and then weekly till delivery. In between if the patient has any problem, then she can have appointment with the doctor accordingly.

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Training for the Expecting Mother:

An expectant lady should have good hygiene, regular and frequent washing especially in the genito-anal region should be done. Most ladies get enough exercise in looking after their homes. However, she should do moderate amount of walking. She can consult the physiotherapist in the second trimester. Clothing must be loose and comfortable. Constipation is very common in pregnancy. Attention towards diet may help. If constipation is not relieved then safe laxatives should be taken with the consult of the doctor. Teeth should be cleaned as in non-pregnant state. Smoking is avoided in the pregnancy as it is harmful for the foetus. Coitus should be less frequent in the first and the last trimester.

Expectant ladies should adhere to a nutritious diet plan. Diet should contain more amount of fruits, green vegetables and protein rich food (egg, cheese, animal protein).

Ante Natal Care – What Comes in a Doctor’s Visit ?

At the first visit, marital, obstetric, medical, surgical and menstrual history is noted. Date of last menstrual period is noted and expected date is calculated on this basis. In the first trimester, she can complain of nausea, vomiting and lethargy. Doctor can prescribe medicines for these complaints and folic acid for the prevention of neural tube defect. All the routine investigations like CBC, TSH, RBS, VDRL (husband & wife), blood group (husband & wife), viral markers and Hb electrophoresis are done. An early ultrasound scan is done at six weeks to see if the pregnancy is intra-uterine or extra-uterine. At 11-13 weeks, advanced screening of pregnancy is done in the form of ultrasound and dual test. If the expectant lady complains of any bleeding per vagina and pain in the lower abdomen then should report to her doctor immediately. In the second trimester, vomiting is less frequent. The expectant lady should start iron and calcium at this time. One dose of tetanus toxoid is administered at this stage. Regular blood pressure and weight is monitored on every visit. Hb estimation and urine examination is done monthly. At 16-18 weeks, level two ultrasound and quadrouple test is done to see any congenital anomaly. In the third trimester, visit to the doctor is fort-nightly. At 32 weeks, ultrasound Doppler flow is done. Some of the warning signs are bleeding, leaking, headache, pain epigastrium, pain right hypochondrium. In any of the above conditions, she should see her doctor immediately.

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