Introduction

 

All pregnant women in the UK are entitled to antenatal care.

 

The aims of antenatal care are:

 

  •  To identify any potential complications for either the mother or foetus so that these can be managed appropriately.
  • To provide information for the mother regarding her care and screening tests for her and the foetus, in a way that she can understand and enables her to make informed decisions. 
  • To monitor and promote the health of the foetus.
  • To prepare the mother for the events of pregnancy and birth.
  • To manage any symptomatic problems of pregnancy. 

 

    Care should be “women-centred” and based on current available evidence. Appointments should be in an easily accessible and appropriate location. Uncomplicated pregnancies should be managed by midwives and GP’s who provide continuous care in a supportive and sensitive manner. 

     

    First Appointment with a healthcare professional

       

      • Confirm positive bHCG test
      • Identify women who may require additional care – i.e. from obstetrician:
          • Establish if the woman is taking any medication and arrange immediate medication review
          • Advise the woman of the benefits of taking folic acid supplements (400 micrograms daily) – prevents neural tube defects and cleft lip and palate. 
          • Give information about the antenatal screening tests and ultrasound scans – explain the purpose, risks and benefits so that the woman can understand. Giving the information at this stage gives the woman the opportunity to consider the implications well in advance and helps to enable her to make informed decisions.
          • Give pregnancy lifestyle advice:

           

            Antenatal appointments for uncomplicated pregnancies

               
              • Usually managed by community midwives
              • Ten appointments for nulliparous women . 
              • Seven for multiparous women. 
              • Further appointments if additional care is required – with obstetricians or specialist teams if necessary. 
              • At all appointments, women should have the chance to discuss issues and ask questions.
              • Early appointments will be longer than those later in pregnancy, in order to accommodate time for questions and discussion about screening tests so that mothers are able to make informed choices. 
              • Healthcare professionals should be aware of any factors (social or medical) that may affect the health of the mother or baby.
              • Women should carry their own hand-held notes and be advised to take these to any health-care appointments during their pregnancy. 

               

                Please see the article Screening in Pregnancy for detailed information on screening tests and scans. 

                 

                 

                Symphysis fundal height measurement is used to identify small or large for gestational age babies

                It is measured with a tape measure from the lowest part of the uterus (pubic symphysis) to the highest part of the uterus.

                 

                References

                NICE guidelines CG62 (2008):  Antenatal Care: routine care for the healthy pregnant woman. 

                Whitehouse, K.  Organisation of ante-natal care.  InnovAiT (2010) 3 (9): 528-538. doi: 10.1093/innovait/inq031

                Clinical Knowledge Summary:  Antenatal Care: Uncomplicated Pregnancy

                 

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