103785
Anatomy & Physiology
(Antenatal)
- 1.BP - Looking for Pre-eclampsia = detrimental to health of mother & baby. Progesterone increase aids the softening of the smooth muscle in the
blood vessel walls; BP should remain in normal limits. Early intervention = effects minimised. NICE recommends BP at each AN visit. NMW rules &
standards = monitor normal pregnancy to recognise warning signs of abnormality
- 2.Urinalysis - Looking for Protein, Glucose, Blood, Ketones & Leukocytes. Protein = pre-eclampsia or infection. Leukocytes = infection. Ketones = Dehydration or
malnutrition. Blood = infection or contamination. Glucose = Diabetes - NICE do NOT recommend testing for glucose in pregnancy, but women at high risk (i.e. obese)
should be monitored closely.
- . 3. Palpation - To ascertain fetal size & growth, fetal health, position & presentation, detect deviation from the norm. Generally done for reassurance (maternal) NICE recommend from 36/40 only.
Done prior to Auscultation of FH - as FH heard clearer between the shoulder blades. INSPECTION - stretch marks, pigmentation & bruises & trauma. PALPATION - fundal (height), lateral (lie) pelvic
(presentation & engagement). MEASUREMENT - locate top of fundus, using paper tape measure (upside down to prevent influence/bias) measure to symphsis pubis (bone). RECORD - measurement
on individualised Growth Chart - Act appropriately if deviates from the norm (perinatal institute). Lateral palpation to ascertain lie = longitudinal left preferred; optimal fetal positioning. Pelvic palpation -
avoid Pawlik's grip, always be cautious about causing pain or discomfort, maintain dignity. Cephalic = normal /optimal position. Assess ENGAGEMENT.
- 4.Auscultation - Pinard Stethoscope or Sonicaid, Normal = 110-160bpm. Maternal pulse - normal = 60-80bpm. Listen for a full minute; may be aware of
accelerations & decelerations inicating good variability.
- 5.Document contemporaneously throughout appointment as per current NICE and NMC guidelines to maintain professional
accountability
- 6.If any deviations from the norm detected refer appropriately to a member of the wider
MDT.
- 7.Book in next appointment
- 8.Make woman aware of contact numbers if concerned or if signs of labour present
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