ANTENATAL EXAMINATION
INTRODUCTION
Antenatal examination or antenatal assessment is examination of pregnant women which
involves screening of high-risk conditions that can affect maternal and fetal outcome.
DEFINITION
It is the systematic and through examination of a women in pregnancy at regular interval to
prepare the mother for normal pregnancy and to detect abnormalities for women with high-
risk pregnancy
AIMS
Ensure normal pregnancy with healthy baby from a healthy mother.
Monitor the progress of pregnancy by conducting regular examination.
Prepare and encourage the pregnant women and her family to have a healthy
psychological adjustment to child bearing.
Prevent and detect any complication at the earliest and provide care as required.
Provide need-based health education an all aspects of antenatal care and importance
of planned parenthood
Prepare the mother for confinement and postnatal care and child rearing.
Educate about family planning.
To investigate and treat any deviation from the normal for safe des
COMPONENTS
History taking
General assessment
Abdominal examination
Vaginal examination
Investigations
Health education
ARTICLES REQUIRED
S. No. ARTICLES RATIONALE
1. Fetoscope/ Stethoscope To auscultate fetal heart sound
2. Thermometer To take temperature
3. Measuring Tape To take abdominal girth and fundal
height
4. Sphygmomanometer To measure blood pressure
5. Weighing machine To measure weight of mother
6. Draping Sheets To provide privacy
7. Cotton swabs To wipe out secretions
8. Torch To visualise clearly
9. Kidney tray and paper bag To discard waste
PREREQUISITES
Explain the procedure clearly to the mother.
Drape the mother and provide enough privacy by curtain or screen.
Room should be well ventilated and properly lighted.
Wash your hand before and after the procedure to prevent cross infection
Make her comfortable
Ask her to empty her bladder before conducting abdominal palpation
Assemble all the articles properly
Check vital signs
Record height and weight
A. HISTORY TAKING
Identification data- Age, Address, Marital status, Education, Occupation, Duration
of marriage, Husband’s occupation
Presenting Complaints- Enquire about pregnancy detection and confirmation test,
each trimester history of any minor ailments or illness, Tetanus Vaccination,
consumption of Folic Acid, Calcium and Iron tablets, date of quickening.
Obstetrical History- Obstetrical Score (GPLA), Period of gestation, Past obstetrical
history [Year of delivery, Place of delivery, Type of Delivery, Nature of pregnancy,
sex of the baby, Birth weight, Any complication in Pregnancy, Delivery or
Puerperium, Current status of the baby)
Menstrual history- age at first menstrual period(menarche), date of last menstrual
period (LMP), Duration and interval of each period, amount of blood flow, any
associated symptoms like dysmenorrhoea
Medical History- History of any past medical illness such as hypertension,
hypotension, Hypothyroidism, Hyperthyroidism, Diabetes mellitus, heart disease, etc.
Surgical History- History of any operation, History of blood transfusion, etc.
Family History- History of congenital abnormality/ Malformation or hereditary
illness, twins, hypertension, Diabetes mellitus, Cardiac diseases, any other conditions.
Personal History- Health habits like smoking, drinking, drugs or any other past
medical history, known allergies to drug, fumes, food or substances, sleeping pattern,
dietary pattern, bowel and bladder pattern, etc
B. General Assessment
Complete systematic examination from head to toe.
Height: Pulse:
Weight: Respiration:
Built: B.P:
Temperature:
i. Hair and Scalp- Healthy or infection
ii. Eyes
- Observe the colour of the conjunctiva - yellow, pink or normal.
- Sclera- Normal, yellow tinge suggest Anaemia
- Infection, discharge
iii. Mouth
- Hygiene
- Gums and teeth- Healthy, Cavities, Infection
iv. Ear, Nose and Throat- Healthy, Enlargement, discharge or infection
v. Breast Changes- Normal Changes during pregnancy
3 – 4 weeks - Pricking and tingling sensation
6 weeks- Enlarged, tense, painful
8 weeks- bluish surface, vein visible
8 – 12 weeks – Montgomery glands become prominent on the areola
16 weeks – Colostrum can be expressed
vi. Abdomen- Palpate for liver or spleen enlargement or any other abnormality
vii. Skin- Observe for any scar or infection
viii. Extremities- Upper: Check hands, color of nails-pink or pale, shape of nails
Lower: Any pain, tenderness, varicose veins, presence of oedema,
presence of homan’s sign
ix. Back and Spine:
- Observe the back and spine for any deformity
- Observe the symmetry of the rhomboids of Michaelis which is a diamond shaped
area formed anteriorly by the fifth lumbar vertebra laterally by the dimples, of the
superior iliac spine and posteriorly by the gluteal cleft.
C. ABDOMINAL EXAMINATION
A through abdominal examination of pregnant woman helps to determine the lie, presentation
and position of the fetus.
D. VAGINAL EXAMINATION
It should be done using the left fingers (thumb and index), the character of vaginal discharge,
cervix consistency, cystocele, uterine prolapse to be elicited.
E. INVESTIGATION
Hemogram, Blood grouping and incompatibility, Urine test- to detect protein, albumin,
acetone and sugar, HIV, VDRL, Ultrasound scans and any other test if needed.
F. HEALTH EDUCATION
Need based health education should be given.
AFTER CARE OF THE PATIENT AND ARTICLES
a) Make the mother comfortable
b) Inform her about findings of examination
c) Ask for any discomfort and record it
d) Replace all the articles properly.
REPORTING AND RECORDING
Record all the findings in the history taking and assessment file.
Inform any abnormalities to the superior and take prompt action.
Record any other information that mother has given.
