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Ante natal care. Sharon Wallis Senior Matron. Appropriate care pathway from start Assessment of maternal & fetal well being Early detection of pregnancy induced conditions or exacerbation of pre exisiting ones Appropriate & timely referral Support women & their families. - PowerPoint PPT Presentation
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Ante natal Ante natal carecare
Sharon WallisSenior Matron
Importance of AN careImportance of AN care
Appropriate care pathway from startAssessment of maternal & fetal well beingEarly detection of pregnancy induced
conditions or exacerbation of pre exisiting ones
Appropriate & timely referralSupport women & their families
Choice, continuity & Choice, continuity & control!control!
Place of birth – hospital or home
Choice of pain relief in labour
Continuity of care / carer
Booking Booking
Ideally between 8 – 10 weeks gestationThorough social / obstetric /medical
/family historyIncludes mental health historyRoutine enquiry into domestic abuseHealth advice – smoking / substance &
alcohol misuse / diet / exerciseMaternity benefitsScreening / blood tests
Social historySocial history
Support - benefitsTeenage Safe guardingLearning disabilitiesNon English speaking / readingInterpreters
Obstetric historyObstetric history
Previous C/SPPH3rd degree tearIUFD / stillbirthBaby >4.5 kgIUGRPreterm labourGrand multipRetained placenta x 2Shoulder dystocia3 x consecutive 1st trimester miscarriage2nd trimester miscarriage
Relevant medical historyRelevant medical history
Cardiac diseaseEndocrine diseaseGenital tract surgeryHaemaglobinopathiesBBVBMI >35 /<18Skeletal / spinal problemsDeclines blood productsMalignanciesSevere asthma
Family historyFamily history
1st degree relative with IDDMFH Pre eclampsiaThromboembolic disordersCongenital abnormalities / deafnessFH – poor obstetric outcome
Mental health Mental health
Past hx of severe MH disorders especially following childbirth
FH of severe MH disorders especially that required hospitalisation
Emphasis on early detection and referal to maternal MH team
Domestic abuseDomestic abuse
Routine enquiry at least 3 times during pregnancy episode
All women askedRE + /-Contact numbers highlightedSafeguarding issues with disclosure
Health adviceHealth advice
Smoking AlcoholSubstance misuse
Don’t do it! Referal to Fresh start / drug and alcohol
specialist midwife if necessary
ScreeningScreening
All women offered NT+ (combined screening) between 11+ - 13+ weeks
FBCSickle + thalasaemia screeningBlood group & anti bodiesMicrobiology screeningMSU
AN visit scheduleAN visit schedule
Based on individual clinical need As a minimum, women are seen; At booking (8-10 weeks) Dating scan +/- NT+ (RDH) 16 weeks Anomaly scan (RDH) 24 weeks 28 weeks – repeat FBC / anti bodies / anti D if Rh neg 31 weeks 34 weeks – repeat FBC 36 weeks 38 weeks Term Manual BP / urinalysis / SF height measurement as
minimum