Slide 2 Prenatal Care, Assessment and Screening Maternal Newborn
Orientation Learning Module July 2012 Slide 3 Objectives On
completion of this module, learners will: Describe the basic
elements of antenatal assessment and screening as identified in the
Nova Scotia Prenatal Record 1 & 2 Explain the relevance of this
information to nursing care of the antepartum woman and family
Identify key resources for care providers working with the
perinatal population Slide 4 Introduction To get the most out of
this module, please refer to the following documents: The Nova
Scotia Prenatal Record (1 & 2) Guidelines for Antenatal
Screening & Testing (card) These may be available on your unit
or can be downloaded from:
http://rcp.nshealth.ca/resources-reports/nova-scotia-prenatal-record
Slide 5 Slide 6 Nova Scotia Prenatal Record 1 Demographics
Pregnancy Dating Obstetrical History Problems/Comments/Referrals
Present Pregnancy Past Illnesses Slide 7 Slide 8 Demographics
Race/Ethnicity: Genetic Screening Culturally Competent Care
http://www.gov.ns.ca/health/primaryhealthcare/diversity.asp Slide 9
Nova Scotia Prenatal Record 1 Demographics Pregnancy Dating
Obstetrical History Problems/Comments/Referrals Present Pregnancy
Past Illnesses Slide 10 Why is this so important? How do I do this?
Slide 11 Pregnancy Dating Dating: LMP (last menstrual period)
Certainty of dates, regular cycle Naegles rule: June 8 th, 2011 + 7
days = June 15 th, - 3 months = March 15 th 2012 EDB Ultrasound
(SOGC) 1 st trimester ultrasound between 11 and 14 weeks Use 1 st
trimester U/S If > 5 days difference between U/S and LMP Use 2
nd trimester U/S if > 10 days difference between U/S and LMP
Gestational age should be determined by the earliest ultrasound
http://www.sogc.org/guidelines/documents/gui214CPG0809.pdf Slide 12
Nova Scotia Prenatal Record 1 Demographics Pregnancy Dating
Obstetrical History Problems/Comments/Referrals Present Pregnancy
Past Illnesses Slide 13 Obstetrical History Pain preferences
Confidence or fear Education, support, individualized care Slide 14
Nova Scotia Prenatal Record 1 Demographics Pregnancy Dating
Obstetrical History Problems/Comments/Referrals Present Pregnancy
Past Illnesses Slide 15 Present Pregnancy Depression/Anxiety
Bleeding Rh Smoking Alcohol & substance use Slide 16 Present
Pregnancy Depression Stage 1 & 2
http://www.bcwomens.ca/NR/rdonlyres/483927DE-698E-42A7-89E5-
6E7080D6ABA9/18624/Perinatal_Brochure1.pdf Bleeding Rh Smoking
Alcohol and substance use Slide 17 Depression: Stage 1 Asking
Educating History of depression Substance use Slide 18 Depression:
Stage 2 Screening for all women using EPDS
http://www.fresno.ucsf.edu/pediatrics/downloads/ edinburghscale.pdf
http://www.fresno.ucsf.edu/pediatrics/downloads/ edinburghscale.pdf
Education, emotional and practical support Diagnostic assessment
and treatment Immediate intervention Slide 19 Present Pregnancy
Depression/Anxiety Bleeding Rh Smoking Alcohol & substance use
Slide 20 Bleeding First Trimester Implantation Infection
Miscarriage Slide 21 Bleeding Second Trimester Placental abruption
Placenta previa Slide 22 Rh Program of NS:
http://rcp.nshealth.ca/rh http://rcp.nshealth.ca/rh Telehealth:
http://videtis.ucis.dal.ca/MedIT/RHTeleH2010-05-10.wmvhttp://videtis.ucis.dal.ca/MedIT/RHTeleH2010-05-10.wmv
Slide 23 Present Pregnancy Depression/Anxiety Bleeding Rh Smoking
Alcohol & substance use Slide 24 Smoking Motherisk :
http://www.motherisk.org/prof/updatesDetail.jsp?content_id=975
http://www.motherisk.org/prof/updatesDetail.jsp?content_id=975
Public Health Agency of Canada :
http://www.phac-aspc.gc.ca/hp-gs/guide/05_sp-tg-eng.phphttp://www.phac-aspc.gc.ca/hp-gs/guide/05_sp-tg-eng.php
Slide 25 Present Pregnancy Depression/Anxiety Bleeding Rh Smoking
Alcohol & substance use Slide 26 Substance Use PRIMA
(Pregnancy- Related Issues in the Management of Addictions)
www.addictionpregnancy.ca www.addictionpregnancy.ca Provincial
Alcohol Strategy - FASD http://www.motherisk.org/women/alcohol.jsp
Slide 27 TPTL Threatened Preterm Labour Predicting Preterm Labour
fFN Cervical length Digital examination Audibert et al., JOGC April
2010 Slide 28 Nova Scotia Prenatal Record 1 Demographics Pregnancy
Dating Obstetrical History Problems/Comments/Referrals Present
Pregnancy Past Illnesses Slide 29 Past Illnesses Acute and Chronic
Illnesses Physiological and emotional components Experiences of
hospitalizations Pain Fear Health care providers Slide 30 Nova
Scotia Prenatal Record 2 Physical Assessment BMI
Psychosocial/Environmental Factors Prenatal Genetic Screening
Education/Discussion Slide 31 Physical Assessment: Body Mass Index
Slide 32 Maternal Pre-pregnancy BMI NSAPD 2010 Slide 33 Maternal
BMI and Weight Gain BMI 29:15 lbs Health Canada Gestational Weight
Gain Recommendations:
http://www.hc-sc.gc.ca/fn-an/nutrition/prenatal/qa-gest-gros-qr-eng.php
http://www.hc-sc.gc.ca/fn-an/nutrition/prenatal/qa-gest-gros-qr-eng.php
Slide 34 Nova Scotia Prenatal Record 2 Physical Assessment BMI
Psychosocial/Environmental Factors Prenatal Genetic Screening
Education/Discussion Slide 35 Abuse in Pregnancy Prevalence
Assessing Intervention Resources:
http://www.cdc.gov/reproductivehealth/violence/IntimatePartnerViolence/sld011.htm#12
http://www.sogc.org/health/health-ipv_e.asp Slide 36 Nova Scotia
Prenatal Record 2 Physical Assessment BMI
Psychosocial/Environmental Factors Prenatal Genetic Screening
Education/Discussion Slide 37 Genetic Screening Slide 38 Guidelines
for Antenatal Laboratory Screening and Testing -RCP July 2007 Slide
39 First Prenatal Visit Slide 40 Guidelines for Genetic Screening
and Testing Screening: Maternal Serum Testing (MST) Integrated
Maternal Serum Testing (IMST) Early Pregnancy Review (EPR)
Diagnostic Ultrasound Diagnostic Tests CVS and amniocentesis
Ethical considerations RCP:
http://rcp.nshealth.ca/clinical-practice-guidelines/antenatal-laboratory-screening-testinghttp://rcp.nshealth.ca/clinical-practice-guidelines/antenatal-laboratory-screening-testing
Slide 41 Nova Scotia Prenatal Record 2 Physical Assessment BMI
Psychosocial/Environmental Factors Prenatal Genetic Screening
Education/Discussion Slide 42 Prenatal education Physical and
emotional well-being Breastfeeding Plans for Labour and Birth
Newborn screening Cord blood banking RCP Prenatal Record Companion
Document http://rcp.nshealth.ca/sites/default/files/resources-
reports/pnr_comp_doc_july2007.pdf
http://rcp.nshealth.ca/sites/default/files/resources-
reports/pnr_comp_doc_july2007.pdf Slide 43 Prenatal Record:
Relevance to Nursing care Individualized nursing care Education and
support Referrals Resources Slide 44 Questions and Comments? We
welcome your feedback. Please click on this link to complete a
quick evaluation form:
http://rcp.nshealth.ca/education/learning-modules/evaluation Please
contact one of the Perinatal Nurse Consultants with RCP at:
[email protected] THANK YOU !
