PHYSIOLOGY AND
MANAGEMENT OF
NORMAL
PREGNANCY.
LECTURE NOTES
BY
SIS .MANU
1
, PHYSIOLOGY AND MANAGEMENT OF NORMAL PREGNANCY.
PRE-CONCEPTIONAL CARE.
Pre-conceptual care
Pre-conceptual care is series of intervention and investigations given to couples and women
before conception or pregnancy.
CONCEPTION is the fusion of an ovum and spermatozoa to form a zygote.
It has the overall aim of preventing birth defects and ensuring the safety of the mother, before
during and the end of pregnancy.
AIMS OF PRE-CONCEPTUAL CARE
To ensure that the woman and her partner are in optimal state of physical and emotional
health at the onset of pregnancy.
It aims at improving maternal and child health.
It brings health benefits to the adolescent’s women and men irrespective to their plans to
become parents.
To enhance pregnancy outcome.
2
,ACTIVITIES AT THE PRECONCEPTION CARE CLINIC
DATA COLLECTION
LABORATORY INVESTIGATION
COUNSELLING
PROCEDURES OF PRE-CONCEPTIONAL CARE
1. INFORMATION;
Family history
Medical history
Menstrual history
Method of conception
Obstetric history
Social history
2. OBSERVATIONS AND INVESTIGATIONS
Height and weight
Blood investigations
Urinalysis
Stool sample
3. General health and fertility.
Fertility and fatness; the average post pubertal woman has a body fat content of
approximately 28%,a minimum of 22% is required for the maintenance of ovulation
3
, .however people who are underweight ,PCC is given to increase their energy intake or
reduce activity.
Body weight; this is done by BMI and is calculated by dividing the weight and the height.
However a high BMI identifies those who are relatively over weight. The aim of PCC is
to help such women achieve an appropriate BMI prior to conception to enhance
pregnancy outcome.
Principles of healthy diet; it involves giving advice about healthy diet, a simple and easy
guide is the balance of good health diagram from the food standards agency. This is to eat
starchy foods like cereals, grains, vegetables, and less fatty foods.
Folate is use to describe folic acid that are produced naturally in food and also the
synthetic form used in vitamins supplement and fortification of foods. During PCC ,they
are encourage to eat foods rich in folate more fortified foods such as bread, cereals, and
taken a daily folic acid supplement .
Vitamin A is essential for embryo against genesis, growth and epithelial differentiation
but a high intake of retinol in a form of vitamin A is called TERATOGENIC.
4. MEDICAL PRE-EXISTING CONDITIONS & DRUGS.
Diabetes; this is the most prevalent chronic medical disease in the pregnant population.
Detecting diabetes will improve perinatal outcome. In newly diagnosed cases the woman
is immediately hospitalized for basal assessment, management and monitoring. The aim
of PCC is to achieve Norma glycaemia both pre and pre conception as many of the
problems seen in the insulin dependent mothers are a direct result of hyperglycemia.
Epilepsy; is the most common neurological problem seen during pregnancy. Fertility in
epileptic women is decreased mainly due to the enzyme including antiepileptic drugs.
The aim of PCC for women with epilepsy is to help plan pregnancies carefully and to
keep her seizures falls on the lowest possible dose of anticonvulsants.
4
MANAGEMENT OF
NORMAL
PREGNANCY.
LECTURE NOTES
BY
SIS .MANU
1
, PHYSIOLOGY AND MANAGEMENT OF NORMAL PREGNANCY.
PRE-CONCEPTIONAL CARE.
Pre-conceptual care
Pre-conceptual care is series of intervention and investigations given to couples and women
before conception or pregnancy.
CONCEPTION is the fusion of an ovum and spermatozoa to form a zygote.
It has the overall aim of preventing birth defects and ensuring the safety of the mother, before
during and the end of pregnancy.
AIMS OF PRE-CONCEPTUAL CARE
To ensure that the woman and her partner are in optimal state of physical and emotional
health at the onset of pregnancy.
It aims at improving maternal and child health.
It brings health benefits to the adolescent’s women and men irrespective to their plans to
become parents.
To enhance pregnancy outcome.
2
,ACTIVITIES AT THE PRECONCEPTION CARE CLINIC
DATA COLLECTION
LABORATORY INVESTIGATION
COUNSELLING
PROCEDURES OF PRE-CONCEPTIONAL CARE
1. INFORMATION;
Family history
Medical history
Menstrual history
Method of conception
Obstetric history
Social history
2. OBSERVATIONS AND INVESTIGATIONS
Height and weight
Blood investigations
Urinalysis
Stool sample
3. General health and fertility.
Fertility and fatness; the average post pubertal woman has a body fat content of
approximately 28%,a minimum of 22% is required for the maintenance of ovulation
3
, .however people who are underweight ,PCC is given to increase their energy intake or
reduce activity.
Body weight; this is done by BMI and is calculated by dividing the weight and the height.
However a high BMI identifies those who are relatively over weight. The aim of PCC is
to help such women achieve an appropriate BMI prior to conception to enhance
pregnancy outcome.
Principles of healthy diet; it involves giving advice about healthy diet, a simple and easy
guide is the balance of good health diagram from the food standards agency. This is to eat
starchy foods like cereals, grains, vegetables, and less fatty foods.
Folate is use to describe folic acid that are produced naturally in food and also the
synthetic form used in vitamins supplement and fortification of foods. During PCC ,they
are encourage to eat foods rich in folate more fortified foods such as bread, cereals, and
taken a daily folic acid supplement .
Vitamin A is essential for embryo against genesis, growth and epithelial differentiation
but a high intake of retinol in a form of vitamin A is called TERATOGENIC.
4. MEDICAL PRE-EXISTING CONDITIONS & DRUGS.
Diabetes; this is the most prevalent chronic medical disease in the pregnant population.
Detecting diabetes will improve perinatal outcome. In newly diagnosed cases the woman
is immediately hospitalized for basal assessment, management and monitoring. The aim
of PCC is to achieve Norma glycaemia both pre and pre conception as many of the
problems seen in the insulin dependent mothers are a direct result of hyperglycemia.
Epilepsy; is the most common neurological problem seen during pregnancy. Fertility in
epileptic women is decreased mainly due to the enzyme including antiepileptic drugs.
The aim of PCC for women with epilepsy is to help plan pregnancies carefully and to
keep her seizures falls on the lowest possible dose of anticonvulsants.
4
