Importance of Antenatal Check-Up During Pregnancy

Significance of Antenatal Check-Up During Pregnancy

Definition of Antenatal Care (ANC):

Systemic supervision (examination and advice) of a woman during pregnancy which should be of a regular and periodic nature in accordance with the principles laid down or more frequently according to the need of the individual is called antenatal care.

Antenatal check-up during pregnancy
Fig: Antenatal check-up during pregnancy

Importance of Antenatal Check-Up During Pregnancy:

For the below reasons antenatal check-up is so much important during pregnancy:

  • To confirm the pregnancy.
  • To confirm that the size of uterus corresponds to the period of pregnancy.
  • To exclude the presence of any tumors or other abnormalities in the pelvis.
  • To diagnose any infections in the vagina or cervix.
  • To diagnose the presence of any ulcer or erosion in the cervix (mouth of the uterus).
  • To take a routine cervical smear to rule out any disease.
  • To assess the size of the pelvic cavity.
  • Since it confirms the presentation of the baby.
  • It helps the doctor to assess the condition of the cervix.
  • It gives a fair idea of the pelvis in comparison to the presenting part of the baby.
  • To screen out high risk cases.
  • Detection of high risk factors.
  • To make the patient realize that the pregnancy is a physiological process & to give psychological support.
  • Regular supervision of pregnancy.
  • A routine examination of urine will provide information about any infection, presence of protein or sugar in urine.

WHO Recommendation for Antenatal Visit:

Prenatal visit:

  • Health history taking,
  • Abdominal assessment,
  • Subsequent visit.

 If pregnancy is normal, prenatal visits are scheduled every month for 7 months, every 2 weeks during the eight month and every week during the last month.

In the developing countries, as per WHO, the antenatal visit is curtailed to at least four (4).

· First visit (by 16 weeks):

· Anaemia, syphilis, medical & obstetric risk factors.

· Individualized birth plan & health education.

· Second  visit (between 24-28 weeks):

· Symphysis fundal height (multiple pregnancies).

· Third visit (at 32nd week):

· Symphysis fundal height (multiple pregnancies, IUGR).

· Pre-eclampsia.

· Further develop individualized birth plan.

· Fourth visit (at 36th week):

· Identify fetal lie / presentation.

· Update the individualized birth plan.

Routine Investigations During Antenatal Care Visits:

A. Routine investigations:

  • Blood: Hb%, ABO grouping & Rh typing, VDRL.
  • Random blood glucose (RBS).
  • Urine R/ME: Protein, sugar & pus cells.
  • Cervical cytology study by Papanicolaou stain has become a routine in many clinics.

B. Special investigations:

  •        Serological tests for rubella & HBV.
  •        Maternal serum a-(alpha) fetoprotein (MSAFP).
  •        Ultra sound examination: 1st trimester scan either trans- abdominal (TAS) or trans-vaginal.

C. Repetition of the examinations should do at every antenatal visit –

  •         Hb estimation at 28th & 36th week.
  •         Urine test (dipstick) for protein & sugar.

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