Antenatal Risk Assessment and Pregnancy Risk Factors

Antenatal Risk Assessment and Pregnancy Risk Factors

Definition of Antenatal Care:

Antenatal care is the clinical assessment of mother and fetus during pregnancy. It traditionally involves a number of routine visits approximately 12-16 for assessment of pregnant women before and during pregnancy.  Antenatal care means the medical care that women receive when they are pregnant.

Antenatal Risk Assessment
Fig: Antenatal Risk Assessment

Risk Assessment of Antenatal Care:

Antenatal assessment is the screening for high-risk factors. Risk factors are any findings that have been shown to have effect on childbirth outcomes.

1. Social personal:

  • Low income level,
  • Low education,
  • Poor diet,
  • Multipara,
  • Weight less than 45.5 kg or more than 91 kgs,
  • Age less than 16 or more than 35 years,
  • Smoking,
  • Use of addicting drug and,
  • Excessive alcohol consumption.

2. Preexisting medical disorders:

  • DM,
  • Cardiac disease,
  • Anaemia,
  • Hypertension,
  • Thyroid disorder,
  • Renal disease,
  • DES exposure.

3. Obstetric conditions:

a. Previous pregnancy:

  • Stillborn,
  • Habitual abortion,
  • Cesarean section,
  • Rh or blood group sensitization.

b. Current pregnancy:

  • Rubella cytomegalo virus,
  • Herpes virus type 2,
  • Syphilis,
  • Abruption placenta/placenta previa,
  • PIH,
  • Multiple gestation and,
  • Spontaneous premature rupture membranes.

Problems Related To Not Receiving Antenatal Care:

Problems related to not receiving antenatal care (ANC) are-

  • Lack of awareness about the advantage of quality of care.
  • Poor woman status: The decision about attending is not the pregnant woman to make; often older members of the family and husbands see no need for ANC and they rely on traditional methods of dealing with pregnancy.
  • The facilities for providing ANC are inadequate, are not functioning correctly.
  • Knowledge gap: ignorance; the pregnant women still not knows why they should attend for ANC.
  • Travel and transport problems make it difficult for the pregnant women to go for ANC or for health care providers to go out to provide community based ANC.
  • Inadequate cultural transport.
  • Superstition and anxiety about letting any health care provider examine the pregnant women during pregnancy.
  • General dislike and distrust of all health care providers.
  • Financial problems.

Risk Factors That May Arise During Pregnancy:

All the risk factors that may arise during pregnancy are-

  • Fetal movement pattern changed or reduced,
  • Hb level lower than 10 g/dl,
  • Poor weight gain, weight loss,
  • Proteinuria, glycosuria, bacilluria,
  • BP systolic of or above 140 mmHg, diastolic of or more above 90 mmHg or 15 more above booking diastolic,
  • Uterus large or small for gestation,
  • Excess or decrease liquor,
  • Malpresentation,
  • Head not engaged in primigravida women at term,
  • Any vaginal, cervical or uterine bleeding,
  • Preterm labor,
  • Infection,
  • Any chronic or acute illness or disease in the women,
  • Relevant sociological or psychological factors.

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