Process of Antenatal Abdominal Examination

Process of Antenatal Abdominal Examination

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.

Aims of Antenatal Care:

Aims of antenatal care includes-

  1. To monitor the progress of pregnancy in order to ensure maternal health and normal fetal development.
  2. To support and encourage a family’s healthy psychological adjustment to childbearing.
  3. To recognize deviation from the normal and provide management as required.
Antenatal Abdominal Examination
Fig: Antenatal Abdominal Examination

Process of Antenatal Abdominal Examination:

It includes-

  • Carry out abdominal palpation at every antenatal visit.
  • Ask the pregnant woman, prior to palpation how she feels, if the baby is moving and her last menstrual cycle occurred or the date she felt the baby first moved.
  • Ensure the place for conducting the palpation provides the pregnant women privacy.
  • Prior to an abdominal palpation ask the women to empty her bladder.
  • Lie the pregnant women on her back with upper of her body supported with cushions. Never lie a pregnant women in her back as the heavy uterus may compress the main blood vessels returning to the heart and cause fainting (supine hypotension).
  • Inspect the abdomen for scars, previous stretch mark, and signs of over distention/other signs of multiple pregnancies such as many fetal parts felt, two fetal heads palpated, excessive or reduced amount of amniotic fluid.
  • Estimate gestation age and assess the fetal growth. After 24 weeks of pregnancy, the most effective way to estimate gestational age is use a tailor’s tape measure.
  • Using the measure tape, measure from the upper boarder of the symphysis pubis to the top of the fundus. Record the measurement in cms. If measurement is different from calculated weeks by more than 3 cms or there is no growth or poor growth from the last examination refer for further investigation.
  • Gently palpate the abdomen to assess the lie of the fetus (it should be longitudinal), If not, and the pregnancy is 36 weeks or more refer/seek advice from next higher level of service.
  • Using two hands, palpate the abdomen and pelvic area to identify the presenting part.
  • After 37 weeks, especially in a primigravida assess if the foetal head is engaged, If not, ask the pregnant women to sit/stand up and see if head can be made to fit into the pelvis, refer to the first referral unit/hospital.
  • Identify where the foetal back is and listen to fetal heart. If fetal stethoscope is not available, listen to the foetal heart directly be ear and ask the pregnant women is the baby is moving. If no fetal heart sound is heard or there were poor/reduced foetal movements in the last month of pregnancy, refer to the first referral unit/hospital.
  • Discuss all things with the pregnant women with her husband/accompanying family members.
  • Record all findings accurately. Review all findings and if any deviations are found refer to the first referral unit/hospital for more specialized investigations as appropriate.

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