Antenatal Care Part 1
Topic outline
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Planning Antenatal Care
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Maternal and newborn mortality
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Maternal deaths and complications
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Newborn deaths and complications
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How can maternal and neonatal mortalities be reduced?
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Planning for maternal and newborn healthcare in your community
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Ranking and prioritising problems to tackle
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Calculating the number of women who need antenatal care services
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Calculating the number of focused antenatal care check-ups
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Calculating the uptake of antenatal care services
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Calculating the proportion of births attended by health professionals
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Calculating the maternal mortality ratio
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Calculating the neonatal mortality rate
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Promoting Antenatal Care
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Health promotion
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Educating your community about antenatal care
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Two-way communication
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Choose communication methods to suit your audience
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Advocacy and community mobilisation
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Organising a health campaign
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Special community events
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Group discussions
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Individual health education
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Preparation is essential
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Getting started
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Keeping everyone involved
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Anatomy and Physiology
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Some common terms in anatomy and physiology
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Anatomy and physiology of the female reproductive organs
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External female genitalia
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Mons pubis
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Labia majora and labia minora
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Vestibule
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Perineum and hymen
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Internal female reproductive organs
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Fallopian tubes and ovaries
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The uterus
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The cervix and the vagina
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Hormonal Regulation
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The female reproductive hormones
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The ovarian cycle
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The follicular phase: days 1 to 14
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The luteal phase: days 15 to 28
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The uterine cycle
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The menstrual phase: days 1 to 5
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The proliferative phase: days 6 to 14
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The secretory phase: days 15 to 28
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The menarche, puberty and the menopause
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Intro
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Male and female sex cells
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Sperm: the male sex cells
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Ova: the female sex cells
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Fertilisation
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Early development of the embryo
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Implantation
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The placenta
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Fetal and maternal blood vessels
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The placental circulation
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The placenta as a filter
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Placental hormone synthesis
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Anatomy of the Female Pelvis and Fetal Skull
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The female bony pelvis
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Ilium
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Ischium
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Pubic bones and the symphysis pubis
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Sacrum
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The pelvic canal
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The size and shape of the pelvis
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The pelvic inlet
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The pelvic outlet
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The fetal skull
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Fetal skull bones
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Sutures
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Fontanels
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Regions and landmarks in the fetal skull
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Physiological Changes During Pregnancy
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Physiological changes in the female reproductive system during pregnancy
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Changes in the uterus, cervix and vagina
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Pregnancy-related changes in posture and joints
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Changes in body weight during pregnancy
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The heart
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Blood volume
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Blood pressure in pregnancy
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Exercise and blood flow in pregnancy
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Oedema in pregnancy
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Respiratory changes
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Changes in the gastrointestinal system in pregnancy
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Changes in the urinary system during pregnancy
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Skin changes
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Linea nigra
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Mask of pregnancy (chloasma)
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Stretch marks
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Sweat glands
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Changes in the breasts
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Diagnosing Pregnancy
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Gaining a woman’s trust in antenatal care
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Finding out if a woman is pregnant
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Possible symptoms of pregnancy
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Probable signs and symptoms of pregnancy
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Positive signs of pregnancy
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Identifying possible risk factors in pregnancy
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How old is she?
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How many children has she had?
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Has she had any miscarriages?
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Has she ever had an abortion?
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Has she had any problems with past pregnancies or births?
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Questions of your own
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General Assessment of the Pregnant Woman
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Checking for symptoms of poor nutrition or lack of iodine
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Checking her weight
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Checking her temperature
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How to check her temperature
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What to do if the woman has a fever
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Checking her pulse
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How to measure her pulse rate
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What to do if the woman has a fast pulse
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Checking for signs of anaemia
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Checking for shortness of breath
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Checking her blood pressure
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How to check blood pressure
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Checking for diabetes
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Urine tests for diabetes
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How to help a woman with diabetes
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Checking for a vaginal infection
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Estimating Gestational Age from Fundal Height Measurement
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What does measuring the height of the mother’s uterus tell us?
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How to measure the fundal height
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How to measure fundal height using the finger method
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How to measure fundal height using a soft tape measure
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The due date you got by counting from the LNMP is wrong
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The uterus is growing too quickly
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The uterus is growing too slowly
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Assessing the Fetus
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Finding the baby's position in the uterus
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Feeling the mother's abdomen
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Is the baby vertical?
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Is the baby facing the mother's front, or her back?
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Is the baby head down or bottom down?
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Feeling for the baby's head
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Asking the mother about the baby's kicks
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Listening for the baby’s heartbeat
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Finding the babyss position by listening to the heartbeat
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Baby is breech
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Baby is lying sideways
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Twins
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After the antenatal check-up
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Minor Disorders of Pregnancy
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Digestive and food-related disorders
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Nausea, vomiting and hyperemesis gravidarum
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Food dislikes and food cravings
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Heartburn
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Constipation
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Swollen veins
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Varicosities (varicose veins)
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Haemorrhoids (piles)
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Back pain
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Joint pain
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Leg cramps
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Sudden pain in the side of the lower belly
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Abdominal cramps in early pregnancy
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Headaches and migraines
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Oedema
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Frequency of urination
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Vaginal discharge
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Feeling hot or sweating a lot
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Dyspnoea (shortness of breath)
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Difficulty in getting up and down
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Chloasma (the mask of pregnancy)
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Changing feelings and emotions
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Sudden changes in feelings
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Worry and fear
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Sleep problems
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Strange dreams and nightmares
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Forgetfulness
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Feelings about sex