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    Prenatal Assessment

    Uploaded by

    Paula Janine Barroga
    This document provides information on prenatal assessment including objectives of prenatal care such as screening, prevention of diseases, and education. It discusses methods for determining estimated due dates (EDD) including Naegele's rule and using last menstrual period (LMP) by adding or subtracting months depending on the quarter of the year. The document also covers determining age of gestation (AOG) using traditional methods based on counting days from LMP, McDonald's rule using fundal height measurement, and Bartholomew's rule on fundal location by gestational age. It discusses implications of discrepancies in fundal height and guidelines for measuring fetal movement.

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    Prenatal Assessment

    Uploaded by

    Paula Janine Barroga
    95 views29 pages
    This document provides information on prenatal assessment including objectives of prenatal care such as screening, prevention of diseases, and education. It discusses methods for determining estimated due dates (EDD) including Naegele's rule and using last menstrual period (LMP) by adding or subtracting months depending on the quarter of the year. The document also covers determining age of gestation (AOG) using traditional methods based on counting days from LMP, McDonald's rule using fundal height measurement, and Bartholomew's rule on fundal location by gestational age. It discusses implications of discrepancies in fundal height and guidelines for measuring fetal movement.

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    Prenatal-Assessment

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    This document provides information on prenatal assessment including objectives of prenatal care such as screening, prevention of diseases, and education. It discusses methods for determining estimated due dates (EDD) including Naegele's rule and using last menstrual period (LMP) by adding or subtracting months depending on the quarter of the year. The document also covers determining age of gestation (AOG) using traditional methods based on counting days from LMP, McDonald's rule using fundal height measurement, and Bartholomew's rule on fundal location by gestational age. It discusses implications of discrepancies in fundal height and guidelines for measuring fetal movement.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    95 views29 pages

    Prenatal Assessment

    Uploaded by

    Paula Janine Barroga
    This document provides information on prenatal assessment including objectives of prenatal care such as screening, prevention of diseases, and education. It discusses methods for determining estimated due dates (EDD) including Naegele's rule and using last menstrual period (LMP) by adding or subtracting months depending on the quarter of the year. The document also covers determining age of gestation (AOG) using traditional methods based on counting days from LMP, McDonald's rule using fundal height measurement, and Bartholomew's rule on fundal location by gestational age. It discusses implications of discrepancies in fundal height and guidelines for measuring fetal movement.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 29

    PRENATAL

    ASSESSMENT
    Mary Joy B. Sande, PhDNEd
    PRENATAL CARE

    It is the monitoring and managing of a patient


    during pregnancy to:

    ▪prevent complications
    ▪promote a healthy outcome for both the mother
    and infant
    Objectives of Prenatal Care

    Screening & Prevention of diseases which may


    complicate pregnancy

    Education of women on danger and emergency


    signs & symptoms

    Birth Preparedness & Complication readiness of


    the woman and her family for childbirth

    3
    DETERMINATION OF
    ESTIMATED BIRTHDATE
    EDC/EDD
    ▪Naegele’s rule
    oStandard method used to predict the length of
    pregnancy by determining the Last Menstrual Period
    (LMP) of the mother

    oFrom LMP you deduct 3 months plus 7 days plus 1 year


    (April-December)

    ofrom LMP add 9 months and 7 days (January-March)


    EDC
    LMP
    Patient A - April 11, 2021
    1. Less 3 months = January
    2. Plus 7 days = 18
    3. Plus 1 year = 2022

    EDC is January 18, 2022


    EDC
    LMP
    Patient B - September 27, 2021
    1. Less 3 months = June
    2. Plus 7 days = 34 days
    (September has 30 days so add 1 month to
    June and the remaining 4 days)
    3. Plus 1 year = 2022

    EDC is July 4, 2022


    EDC
    LMP

    Patient C - January 10, 2022


    1. Add 9 months = October
    2. Plus 7 days = 17
    3. No need to add 1 year

    EDC is October 17, 2022


    EDC
    LMP
    Patient D - December 28, 2021
    1. Less 3 months = September
    2. Plus 7 days = 35
    (December has 31 days so add 1 month to
    September and the remaining 4 days)
    3. Plus 1 year = 2022

    EDC is October 4, 2022


    AGE OF GESTATION (AOG)
    EDC Dec 12 LMP March 8

    OB WHEEL
    DUE DATE CALCULATOR Today is Aug 24
    GESTATION AGE WHEELS/BIRTH DATE CALCULATORS AOG is between 24 - 25 weeks
    AGE OF GESTATION (AOG)
    TRADITIONAL WAY BASED ON LMP

    • adding the total number of day of the month from


    LMP up to the time of visit then divide by 7 to
    determine the AOG in weeks

    • expressed in fraction
    COMPUTE FOR AOG
    SITUATION:
    Date of Prenatal visit: August 24, 2022
    LMP: May 25, 2022 (May has 31 days)
    Note: Consider the date of the LMP as day 1
    May - 7 days
    June - 30 days
    July - 31 days
    Aug - 24 days
    Total - 92 days/7

    AOG - 13 1/7 weeks


    The woman is 13 weeks and 1 day pregnant or
    The fetus is 13 weeks and 1 day old
    McDonald’s rule
    ▪a method of determining AOG during mid-
    pregnancy by measuring fundal height

    ▪distance from the symphysis pubis to the fundus in


    cm is equal to the week of gestation between the
    20th and 31st week of pregnancy
    How to measure the fundal height

    Preparatory steps
    ▪ Introduce yourself and identify your client by getting her full name
    ▪ Explain the procedure
    ▪ Provide client’s privacy
    ▪ Wash hands

    Implementation
    ▪ Let the woman void
    ▪ Assist her to lie in supine position
    ▪ Drape the client exposing only the abdomen
    ▪ Apply the tape with the calibration hidden to avoid bias
    McDonald’s rule
    ▪ Using the fundal height measurement compute the AOG in
    weeks/months
    o length of fundus in cm x 8/7 = AOG in weeks
    o length of fundus in cm x 2/7 = AOG in months

    ▪ becomes inaccurate
    o during the 3rd trimester of pregnancy (fetus is growing more
    in weight than height)
    o Patients who are obese or with fibroids or myoma
    (abnormal growths in the uterus)
    EXAMPLE

    SITUATION:

    Date of Prenatal visit: Aug 1, 2022


    MEASUREMENT OF FUNDAL HEIGHT = 20 cm
    ▪ Get AOG in weeks (20 cm x 8)/7= 22 6/7 weeks
    ▪ Get AOG in months (20 cm x 2)/7 = 5-6 months
    IMPLICATION

    FH greater than this standard suggests


    ▪ Computed AOG is wrong
    ▪ Multiple pregnancy
    ▪ Polyhydramnios (too much amniotic fluid)
    ▪ Molar Pregnancy (abnormal form of pregnancy)
    ▪ Pregnancy with Myoma or Ovarian Tumor
    IMPLICATION

    FH much less than suggests


    ▪Computed AOG is wrong
    ▪Baby is not growing well - Intra-uterine growth
    restriction (IUGR)
    ▪Oligohydramnios
    Bartholomew’s rule

    ▪to determine age of gestation by fundal location


    12 weeks (3 months) – over symphysis pubis
    16 weeks (4 months) - midway between symphysis pubis and umbilicus
    20 weeks (5 months) – at the umbilicus
    36 weeks (9 months) – just below xiphoid process
    23
    FETAL MOVEMENT

    ▪Vary
    o depends on the sleep cycles of fetus and
    mother’s activity during observation time

    ▪ Quickening – 18th-20th week


    FETAL MOVEMENT
    SADOVSKY METHOD
    ▪ mother on left recumbent position after a meal and record
    how many fetal movements she feels over the next hour

    ▪ 2x/10 min (ave 10-12x/hour)


    ▪ less than 5 (call health care provider)
    INSTRUCTIONS
    1. Please watch the videos uploaded on
    Measurement of fundal height.
    2. Please accomplish the worksheet on the EDD,
    AOG, FH
    3. Please submit the completed worksheet to the CI
    assigned to you next week

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