Final-Antenatal Care(Latest) 4

8/9/2019 Final-Antenatal Care(Latest) 4

1/20

G= number of pregnanciesregardless of duration or outcome

T = number of full term infantsborn(infants born at 37 weeks orafter)

P = number of preterm infantsborn(infants born before 37 weeks)

A = number of

abortions(spontaneous miscarriagesor therapeutic abortions)

L = number of liing children

! = multiple pregnancies


2/20

A woman who has had two preiouspregnancies" has gien birth to two

term children" and is again pregnantis #

graida 3"para $%3$&&$(GTPAL)

3$&&$&(GTPAL!)


3/20

A woman who has had twomiscarriages at '$ weeks(under the

age of iabilit) and is againpregnant is

graida 3" para &

3&&$&(GTPAL)


4/20

A multigestation pregnanc isconsidered as one para% or e*ample"

a woman who had term twins" thenone preterm infant" and is nowpregnant again would be a #

graida 3" para $

3$'&3'(GTPAL!)

Graida 3"para $

3$'&3(GTPAL)


5/20

A pregnant woman who had thefollowing past histor+ a bo born at3, weeks gestation" now alie andwell- a girl born at .& weeksgestation"now alie and well- a girlborn at 33 weeks gestation" now

alie and well+ would hae herpregnanc information summari/edas follows#


6/20

EX: Utilize the GTPAL system to classifya woman who is currently 8 months

pregnant. This is her fourth pregnancy.he !eli"ere! # $a$y "aginally at %&wee's who !ie!( e)perience! a

miscarriage( an! has one li"ing chil!who was !eli"ere! at *8 wee'sgestation.

a.G* P# +% # % #,$.G- P%+% % # #,c.G* P* +% # # #,!.G- P% +# # # #,


7/20

EX: A mi!wife is collecting the !ata!uring an a!mission assessment of

anilyn( a client who is pregnant withtwins. he has healthy - years ol! chil!that was !eli"ere! *8 wee's an! tell

the mi!wife that she !oes not ha"e ahistory of a$ortion or fetal !emise. Thenurse woul! !ocument the GP+TPAL, forthis client as

a. G*P# + %/0/0/#,$. G%P% +0/#/0/#,c. G%P# +#/0/0/#,!. G%P% + %/0/0/%)


8/20

A woman who has had term twins"then ' preterm infant 0 is nowpregnant again is classi1ed as#

G3 P $'&3' ( GTPAL!)


9/20

Consultation

2omplete Assessment and Phsicale*amination


10/20

1.Assessm ent of Fetal Grow th

and Developm ent

42544546

*pected date of con1nement5estimateddate of delier5estimated date of birth


11/20

DETERMINATION OF ESTIMATED BIRTH DATE

a. NAEGELES RULE calculation of expected date of

confinement(EDC)

FORMULA: count backwad ! mont"# fomt"e fi#t da$ of a woman%# la#t men#tual

peiod (LM&) t"en add ' da$# plu# $ea

E*AM&LE: LM& A&R+L ,,- ../

0 ! 1' 1

EDD 2A3 ,.- ..4


12/20

Gien L!P# !a $&"$&&

8 $& $&&+ 3 9 7 9'

:::::::::::::::::::::::::::::::

$ $7 $&&,

44 # ebruar $7" $&&,


13/20

EDCLAST MENSTRUAL PERIOD ( LMP ) counted !o" #!$t

da% o t&e 'a$t "en$e$


14/20


15/20

D ETERM IN ATIO N O F FETAL GRO W TH

a. AO G(AGE OF G ESTATIO N ) computation of age of gestation

E)ample: LP: 1anuary #( %0#-

2ate of consult: August *#( %0#-

A3G: Total 4 of !ays from LP up to !ate ofconsult

5

1anuary *# !ays

6e$ruary %8arch *#

April *0

ay *#

1une *0

1uly *#


16/20

Total 7 %-* !ays

A3G 7 %-* 5

*- to * wee's


17/20

. M DONALDS RULE

5 e#timation of AO6 in mont"# 7 week# b$fundic "ei8"t mea#uement in centimete#(cm#)

5 U#ed in #econd and t"id time#te#

5 Fi#t take t"e fundic "ei8"t(F9) in centimete#u#in8 a tape mea#ue

5 Mea#ue t"e di#tance fom t"e top of t"e

#$mp"$#i# pubi# oe t"e cue of t"e abdomen

to t"e top of t"e uteine fundu# u#in8 a tape

mea#ue


18/20

LA # estimating A


19/20

@A!PL#

>4B2 ?BG?T BC $' 2!C

$' 2!C @ $ =.$.$

7

= D months ( A


20/20

LA# estimating A

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Final-Antenatal Care(Latest) 4