MATERNAL ASSESSMENT

The aim of maternal assessment
1- to identify the high risk of cases

2- to prevent and treat early complication

3- to ensure from contained risk assessment and provide on going to primary health care

4- educate the mother about physiology of pregnancy and labor and care newborn



The procedures of the first visit

1- Demographic data ( age – occupation- LMP- EDD- P G A- type of labor – blood group + RH)
2- Family history
3- past history
4 -obstetric history
5 -mensterial history

Signs of pregnancy
Breast changes
- Nausea & vomiting
- Amenorrhea
- Frequent urination
- Fatigue & uterine enlargement
- Line anigra
- Melasma
- Goodell signs
- Hegar signs
- Braxton contraction

First Trimester
* (Subjective symptoms)
- Amenorrhoea
- Morning sickness
- Frequent of micturation
- Breast discomfort
- Fatigue
- breast changes


Objective signs

- breast changes
- abdominal enlargment
- pelvic changes

* ( THE TESTING FOR DIAGNOSIS OF PREGNANCCY IN FIRST TRIMESTER ( BHCG) AND ( U/S)


In ultrasonograph :-

-gestational sac( 29-35) day of gestation
- gastational age to determine by the detecting the following structures
- cardiac activity in (6 week) and heart rate at (10 weeks)
- embryo growth by 7 weeks

Second trimester

General examination
- Breast changes
- Enlargment of lower abdomen
- abdomenal examination :- included:-
a-inspaction:- included lineanigra

b- palpation:- include
- fundal height
- the uterus feel soft & elastic
- braxton s – hicks contraction
- active fetal movement
- palpation of fetal parts

C – auscultation:- included ( fetal heart sound )

* symptoms :-
- amenorrhoea
- enlargment of abdominal
- frequency of urine
- fetal movement

* signs :- - cutaneous changes
- uterine shape:- change from cylindrical to spherical at 36 weeks

* fundal height ( from 32 to 38 the fetal head down engagement should be tested)

* fetal movement s are easily felt
*- Braxton contraction
* palpation of fetal parts
* Sonography :- ( aminotic fluid assessment )

- Baseline measurment height and weight
- check vital signs
- head and scaple
- Eye
- Ear
- Nose and Mouth and oral cavity
- Neck
- Breast
- thorax
- back
- skin

- Preliminaries
- Inspaction
- Palpation :-
- hight of uterus
- obstetric grips
- Ausculation
- The relationship of the uterus and fetal:-
(lie– presentation – attitude –position and engagment )

Labortory test

@ Blood studies:-
- CBC
- Genetic screen
- Blood group + RH
- antibodies such as hepatities B & rubella
- HIV testing
- Glucouse test

B- Urinalysis (GUE )

Signs of complication during pregnancy


@ Vaginal bleeding
@ persistent vomiting
@ chill and fever
@ abdominal or chest pain
@ increase or decrease fetal movement