Why is Antenatal Assessment important?

Antenatal Assessment - using ultrasound

Routine antenatal care (ANC) is defined as the care provided by health practitioners (or others) to all pregnant women to ensure the best health conditions for the women and their foetuses during pregnancy.

This series of medical check-ups, screenings, and support services are designed to monitor the well-being of both the expectant mother and the developing baby. By providing comprehensive care and early intervention when necessary, antenatal assessment plays a pivotal role in promoting a positive pregnancy experience

The Importance of Antenatal Assessment

  1. Monitoring Maternal Health: Regular antenatal assessments monitor the mother’s physical and emotional well-being. This includes checking blood pressure, weight, and assessing any signs of complications or discomfort.
  2. Foetal Well-being: Continuous monitoring of the baby’s growth, development, and heartbeat helps identify potential issues early, allowing for timely intervention.
  3. Education and Support: Antenatal care is an opportunity for healthcare providers to educate expectant parents about healthy pregnancy practices, nutrition, and lifestyle choices. It also provides a platform for addressing any concerns or questions the parents may have. A study in 2015 found that health promotion (one of the core contents of routine ANC for healthy women) was not consistently addressed in all clinic guidelines. Advice regarding nutrition during pregnancy, exercise and/or rest and tobacco smoking cessation or reduction was an explicit recommendation in 11 (out of 15 studied), breastfeeding advice was considered in nine, family planning in four, and prevention of and protection from HIV and other sexually transmitted diseases only in two.
  4. Identification of Risk Factors: Antenatal assessments aim to identify risk factors such as pre-existing medical conditions, genetic predispositions, or lifestyle factors that may impact the pregnancy. This early identification allows for proactive management and reduces the risk of complications.
  5. Prevention and Management of Complications: Through regular assessments, healthcare providers can detect and address complications such as gestational diabetes, pre-eclampsia, and infections, ensuring prompt and effective management. Screening and management of pre-eclampsia, gestational diabetes, anaemia, mental and social health (including intimate partner violence) are recommended universally.

Components of Antenatal Assessment

The specific program for antenatal care varies between individual clinics though there are many common features.

  1. Initial Consultation: The first antenatal visit usually occurs early in pregnancy and includes a comprehensive medical history, physical examination, and discussion of lifestyle and nutrition.
  2. Regular Check-ups: Subsequent visits are scheduled regularly throughout the pregnancy to monitor the progress of both mother and baby. These visits may include blood pressure checks, urine tests, and assessments of foetal growth.
  3. Ultrasound Scans: Ultrasound scans provide detailed images of the developing foetus, allowing healthcare providers to assess foetal growth, detect abnormalities, and determine the baby’s sex if desired.
  4. Blood Tests: Routine blood tests help monitor maternal health, detect anaemia, screen for infections, and identify conditions such as gestational diabetes.
  5. Genetic Screening: Depending on individual and family medical histories, genetic screening tests may be recommended to assess the risk of chromosomal abnormalities or hereditary conditions.
  6. Monitoring Foetal Movements: Pregnant individuals are often encouraged to monitor and report foetal movements regularly as changes in movement patterns can indicate potential issues.
  7. Educational Sessions: Antenatal care includes educational sessions on topics such as childbirth, breastfeeding, and postpartum care. These sessions empower expectant parents with the knowledge and skills needed for a smooth transition to parenthood.

Active Involvement of Expectant Parents

Antenatal care is a partnership between healthcare providers and expectant parents. Active involvement in the process ensures that individuals are well-informed, receive appropriate support, and actively participate in decisions related to their care and the well-being of their baby.

Conclusion

Antenatal assessment is vitally important as a comprehensive approach to ensuring the health and well-being of both the expectant mother and the developing baby. Through regular check-ups, screenings, and education, antenatal care provides a foundation for a healthy pregnancy, reducing the risk of complications and promoting a positive pregnancy experience. Expectant parents are encouraged to actively engage with their healthcare providers, ask questions, and take an active role in nurturing the well-being of their growing family.

Maternity Wear
Maternity Clothing

References

  1. “Antenatal assessment of fetal gestational age”
    Authors: Gardosi J, Geirsson RT.
    Journal: Ultrasound in Obstetrics & Gynecology. 2002 Oct;20(4):313-9.
  2. “Antenatal assessment of fetal well-being: a practical approach”
    Authors: Arulkumaran S, Fisk NM.
    Journal: Journal of Obstetrics and Gynaecology. 1996 Sep;16(5):285-91.
  3. “Antenatal assessment of fetal compromise: doppler and biophysical”
    Authors: Arduini D, Rizzo G.
    Journal: Ultrasound in Obstetrics & Gynecology. 2002 Oct;20(4):313-9.
  4. “Antenatal assessment of the high-risk pregnancy”
    Authors: NICE.
    Journal: National Institute for Health and Clinical Excellence (NICE) Guideline. 2010 Jan.
  5. “Antenatal assessment of fetal well-being: ultrasound vs. fetal movement counting”
    Authors: Olesen AG, Svare JA.
    Journal: Journal of Perinatal Medicine. 1989;17(4):289-92.
  6. “Antenatal assessment of foetal growth: a challenge for the clinician”
    Authors: Gardosi J, Francis A.
    Journal: British Journal of Obstetrics and Gynaecology. 1999 Mar;106(3):181-3.
  7. What are the essential components of antenatal care? A systematic review of the literature and development of signal functions to guide monitoring and evaluation Authors: H McCauley, K Lowe, N Furtado, V Mangiaterra, N van den Broek BJOG 28 November 2021

8. Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care. E Abalos, M Chamillard, V Diaz, Ӧ Tuncalp, AM Gülmezoglu BJOG 23 December 2015

FAQ

1. What is an antenatal assessment?

An antenatal assessment, also known as prenatal care, involves regular medical check-ups and tests during pregnancy to monitor the health of both the mother and the developing baby. These assessments help identify any potential issues early and provide guidance for a healthy pregnancy.

2. Why is antenatal assessment important?

Antenatal assessments are crucial because they:

  • Monitor the growth and development of the baby.
  • Ensure the mother’s health and well-being.
  • Detect and manage any complications or risk factors.
  • Provide education and support to expectant mothers.
  • Prepare the mother for labour and delivery.

3. When should I start antenatal assessments?

Antenatal assessments typically begin as soon as you find out you are pregnant. The first visit is usually scheduled around 8-12 weeks of pregnancy, followed by regular appointments throughout the pregnancy.

4. What happens during the first antenatal assessment?

During the first antenatal assessment, your healthcare provider will:

  • Take a detailed medical history.
  • Perform a physical examination.
  • Confirm the pregnancy and estimate the due date.
  • Order blood tests and urine tests.
  • Discuss lifestyle and dietary advice.
  • Provide information on what to expect during pregnancy.

5. What types of tests are performed during antenatal assessments?

Common tests and procedures include:

  • Blood tests to check for anaemia, blood type, infections, and other conditions.
  • Urine tests to screen for infections, protein, and sugar levels.
  • Ultrasound scans to monitor the baby’s growth and development.
  • Glucose screening for gestational diabetes.
  • Screening for chromosomal abnormalities and genetic conditions.

6. How often will I need antenatal assessments?

The frequency of antenatal assessments typically follows this schedule:

  • Every 4 weeks during the first 28 weeks of pregnancy.
  • Every 2 weeks from 28 to 36 weeks.
  • Weekly from 36 weeks until delivery. Your healthcare provider may adjust this schedule based on your individual needs and any complications that arise.

7. What should I bring to my antenatal assessments?

When attending antenatal assessments, bring:

  • Your medical records and any test results.
  • A list of any medications or supplements you are taking.
  • Any questions or concerns you have.
  • A notebook to jot down important information.

8. Can my partner attend antenatal assessments with me?

Yes, partners are usually welcome and encouraged to attend antenatal assessments. Having your partner involved can provide additional support and help them stay informed about the pregnancy.

9. What are common topics discussed during antenatal assessments?

During antenatal assessments, common topics discussed include:

  • Nutrition and exercise recommendations.
  • Managing common pregnancy symptoms.
  • Labor and delivery plans.
  • Breastfeeding and newborn care.
  • Mental health and emotional well-being.

10. What should I do if I miss an antenatal appointment?

If you miss an antenatal appointment, contact your healthcare provider as soon as possible to reschedule. It’s important to keep up with regular assessments to ensure the health of both you and your baby.

11. What should I do if I have concerns between antenatal assessments?

If you have concerns or experience any unusual symptoms between antenatal assessments, contact your healthcare provider immediately. It’s always better to seek advice and ensure everything is progressing well.

12. Can antenatal assessments predict the exact delivery date?

Antenatal assessments can provide an estimated due date based on the first day of your last menstrual period and ultrasound measurements. However, it’s important to remember that the actual delivery date can vary, and only about 5% of babies are born on their exact due date.

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