Prenatal care should be initiated in the first trimester and should provide comprehensive medical care in second and third trimester.
Less than 50 percent of women in developing regions receive early antenatal care
So second trimester care is important, even after the initial prenatal assessment and patient counseling
Second Trimester is from 14 to
28 weeks of gestation
Antenatal care in second Trimester is directed at
NULLIPAROUS WOMEN WITH UNCOMPLICATED PREGNANCIES
Standard one-on-one care by midwives, obstetriciangynecologists, family medicine clinicians, and maternal-fetal medicine (MFM) subspecialists.
Referral to a MFM subspecialist
Women with medical comorbidities: collaborative multidisciplinary care by a team including obstetric provider and appropriate medical or surgical subspecialists, specialists in genetics, anesthesia and pediatrics.
Screening and diagnostic testing if not performed at the first prenatal visit or later in the first trimester are done now :
Ultrasound examination Discussion of screening and testing for genetic abnormalities in offspring
Carrier screening = ethnic-specific, panethnic, and expanded carrier screening acceptable strategies
Prenatal screening should be performed early within recommended intervals to allow adequate time for:-
|RL pain||BH contractions||Misc (heart burn, contipation)|
|pain||cramping/stabbing agg by movement||irregular tightening||mild/varied|
|trimester||late 1 st / 2 nd||late 2 nd / 3 rd||3 rd|
Counseling about Diet, Exercise, Rest, Immunisation,weight gain , Alcohol, Smoking, Dress, Personal hygiene and warning symptoms
|particulars||Kcal/day||protein (g/d)||fat (g/d)|
A thorough clinical exams mandatory before recommending an exercise program.
EXERCISE DURING PREGNANCY ACOG(2015) A thorough clinical exams mandatory before recommending an exercise program. In the absence of C/I –regular, moderate intensity physical activity for 30 min/day is recommended for pregnant women Activities with a high risk of falling, abdominal trauma/ scuba diving (increase fetal risk of decompression sickness) should be avoided.
1st dose: Between 16–20 weeks, 2nd dose: After 4–6 weeks after the 1st dose.
Infuenza vaccine (during flu season) Intramuscular after first trimester .(FOGSI Recomm 2017)