``File`` of future mother. What is ``prenatal record``?
the Prenatal record are the main document of future mother which is always desirable for having at itself. What does it represent for what it is necessary and why it is so important for any woman expecting the birth of the kid?the Prenatal record of maternity hospital, delivery room of hospital is intended to
for implementation of continuity in supervision over the woman and her child in a maternity welfare unit, an obstetric hospital and children`s policlinic. Information which is contained in the prenatal record is important for any doctor advising the woman during pregnancy and during the postnatal period in the conditions of policlinic and the hospital conducting childbirth at this woman and for the pediatrician of maternity hospital and children`s policlinic.
According to the Order № 50 of February 10, 2003 “About improvement akushersko - the gynecologic help in on an outpatient basis - polyclinic establishments“, the prenatal record of maternity hospital is handed out by the pregnant doctor of a maternity welfare unit in terms of 22 - 23 weeks. It is connected with the fact that in this term the last stage of diagnostics on presence of congenital malformations at a fruit is carried out, besides, after this term pregnancy interruption will already be considered as premature birth.
Of what the card consists?
the Prenatal record consists of three parts - coupons. When filling the first coupon of “The data of a maternity welfare unit on the pregnant woman“ the doctor of a maternity welfare unit in detail writes down data on feature of a course of former pregnancies, childbirth, the postnatal period and those features of a course of the real pregnancy and a condition of the pregnant woman which knowledge is important for the doctor conducting childbirth at this woman and for the pediatrician of maternity hospital. At the subsequent visits of consultation the pregnant woman brings the prenatal record for records of these subsequent surveys in it and researches. At receipt in a hospital (on childbirth or in office of pathology of pregnancy) the woman is obliged to show the prenatal record. At its absence the woman is hospitalized in 2 - e obstetric office to which women without the put inspection, and also pregnant women at whom these or those infections, in order to avoid possible infection of the examined pregnant women are revealed usually come. In case the woman is hospitalized in office of pathology of pregnancy to the term of issue of the prenatal record in (22 - 23 weeks), have to issue it the prenatal record before this term and bring in it results of the available inspections and analyses.the Second coupon of “The data of maternity hospital, delivery room of hospital on the woman in childbirth“ is filled in with
in an obstetric hospital before an extract of the woman in childbirth and is given by her for transfer to a maternity welfare unit. The doctor of an obstetric hospital when filling the second coupon in detail writes down data on those features of a course of childbirth, the postnatal period and a condition of the woman in childbirth which cause the necessity of special supervision over it.
in children`s office of an obstetric hospital before an extract of the newborn and is issued mothers for his transfer to children`s policlinic. Doctors of an obstetric hospital (the obstetrician - the gynecologist and the pediatrician) when filling the third coupon most in detail write down in it data on those features of childbirth and a condition of the newborn which cause the necessity of special supervision over it after an extract from a hospital.
the Section completed in a maternity welfare unit
the section contains the information of a maternity welfare unit about the pregnant woman.
- of F. I. O.
- Age. At pregnant women till 18 years 30 years more often are also more senior complications during pregnancy and childbirth are observed.
- Address. Naturally, it is necessary for emergencies when contact with the pregnant woman is complicated or impossible, for finding of relatives and relatives and receiving from them for necessary information on the woman.
- the Postponed general, gynecologic diseases, operations. Hereditary and chronic diseases at the woman are of interest because they can exert adverse impact on development of a fruit, the course of pregnancy and childbirth. Information on diseases of children`s age is important. For example, the rickets postponed in the childhood leads to deformation of bones of a basin which conducts to the complicated course of childbirth, Also pregnancy and childbirth can provoke undesirable exacerbations of the available chronic diseases. Existence of chronic gynecologic diseases often brings to the complicated course of pregnancy and childbirth.
- of Feature of a course of former pregnancies, childbirth, the postnatal period, in case of existence of some complications during the previous pregnancies it is necessary to watch especially carefully a current this as it indicates existence of tendency to these or those pathological states at pregnancy in general. Pregnancy interruption threat, early or late toxicosis, anemia, etc. concern to them, for example. Also it matters for definition in what way the woman will give birth, Surgical intervention at the previous childbirth can speak about possible anomalies in patrimonial ways and diseases of the pregnant woman. Pathological childbirth in the past gives the grounds for the doctor to expect development of complications at this pregnancy, in labor and the postnatal period.
- What pregnancy on the account? What childbirth is coming? The number of the previous pregnancies and the number of the been born children is of great importance. It also matters when forecasting a course of the forthcoming childbirth.
- How many was abortions (year, on what term)? After abortion various inflammatory diseases of a uterus and appendages of a uterus develop that results in tendency to premature interruption of pregnancy, to the wrong patrimonial activity and complications after the delivery.
- Premature birth (year, term). Their existence in the past can speak about tendency to some pathological states at the pregnant woman in the present.
- Last periods. Date of the first day of the last normally last periods is specified. It matters for calculation of term of estimated childbirth.
- pregnancy Term at the first visit. Matters at calculation of date of estimated childbirth. Indirectly speaks to the doctor about character of the pregnant woman - her responsibility for the health and health of her future child.
- of All time. According to the order № 50, depending on the course of pregnancy there is a certain order of supervision over the woman. Within such algorithm of supervision it is necessary to visit the doctor a certain number of times for carrying out full and high-quality inspection of the woman. At uncomplicated pregnancy - 10 times (after the first survey - an appearance in 7 - 10 days for an assessment of results of analyses and conclusions of the therapist and other experts, further - once a month till 28 weeks, 2 times a month till 37 weeks, after 37 weeks - each 7 - 10 days). At detection of pathology the frequency of visit of the doctor of the obstetrician - the gynecologist is defined individually.
- First stir of a fruit. This date is important for calculation of term of estimated childbirth. The term of the first stir different at pervoberemenny and at the woman who already had childbirth in the past (the first stir is felt at povtornoberemenny earlier).
- of Feature of a course of this pregnancy. It is important for the doctor in maternity hospital as these complications can influence the course of childbirth and the postnatal period.
- basin Sizes. Measure several sizes. Basin is considered narrow if at least one of the sizes is less than norm on 1,5 - 2 cm and more. When narrowing a basin there is a danger that in the course of childbirth the child will not be able to pass through patrimonial ways of mother, especially in case a fruit large.
Growth and weight at the first appearance. With a height below 150 cm deformations of a backbone and coxofemoral joints are possible that can lead to narrowing of a basin. Weight at the first appearance is defined. The increase in weight for all pregnancy on average has to make 10 - 11 kg.
- Provision of a fruit. This factor is important very much for conducting childbirth. Final situation is defined closer to the term of the full-term pregnancy (37 - 40 weeks) and date of estimated childbirth. Before the fruit can hold different position in a uterus. Can be the longitudinal, cross and slanting provision of a fruit. By the time of childbirth longitudinal situation is normal, it happens in 99,5% of all childbirth. Cross and slanting provisions - pathological. At such provisions there are absolute obstacles for passing of the child on patrimonial ways.
the Prelying part. It is part of a fruit which the first passes through patrimonial ways. It can be a fruit head (the person, the top, a nape) or its pelvic end (buttocks or legs). The most frequent and favorable prelying is head. Definition prelying part of a fruit is important for the choice of a method of a rodorazresheniye.
Heartbeat of a fruit in a minute. On nature of heartbeat it is possible to judge a condition of a fruit (normal clear, rhythmical, up to 140 beats per minute). It has exclusive value at supervision over a condition of a fruit during pregnancy and in labor. Depending on the place of listening of heartbeat it is possible to judge a fruit arrangement in a uterus. The heartbeat of a fruit which is listened from 32 weeks is specified in the prenatal record.
- Laboratory analyses. The plan of inspection of the pregnant woman surely included diagnosis of syphilis, HIV - an infection, viral hepatitises B and C. In our country triple examination on these infections of pregnant women (is conducted at the first visit of a maternity welfare unit at registration on pregnancy, in 30 weeks of pregnancy, in 2 - 3 weeks prior to childbirth or at receipt in maternity hospital).
of the Rhesus factor - a factor. the Rhesus factor - a factor - the protein which is contained in erythrocytes of 85% of people and also at monkeys of Macacus rhesus (from here and the name). Blood of people whose erythrocytes contain a Rhesus factor - a factor is called a Rhesus factor - positive. If this protein is not in erythrocytes, then blood will be a Rhesus factor - negative.
If at a Rhesus factor - the negative woman develops a Rhesus factor - a positive fruit (it is inherited from a Rhesus factor - the positive father), then development a Rhesus factor - the conflict when the organism of mother perceives a fruit as alien object is possible and develops against erythrocytes of a fruit of a squirrel - antibodies which destroy erythrocytes of a fruit and the last develops in the conditions of anemia that can lead to pregnancy complications (an abortion, not developing pregnancy).
of Caption of antibodies. > in case of development a Rhesus factor - the conflict for the choice of tactics of conducting pregnancy, terms and a way of a rodorazresheniye it is important to em to estimate severity of a disease, the Important diagnostic sign is detection in blood of mother of antibodies and definition of a caption (quantity) of antibodies in dynamics.
of Blood type. All people are divided by features of blood which cornerstone distinctions in a structure of erythrocytes are. The hemolytic illness of a fruit can develop in certain cases and at incompatibility of blood of mother and a fruit on a blood type. Definition of a blood type of mother is very important during pregnancy as emergency situations where urgent blood transfusion can be required are possible. The Rhesus factor - accessory of blood of the husband needs to be defined if the woman has a Rhesus factor - negative blood.
of Clinical blood tests and urine. the General blood test is made 3 - 4 times for pregnancy (at an uncomplicated current) - at registration on pregnancy, in 18 weeks and in 30 weeks.
of Research of factors of coagulability of blood: platelets, fibrillation time, bleeding time, protrombinovy index. Research is necessary for specification of a possibility of complications in labor from the curtailing system (bleeding) at mother and the child. 3 times - are carried out at registration, in 22 - 24 weeks and in 32 weeks. It is desirable to enter all three researches in the prenatal record. Biochemical blood test is made 2 times for pregnancy. Change of normal indicators can indicate the complicated course of pregnancy, an imbalance necessary for mother and a fruit of substances. In the prenatal record both results briefly register.
of the General analysis of urine is given at each visit - 10 times at uncomplicated pregnancy, in the prenatal record write down 1 indicator - protein in urine. Normal it is absent.
of Analysis of contents of a vagina, dab. This analysis allows to assume presence of inflammatory process of the infectious nature at the woman. The infectious disease developing in the pregnancy period is fraught for the woman, first of all, with emergence in the postnatal period of such terrible complications as an endometritis and sepsis, and at the child - congenital defects and pathologies, postnatal complications.
of Kal on eggs a worm. For an exception at a pregnant gelmintny invasion the analysis a calla on eggs of helminths becomes (worm) at registration on pregnancy.
- Physical culture, number of occupations. If her state allows, it is desirable for pregnant woman to go in for physiotherapy exercises. If the woman attended such classes, their number is specified. All questions concerning physiotherapy exercises are solved the doctor of physiotherapy exercises in coordination with the observing obstetrician - the gynecologist. But in recent years, unfortunately, such occupations in the conditions of a maternity welfare unit are more often and to policlinic are not carried out - everything is limited to recommendations of the obstetrician - the gynecologist on reception on a complex of the allowed exercises.
- Psychological preparation for childbirth. 10 classes from 28 - 30 weeks by the doctor by the obstetrician - the gynecologist in a maternity welfare unit are given.
- School of mothers. These occupations are devoted to questions of care of the child. Are carried out also in a maternity welfare unit by doctors the obstetrician - the gynecologist, the pediatrician who is specially trained by the midwife or the nurse. The number of classes which were attended by the woman is specified in the prenatal record.
- Date of Introduction of a staphylococcal anatoksin. Often golden staphylococcus is found in pregnant women (St, aureus). In the presence at the pregnant woman of a chronic inflammatory disease (for example, chronic bronchitis) microbiological research (crops) for identification of staphylococcus which can lead to complications in labor and the postnatal period at mother and the child is conducted. For prevention of infection of the newborn child that can be followed by already rather serious diseases, up to sepsis (blood poisoning), the pregnant woman carry out immunization to terms of 32, 34 and 36 weeks of pregnancy by a staphylococcal anatoksin on 0,5 ml hypodermically under a shovel three times. The Arterial Pressure (AP) is carried out at the pregnant women having a sharp or chronic staphylococcal infection,
- . The table of control HELL from 30 weeks, Increase HELL higher than 135/85 can confirm development of a gestoz (pregnancy complication), especially if it is combined with hypostases and availability of protein in urine.
- Date of issue of a leaf of disability on prenatal holiday. The leaf of disability is given in 30 weeks of pregnancy.
- Date of estimated childbirth. Is defined approximately on the basis of different parameters.
- the Doctor the obstetrician - the gynecologist. The signature of the doctor conducting pregnancy.
- Diary of the subsequent visits. It is filled after 32 weeks.
- a weight Increase during pregnancy. Its definition valeno for forecasting of complications in the third trimester and in labor.
- Estimated weight of a fruit. It is important for definition of tactics of conducting childbirth. It is brought in the prenatal record after 37 weeks when pregnancy is considered already full-term.
- Date, HELL, weight, hemoglobin, analysis of urine, signature of the doctor. From 32 weeks research HELL, increases of weight, hemoglobin and urine regarding protein is carried out every week for early identification of a gestoz.
- of ultrasonography. Inspection of pregnant women includes obligatory triple ultrasonic research: in time 10 - 14 weeks, in 20 - 24 weeks, in 32 - 34 weeks.
- the Doctor examines future mother 2 times - at registration and in 30 weeks of pregnancy. In the presence of chronic diseases - according to indications.
- Conclusion of the oculist, stomatologist, otolaryngologist. The woman looks round 1 time at registration, at pathology - according to indications.
- the Conclusion of the endocrinologist - in the presence of indications.
- the Leaf for subbonding of analyses and other documents. The analyses which do not have special columns are entered in this section.
the Section completed in maternity hospital
the section contains the information of maternity hospital, delivery room, hospital about the woman in childbirth. The woman has to bring this part of the prenatal record in a maternity welfare unit after an extract from maternity hospital. The data transferred from maternity hospital are important for the doctor of a maternity welfare unit for definition of tactics of rehabilitation of the woman after the delivery.
- of F. I. O.
- Date of receipt.
- Childbirth happened (date). Date is necessary for registration of the birth certificate of the child, for delivery of an additional leaf of disability in case of the complicated childbirth.
- of Feature of a course of childbirth (duration, complications at mother and a fruit). All details of a course of childbirth are specified in this column. This information is important for forecasting of a current of the postnatal period.
- Operational grants in labor. It is specified whether there was a Cesarean section, and indications for it are listed.
- Anesthesia (it was applied or not, what, efficiency). The anesthesia method in labor is described. It is important for the analysis of the possible delayed complications after the delivery not of obstetric nature, for example, of neurologic complications (backbone pain) after spinal anesthesia.
- Current of the postnatal period. Important information for the forecast of a current of the postnatal period. by
- It is written out (for what day after the delivery). The term of finding of the woman in postnatal office testifies to a state of her health and health of the kid.
- the Condition of mother at an extract.
- the Condition of the child at the birth, in maternity hospital and at an extract. Data on the child for a maternity welfare unit are important for the analysis of correctness of conducting pregnancy.
- the Mass of the child at the birth and at an extract.
- Growth of the child at the birth. whether
- mother (indications) Needs patronage. In certain cases after an extract from maternity hospital the woman needs consultation of the obstetrician - the gynecologist at home. For example, if the doctor of maternity hospital sees that the specific woman can have problems with breastfeeding. Indications for this purpose are specified in this column.
- Special remarks. At the complicated course of childbirth addition of several days to already written out disability leaf on prenatal holiday is shown to the woman, the number of the added days is usually specified In this column.
- the Doctor the obstetrician - the gynecologist. The signature of the doctor - the obstetrician of maternity hospital.
to children`s policlinic in which her child will be observed. The section is filled in with the pediatrician of maternity hospital. All information is important for definition of tactics of maintaining the kid.
- of F. I. O. of the woman in childbirth.
- Date of childbirth. From what pregnancy on the account the child was born
- . On what week of pregnancy there was childbirth. The previous pregnancies ended with abortions artificial, spontaneous, with childbirth, including with a dead fruit.
- Childbirth one-fetal, polycarpous. It is specified what the child was born if childbirth was polycarpous.
- of Feature of a course of childbirth (duration, complications at mother and a fruit).
- Anesthesia (whether it was applied, what). Efficiency.
- Current of the postnatal period. by
- It is written out (for what day after the delivery).
- the Condition of mother at an extract.
- Sex of the child.
- Weight at the birth, at an extract.
- Growth at the birth.
- the Condition of the child at the birth on a scale Apgar. The scale Apgar represents a score, the bodies estimating a condition of functioning and systems of the newborn on 1 - y and 5 - y minutes of life. The maximum point - 10, pays off the pediatrician of maternity hospital, the attendee at childbirth. whether
- Cried at once? It is important as is an indicator of how the child felt in a womb as he transferred childbirth. whether by
- carried out measures for revival (what)? by
- It is attached for the first time to a breast in maternity hospital (for what day of life).
- Feeding (chest, the decanted milk of mother, donor). It is specified what mix was applied in maternity hospital and on what mix definitely the child has no allergy (it it is possible to use the house, in the absence of breastfeeding). In case of transfer to feeding donor breast milk specifies the reasons.
- the Umbilical cord disappeared (for what day of life). Was ill
- or was not ill? It is specified whether the child in maternity hospital had any diseases.
- At an extract. Antitubercular vaccination is carried out by
- completely. If is not present, then the reason is specified.
- of the Recommendation.
- Special remarks.
- the Doctor the obstetrician - the gynecologist of maternity hospital.
- Pediatrician of maternity hospital.