ANTEPARTAL ASSESSMENT TOOL:

Purpose of Prenatal Care:

1. Establish a baseline of present health
2. Determine fetal AOG
3. Monitor fetal development
4. Identify woman risk of complications
5. Minimize the risk of complications
6. Provide time for education about pregnancy & possible danger

ANTEPARTAL NURSING ASSESSMENT RATIONALE- 3 points each number

1.Monitor the common complications such as: a. When a woman has high blood pressure during
A. Hypertension
B. Infection pregnancy, it is harder for her blood to bring food and
C. Bleeding oxygen to the baby via the placenta. The baby then
grows too slowly. Very high blood pressure can also
cause the woman to have kidney problems, bleeding in
the uterus before birth, or bleeding in the brain
(stroke). It can also be a sign of pre-eclampsia, which
can cause premature birth, bleeding, convulsions, or
even death for the mother.

b. Some infections in pregnancy can cause or

contribute to:

 Pregnancy loss/miscarriage (before 20 weeks

of pregnancy)
 Ectopic pregnancy (when the embryo implants
outside of the uterus, usually in a fallopian
tube)
 Preterm labor and delivery (before 37
completed weeks of pregnancy)
 Low birth weight
 Birth defects, including blindness, deafness,
bone deformities, and intellectual disability
 Stillbirth (at or after 20 weeks of pregnancy)
 Illness in the newborn period (first month of
life)
 Newborn death
 Maternal health complications

c. Problems with the cervix, including cervical

insufficiency (when the cervix opens too early in
pregnancy) or infection of the cervix, can lead to
bleeding. More serious causes of bleeding in later
pregnancy include placenta previa, preterm labor,
uterine rupture, or placental abruption.
Serious causes of bleeding:
 Miscarriage
 Molar pregnancy
 Ectopic pregnancy
 Threatened miscarriage
 Subarachnoid hemorrhage

2.Monitor the danger signs of pregnancy: a. pregnant women are also more susceptible to urinary
A. Dysuria tract infections. Be careful not to confuse increased
B. Decrease fetal movement frequency of urination with a bladder infection
C. Vomiting (cystitis). If a pregnant woman notices that she is
urinating more frequently, that urination is painful
D. Severe abdominal pain
(dysuria), or that she has a fever, she may have
E. Sudden gush of fluid from vagina infection.
F. Vaginal bleeding b. fetal movement (quickening) can usually be felt
between 16 and 23 weeks; movements are intermittent
and infrequent. a change in movement in the third
trimester is often the earliest sign of distress in a baby.
Fetal movements felt by pregnant women are a sign
that the fetus is growing in size and strength. 
the childhood reflex movements literally grow the
brain. Repetitive, automatic reflex movements are
essential for the development of balance, mobility,
vision, hearing, speaking, learning and communicating.
of the nervous system. 
c. Nausea during pregnancy, also called morning
sickness, might be a good sign. Women with nausea
and vomiting during the first trimester have a lower
risk of miscarriage than do women without these
symptoms.
It may be caused by low blood sugar or the rise in
pregnancy hormones, such as human chorionic
gonadotropin (HCG) or estrogen. Morning sickness
may be worsened by stress, being overtired, eating
certain foods, or having sensitivity to motion (motion
sickness).
The nausea and vomiting are usually so severe that it's
impossible to keep any fluids down, and this can cause
dehydration and weight loss. Dehydration is when you
don’t have enough fluids in your body.

Hyperemesis gravidarum is very unpleasant with

dramatic symptoms, but the good news is it’s unlikely
to harm your baby. However, if it causes you to lose
weight during pregnancy there is an increased risk that
your baby may be born smaller than expected.

d. uterus is expanding ligaments are stretching-all of

which can cause benign aches and pains.

Serious causes of abdominal pain in pregnancy

- Ectopic pregnancy
- Miscarriage
- Preterm labor
- Placental abruption
- Preeclampsia
- UTI
- Appendicitis
- Gallstones

e. A pregnant woman with a liquid other than urine or

normal discharge coming from the vagina should visit
the doctor. This is particularly true if the fluid is green,
brown, or has a foul smell. Leaking amniotic fluid will
usually be clear and odorless and will continue to leak.
leaking amniotic fluid, it means that your water has
broken – the membranes that make up your amniotic
sac have ruptured. If your pregnancy is full-term when
your water breaks, but you're not in labor, it's called
preterm rupture of membranes (PROM).

f. miscarriage, threatened miscarriage, ectopic

pregnancy

3.Pregnancy risk factors: Factors like age and overall health status can increase
A. Age less than 18 and more than 35 the chances of experiencing complications.
B. Decrease socio economic status a. (less than)-deliver prematurely ,have a baby with
C. Increase/ decrease weight low birth weight, experience pregnancy-induced
hypertension (PIH), develop pre- eclampsia
D. Substance use abuse
( over age 35)- high blood pressure, diabetes,
cardiovascular disease – miscarriage, poor fetal growth
and birth defects, needing cesarian section

b. associated with abortion, preterm delivery,

preeclampsia, eclampsia and gestational diabetes.
Women with decrease socio economic status are less
likely to receive prenatal care

c. (obese)-certain birth defects- spina bifida, heart

problems, hydrocephaly, cleft palate and lip. Most
likely to be diagnosed with gestational diabetes during
the pregnancy or have high blood pressure. And lead to
smaller than expected baby as well as increase in
preeclampsia.
(underweight) weigh less than 100 pounds are more
likely to deliver or give birth to an underweight baby.
d. smoking cigarettes, drinking alcohol and using
illegal drugs c an put a pregnancy at risk (fetal alcohol
spectrum disorders, sudden infant death syndrome,
birth defects. Miscarriage and stillbirth

4. Possible causes: a. infections of uterus, cervix or vagina ,too much

stretching of the amniotic sac, smoking, surgery or
A. rupture membrane
biopsies of the cervix, pregnant before and had prom
B. Infection (premature rupture of membrane)
C. Hyperemesis gravidarum b. During pregnancy, some common infections that
D. Hypertension may occur are the flu, vaginal yeast infections, uterine
E. UTI infections, group B streptococcus, bacterial vaginosis,
and listeria. Changes in immune function may cause
this increased risk of infection, and if left untreated,
may lead to serious complications.
c. The exact cause of nausea and vomiting during
pregnancy is not known. However, it is believed to be
caused by a rapidly rising blood level of a hormone
called human chorionic gonadotropin (HCG). HCG is
released by the placenta. Mild morning sickness is
common.
d. smoking, being overweight or obese, lack of
physical activity’ too much salt in the diet, alcohol
consumption, stress, older age, genetics
d. Changes in hormones can also lead to vesicoureteral
reflux, a condition in which your pee flows back up from
bladder to kidneys. This can cause UTIs.

When pregnant, urine has more sugar, protein, and

hormones in it. These changes also put higher risk for a
UTI.

In pregnant woman , growing uterus presses the bladder.

That makes it hard to let out all the urine in bladder.
Leftover urine can be a source of infection.

5. Client history / initial interview To obtain a thorough and meaningful health history
A. Establish rapport and the rapport established by face-to-face
B. Gain a woman information about physical and interviewing with healthcare personnel , a reason a
psychological health status woman returns for follow up care as her desire to be
assured her pregnancy is progressing normally.
Best accomplished in a private, quiet setting.
Pregnancy is too private an affair to be discussed in a
crowded hallway or a full waiting room.
Be certain to ask how a patient wants you to address
her taking into account gender identification. Make
certain she also knows your name and understand your
roles. So that so that they will have the will to discuss
more intimate things ( her feelings towards the
pregnancy , the difficulty she has reworking old fears
or how scared she is about birth).
6.Component of health history:
Demographic Data includes: Demographic information can be important in
A. Name evaluating risk (e.g. partnership status and availability
B. Age of family support), guiding educational plans
C. Address (e.g. educational level and preferred language),
identifying specific testing needs (e.g. special genetic
D. Religion
testing for members of specific racial or ethnic groups),
E. Contact # and potential religious restrictions (e.g. blood
F. Health Insurance Information transfusions are prohibited in a Jehovah's Witness).
Patient age will alert the provider to social issues
(e.g. a teen who is still in school) or medical concerns
(e.g. increased genetic abnormalities in the patient who
is older than 35 years of age). 

Insurance information to be readily available with the

health record to facilitate appropriate referrals and
clearances for testing and consultation for patients .

7.Chief complaints includes: a. helps to catch potential concerns early and reduces
A. Reason why woman make a visit in HC facility the risk of pregnancy and birth complications
B. inquire LMP b. The first important historical information that
C. Signs of early pregnancy obstetricians usually gather is the date of the first day
D. Discomfort of pregnancy of the last menstrual period (LMP). The record should
E. Exposure to any contagious disease reflect the accuracy of the date, cycle length, and
F. Danger signs of pregnancy normality of the LMP. Information on prior
contraception and fertility treatment is important to
determine the utility of the LMP to predict the
estimated date of delivery (EDD). The accuracy of an
EDD calculated from the LMP must be confirmed by
clinical examination, ultrasound, and/or auscultation of
fetal heart tones.
Some record systems include a specific section for re-
evaluating the EDD based on LMP, clinical estimators
of gestational age, and ultrasound information (Fig. 1).
The first ultrasound in the pregnancy is the most
accurate for dating purposes and should be used when
establishing EDD. Changes in the EDD and the
reasoning behind the change should be documented in
the record. Many important management decisions in
obstetric care rely on knowledge of the current
estimated gestational age
c. to assess any early signs of pregnancy such as
nausea and vomiting, fatigue, and breast tenderness.
d.e.f. to detect and prevent early complications

8.Past Medical History inquire about: It is important to assess any past illness because it
A. past medical disease might become active during or after pregnancy.
B. childhood disease Assess if there are any infections from the past,
C. allergy drug sensitivity especially sexually transmitted diseases , to educate the
woman and suggest any vaccines available.
D. past surgical procedure
There are vaccines that are not friendly for a pregnant
E. med/surg history woman, however, vaccines such as influenza and
poliomyelitis can be administered.
Allergies present even before pregnancy to avoid
triggers that could also affect the fetus.
Any past surgical procedures are also important to
document because adhesions resulting from past
abdominal surgery such as ruptured appendix could
interfere to uterine growth. If a birthing parents has had
prior cesarian birth, the details will be importance to
know for planning route of delivery and to evaluate
placental location.
9.Family history ask:
A. cardiovascular disease Can help identify potential problems a woman or her
B. renal disease infant could experience during pregnancy or after birth.
C. cognitive impairment
D. blood disorder
E. known inherited disease
F. congenital anomalies
G. health status of parents
H. Genetic disorders
I. chronic disease
J.s substance abuse

10.Gynecological history ask: Obtain the age of the woman’s menarche, her usual
A. info about menarche cycle, the duration and amount of menstrual flow.
B. past Surgery in reproductive system Assess any past reproductive tract surgery as it can
C. sexual history affect the present pregnancy, such as tubal surgery
from ectopic pregnancy. (Influence woman ability to
D. menstrual history
conceive and give birth).
E. onset of menses Assess the reproductive planning method that the
F. LMP woman used or will be using after pregnancy, and also
G. contraceptives her sexual history to educate her about safe sex
practices.
11. Obstetric History ask: Assess the woman’s pregnancy history using
A. history of previous pregnancy GTPALM.
B. history of present history G: the gravida classification or the number of times the
C. GTPAL women become pregnant.
T: the number of full-term infants born (infants born at
D. types of delivery
37 weeks after)
E. types of feeding P: the number of pre term infants born (infants born
F. maternal/infant complication before 37 weeks)
A: the number of spontaneous miscarriages or
therapeutic abortions
L: the number of living children
Past pregnancy history is an important predictor of
pregnancy risk in multiparous women.
Total Score: 33 Points