Antepartal Care
Antepartal Care tests whether you can establish a safe baseline for pregnancy: date the pregnancy, identify risk, promote nutrition and immunization, and recognize danger signs early enough for referral.
Core rules
- GTPAL records all pregnancies: gravida counts the current pregnancy; term and preterm are counts of births; abortion includes miscarriage and induced abortion; living counts children alive. A woman pregnant now with one term birth, one preterm birth, and one miscarriage is G4 T1 P1 A1 L2.
- Naegele's rule uses the first day of the last menstrual period: add 7 days, subtract 3 months, add 1 year. It assumes a 28-day cycle; for a 35-day cycle, add 7 days to the estimated due date.
- Fundal height in centimeters roughly equals gestational weeks from about 20 to 36 weeks, with a ±2 cm allowance; it is less reliable in obesity, multiple pregnancy, and fibroids.
- Supplements and prevention: elemental iron 60 mg and folic acid 400 mcg daily; tetanus-diphtheria immunization per national schedule; calcium and iodine according to local protocol.
- Danger signs: vaginal bleeding, severe headache or blurred vision, epigastric pain, fever, leaking fluid, reduced fetal movement, and convulsions require immediate referral.
Worked example
A woman's LMP was January 1, 2025. Add 7 days = January 8; subtract 3 months = October 8, 2025. If her cycles are 35 days, add 7 more days, giving October 15, 2025. The EDD is an estimate, not a deadline.
Traps
Do not count the current pregnancy twice in para; do not use a sure LMP when the date is uncertain; do not treat fundal height as exact; do not dismiss visual disturbance or epigastric pain as ordinary heartburn.