Prenatalcare

Prenatal care (after initial prenatal assessment)
Authors
Charles J Lockwood, MD
Urania Magriples, MD
Section Editor
Susan M Ramin, MD
Deputy Editor
Vanessa A Barss, MD
Disclosures

All topics are updated as new evidence becomes available and our peer review process is complete.
Literature review current through: Apr 2013. | This topic last updated: Jan 22, 2013.

INTRODUCTION — The goal of prenatal care is to ensure the birth of a healthy baby with minimal risk for the mother. After the initial prenatal assessment, prenatal care is directed at ongoing evaluation of the health status of both mother and fetus, anticipation of problems, and intervention, if possible, to prevent or minimize morbidity.

INITIAL PRENATAL ASSESSMENT — (See "Initial prenatal assessment and patient education".)

FREQUENCY OF PRENATAL VISITS — Observational data suggest that prenatal care saves lives compared to no prenatal care [1] and show an association between the number of antenatal visits and/or early gestational age at the initiation of care and pregnancy outcomes, after controlling for confounding factors (eg, length of gestation) [2]. However, there are limited data as to what constitutes the optimal number and frequency of prenatal visits, or the optimal content of those visits. In the United States, the typical intervals for prenatal visits for nulliparous women with uncomplicated pregnancies are every 4 weeks until 28 weeks of gestation, every 2 weeks from 28 to 36 weeks, and then weekly until delivery [3]. Parous women with uncomplicated medical and obstetrical histories can be seen less frequently. Women with problems are seen more frequently, depending on the nature of the problems. According to this schedule, an uncomplicated pregnancy where the first visit is at 6 weeks of gestation and the last visit is at 41 weeks will comprise 16 prenatal visits. The National Institute of Health and Clinical Excellence (NICE) suggests a reduced frequency of visits: 10