Chapter 12: Nursing Management During Pregnancy

The initial prenatal assessment involves collecting a detailed health history, calculating gestational age using Nagele's rule, and performing pelvic examination to evaluate anatomical landmarks such as the diagonal conjugate and obstetric conjugate measurements. Ongoing prenatal management requires systematic monitoring of fundal height progression, maternal blood pressure and vital signs, and fetal heart rate documentation to detect complications early. Patient education emphasizing daily fetal movement assessment serves as a simple but critical tool for identifying potential fetal compromise or hypoxia. The chapter explores multiple fetal assessment modalities, including real-time ultrasound imaging, Doppler flow studies to evaluate placental and umbilical blood flow, maternal serum alpha-fetoprotein screening for chromosomal and neural tube abnormalities, amniocentesis for genetic testing and lung maturity evaluation, chorionic villus sampling for early genetic diagnosis, nonstress testing to evaluate fetal heart rate reactivity, and the biophysical profile score combining ultrasound findings with fetal movement and breathing assessment. Nursing management also addresses the common physiologic changes and discomforts arising from pregnancy, including nausea and vomiting, urinary frequency, musculoskeletal pain, and dependent edema, while promoting healthy self-care strategies encompassing hygiene practices, oral health maintenance, safe exercise modifications, and travel precautions. The chapter concludes by examining perinatal education and childbirth preparation, including discussion of birth setting choices, infant feeding methods, and established preparation approaches such as the Lamaze technique emphasizing breathing and relaxation, the Bradley method focusing on partner support, and the Dick-Read method addressing fear-tension-pain reduction.