Chapter 2

Antenatal Care

The purpose of antenatal care is to ensure good health in every

expectant and lactating mother, to enable her to have a normal delivery
and a healthy baby and to teach the art of child care. Thus, the
antenatal clinic is meant not for detection of rare abnormalities, but for
the supervision of the normal pregnancy. The health of the newborn
baby is closely related to what happens to him in the womb, e.g.
nutrition of the mother, her illnesses, and so on, and therefore if
normal maternal health is maintained, the developing foetus will also
have a better chance of being healthy.
The assumption that antenatal care which is adequate from the
obstetric point of view for the mother is also all the care that can be
expected for the foetus is not entirely true; experience has shown that
viral or chemical agents which may produce no upsets in the mother
may cause harm to the foetus. Hence a knowledge of these noxious
agents is essential for adequate protection of the foetus.
The first three months of foetal life are critical. It is the period
during which different organs and body parts are being differentiated;
any interference with this process may lead to possible congenital
malformations (see figure 4). The effects of various drugs administered
to the mother or maternal infections like german measles are felt most
during this period of foetal life. It is believed that amongst congenital
malformations, 10 per cent are due to genetic factors and traceable in
the family history, another 10 per cent are due to chromosomal
aberrations and the vast majority (80 per cent) are due to some
extraneous factors and are potentially preventable. Certain infective
agents can affect the foetus directly if they are present in the mother's
blood stream. In congential syphilis the foetus is infected in utero and
may show signs of secondary syphilis in the neonatal period; malarial
infection of the placenta is responsible for low birth weight of the baby
and infection of the mother with the cytomegalic virus can damage vital
organs in the foetus.
One of the main purposes of antenatal care is to provide a proper
standard of nutrition for the mother. In most developing countries, the
average woman of child-bearing age goes through repeated cycles of

7
G. J. Ebrahim, Practical Mother and Child Health in Developing Countries
© G.J. Ebrahim 1978
 00

3 - week embryo
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~
c
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§
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Ovary
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Embedded ovum in mucous membrane S-
of uterus s·
tJ
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Upper limb
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Lower limb §
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5 - week embryo

a-week embryo
FIG . 4 The develop ing foetus