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Antenatal Checklist

Antenatal Checklist. Nagercoil ob-society. Antenatal Care. Preventive medicine in pregnancy. Clinical examination Investigations Counselling. Antenatal Care. Investigations in Pregnancy. Rifle vs Shotgun approach . Rifle – hit bull’s eye Specific test based on

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Antenatal Checklist

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  1. Antenatal Checklist Nagercoil ob-society

  2. Antenatal Care Preventive medicine in pregnancy

  3. Clinical examination Investigations Counselling Antenatal Care

  4. Investigations in Pregnancy

  5. Rifle vs Shotgun approach Rifle – hit bull’s eye Specific test based on Clinical judgment Diagnostic accuracy Predictive value Shotgun – spray shots Many tests Diagnostic accuracy + /- Predictive value + /- May not hit the bull’s eye!!

  6. What is a ‘necessary’ test? A test should be done only if the result is likely to make a difference to the management

  7. What is an ‘unnecessary’ test? Any test the results of which are not likely to be make a difference in the appropriate management of the patient

  8. Questions to ask before ordering a test • Why is the test being ordered? • What are the consequences of not ordering the test? • How good is the test? • How are the test results interpreted? • How will the test results influence patient management and outcome?

  9. Reasons for ordering a test • Diagnosis (eg, Pregnancy / no pregnancy) • Screening (eg, for Down’s syndrome) • Monitoring (eg, serial ultrasound scan) • Research (to understand the pathophysiology of a particular disease process)

  10. Reasons for unnecessarily ordering a test • Financial gains • Defensive medicine • Institutional pressures • Patient demands

  11. The flip side…. • Generates anxiety • Involves time, cost • Risks & complications exist • Results may be shocking! • Leads to unnecessary/inappropriate interventions

  12. Pre test Counseling • What test? • Why is it done? • How is it done? • What is the likely expense? • What are the risks & likely outcomes? • What is the plan of management? • What are the fall outs if it is not done?

  13. Investigations in PregnancyWhich and when???Developed byAbbott National Advisory Boardfor Duphaston

  14. Members of the Advisory Board • Dr Ameet Patki, Chairman, Mumbai • Dr Mala Arora, Delhi • Dr Ritu Joshi, Jaipur • Dr Bhasker Pal, Kolkata • Dr Parul Kotdawala, Ahmedabad • Dr Susheela Rani, Bangalore • Dr Suchitra Pandit, Mumbai • Dr Anita Singh, Patna

  15. Investigations in Antenatal Care • Mandatory • Preferable

  16. Mandatory These tests are mandatory in the provision of standard antenatal care

  17. Preferable These tests have been shown to be of clinical value, but are not into evidence based recommendations as of now

  18. ANC was released in FOGSI Varanasi, Jan 27th 2012

  19. Acknowledgements A special thanks to – Dr Susheela Rani, Bangalore and Dr Bhasker Pal, Kolkata for providing material for this presentation.

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