Antenatal Care

Antenatal Care

Pregnancy and antenatal also known as prenatal care are closely associated. During the first trimester, prenatal care includes blood tests, a physical exam, conversations about lifestyle and more.

1st Trimester Visits

In the first visit you doctor goes through your medical history and risk factors or problems that may arise during pregnancy. Your doctor may seek information like menstrual cycles, gynaecological history, past pregnancies details, personal and family medical details, lifestyle information, on-going medications etc.

Examinations and tests:

Your doctor will do a physical exam like breast and pelvic exam. Other tests like screening of heart, lungs and thyroid tests are done. Blood test is done to ascertain the whether the blood includes Rh factor. Haemoglobin test will also be done to check if you are anaemic and to recommend diet changes. In certain cases a Pap test is also done to check for cervical cancer. Along with these tests and examinations, body weight and height is also measured to check the BMI.

Due date:

In your first visit your due date will be calculated. It is calculated on the basis of when you will be 40 weeks pregnant. It is not imperative that all women will give birth on their due dates. Calculation of due date helps your doctor to monitor the baby’s growth and progress of the pregnancy stages as per the schedule and appropriate time. Your due date is calculated as 40 weeks from the first day of the last period. Ultrasound of the foetus is also done to confirm this estimation.

Foetus screening tests:

Foetal ultrasound or blood tests will be done to check for any genetic abnormalities like Down syndrome in the baby. Prenatal genetic screen tests provide important information about the foetus’s health and growth. Therefore it is important to get these done.

Lifestyle issues:

Your doctor may also recommend certain lifestyles changes. Does of vitamins and other supplement might be added to your diet.  Your doctor may also have discussions about exercises, dental care, travel during pregnancy, work environment, vaccinations, sex, etc. your doctor may also help you to quit alcohol or smoking.

Other 1st trimester visits:

Your first trimester begins from the week 1 to the end of week 12.  Your doctor will help you schedule other visits. Normally visits are scheduled for every 4 weeks during the 1st trimester.

Normal discomforts of pregnancy:

Most women experience nausea or morning sickness in the first trimester. Some women experience it throughout the pregnancy. Breasts also become more tender and swollen. Seek your doctor’s help if morning sickness is severe

Your antenatal appointments are a perfect time to discuss any concerns. Also find out how to reach your doctor between appointments. Knowing help is available can offer peace of mind.

2nd Trimester Visits

During the second trimester you may feel a renewed sense of well-being. Morning sickness begins to ease and belly bulge becomes more noticeable.  Main objective of prenatal care is to make sure you have a healthy pregnancy.  Prenatal care appointments are scheduled every four weeks throughout the second trimester. In second trimester routine lab tests, baby’s growth measurements, and other prenatal testing is done. Your blood pressure and weight will be measured in every visit. At this stage taking required vaccines is also recommended.

Baby’s measurements:

  • In the second trimester you can hear your baby’s heartbeat with the help of a Doppler instrument. Baby’s motions can be detected.
  • You will begin to feel your baby’s movements like kicks around 18 – 20 weeks. However this time is not the same for all women. Timing of the baby’s movements is unpredictable.
  • Baby’s growth is measured by measuring the distance between the pubic bone and to the top of the uterus.

During the second trimester, various prenatal screenings or tests are required:

  • Ultrasound: An ultrasound is done to monitor and study the baby’s anatomy. One can also detect the growth of baby’s organs with the help of images produced by high frequency sound waves.
  • Blood test: Blood test is done between 24 – 28 week of pregnancy to gauge the blood count, iron levels and detection of gestational diabetes. Blood test is required to check presence of Rh antibodies. These antibodies develop when the baby’s Rh positive blood mixes with your Rh negative blood. This condition needs appropriate treatment in the absence of which these antibodies can attack baby’s red blood cells via placenta.
  • Genetic test: Blood tests might be done to check if the baby has any genetic or chromosomal disorders such as Down syndrome. For further detection diagnostic tests such as amniocentesis can be recommended. In this test, sample of amniotic fluid is taken for testing.

3rd Trimester Visits

As your due date approaches your third trimester appointments should be scheduled in every 2-4 weeks. From the 36th week, you will require weekly check-ups until delivery. In the third trimester prenatal care is a very essential part. Depending on your health and pregnancy history routine health checks will be scheduled. Your doctor will enquire about signs and symptoms of contractions or leakage of fluid or bleeding. Your blood pressure, weight gain and the baby’s movements and heartbeats will be monitored. You will be asked to track baby’s movements on daily basis. You might require vaccines like flu shot, tetanus, and Tdap vaccine. Normally Tdap vaccine is given between 27 to 36 weeks of pregnancy.

Test for group B streptococcus:

In the 3rd trimester you will be screened for a bacterium called group B streptococcus. This bacterium is naturally present in the intestines or lower genital tract and is harmless in adults. During vaginal delivery if the baby comes in contact with this bacterium, your baby may fall seriously ill. For detection of group B streptococcus swab samples are taken from the vaginal and anal area and are sent for lab testing. If the tests are positive intravenous antibiotics are given during labour. This medication will prevent spread of infection in the baby.

Checking the baby’s position:

Your doctor will check to see if the baby is in the inverted position that is headfirst in the uterus. If the baby is in the frank breech or feet first position after 36 weeks, probability of the baby to change to head first position before delivery are rare. The baby remains in breech position your doctor may take you through the C-section delivery procedure and planning

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