In the morning you found out that you are pregnant, and in the evening you are ready to choose a maternity hospital and buy a crib. Sound familiar? But until the day of discharge from the hospital, there is still a whole 9 months, a lot of things to do and … going to doctors. Woman’s Day asked Tatiana Butskaya, a pediatrician and popular blogger, to draw up a medical plan-calendar for the entire pregnancy. Thanks to him, you will be able to navigate in all analyzes and examinations.
If your pregnancy is proceeding normally, then up to 28 weeks you are recommended to visit a gynecologist monthly, after 28 weeks – twice as often. Prepare that during each visit you will need to take a general blood and urine test. At least two ultrasounds are waiting for you, but it is better to do five screenings: at 6-8 (with early registration), 12, 22, 32 and 36-38 weeks.
What else? Let’s go over the weeks of pregnancy and draw up a schedule of tests and diagnostic procedures.
The test showed two stripes
Most likely, you have the first week of delay. This is approximately 5-6 obstetric weeks of pregnancy. Obstetric weeks are counted from the first day of the last menstrual period, that is, in fact, even before ovulation, in which conception took place. Why is that? Ovulation in women occurs on different days of the cycle, and in some cycles there may even be two ovulations. It is not known exactly on what day conception occurred and, moreover, when the embryo entered the uterine lining. Therefore, obstetricians count the gestation period from the day the egg begins to ripen, that is, from the first day of the last menstruation.
5-6 weeks
You can already register with the antenatal clinic. Early registration will at least make it possible to determine whether the pregnancy is uterine. Unfortunately, even the most expensive pharmacy pregnancy test reacts only to the presence of hCG in the urine, but does not determine its amount, which is important for diagnosing an ectopic pregnancy. At the reception, the gynecologist will definitely prescribe a laboratory blood test for hCG – determining the amount of the hormone will help to exclude or confirm an ectopic pregnancy and to set the period as accurately as possible.
7-8 weeks
An ultrasound is waiting for you, where you can already see the embryo and hear its heartbeat. You will visit the doctor again. He will conduct an examination, check your breasts, prescribe the necessary tests and consultations with other specialists to get a complete picture of your health. It is important to pass a general blood test, urine test, a smear for flora, determine the blood group and Rh factor (Rh factor), sugar level, make a coagulogram (check blood clotting), test for HIV, hepatitis, RW and TORCH infections.
When a negative rhesus is detected in the mother and its combination with a positive rhesus, the father has the likelihood of a rhesus conflict, but only if the fetus “takes” a positive rhesus from the father. Therefore, if a woman is found to have a negative Rh factor, her husband must be examined. If the Rh-conflict nevertheless arises, then it will be necessary to donate blood every month until the 32nd week of pregnancy to determine the level of antibodies, then more often. In order to neutralize possible anti-rhesus antibodies, antiglobulin D is administered to the expectant mother at the 30th week.
Coagulogram indicators are also particularly important. This is a study of the blood coagulation system. Since the so-called third circle of blood circulation – uteroplacental – is formed in the mother’s body during pregnancy, it is very important to monitor blood clotting indicators. Violations in the hemostasis system threaten complications that are extremely dangerous for pregnancy.
TORCH infections are a group of especially dangerous infections that can be transmitted from mother to fetus, causing serious and irreversible developmental disorders. There are four of them: toxoplasmosis, rubella, cytomegalovirus and herpes. It is best to take a blood test to determine antibodies to these diseases while planning pregnancy and get vaccinated against infections.
10 weeks
You will visit the doctor again to determine the tactics of managing your pregnancy based on the results of tests, diagnostic procedures and the conclusions of specialists of other profiles.
11-13 weeks
You will have prenatal screening, which detects fetal malformations already in the early stages of pregnancy. Screening consists of an ultrasound scan and a blood test. Ultrasound measures the parameters and sizes of certain areas of the fetus, and then the results are compared with the standard indicators. Blood is donated for the analysis of PAPP-A and determination of the level of hCG. This is the so-called “double test”. The PAPP-A assay detects the level of a special protein that is produced by the placenta and should increase steadily as the fetus develops.
12-14 weeks
During this period, you will need to consult with your doctor on the results of screening and decide on the advisability of visiting a geneticist.
16 weeks
We pass the next tests of urine and blood, but this time blood is needed for two things: – to determine the level of hemoglobin and to exclude the development of anemia, which is dangerous to the health of the child; – determination of the level of proteins of alpha-fetoprotein (AFP) and chorionic gonadotropin (CG). This diagnosis also provides clarity regarding the presence or absence of chromosomal abnormalities in the fetus.
16-18 weeks
Here, the cervix is carefully examined to exclude ICI (isthmic-cervical insufficiency), that is, its shortening. Cervicometry is performed – measurement of the length of the cervix using ultrasound. Or examination on the chair.
20-21 weeks
The next screening ultrasound scan and a planned examination by a doctor are being carried out.
24 week
We undergo a glucose tolerance test to detect diabetes mellitus in pregnant women.
28 weeks
Scheduled visit to the gynecologist, control blood test to detect Rh antibodies.
30 weeks
Childbirth is coming soon! Therefore, you will receive a generic certificate and an exchange card. In the same period, the choice of the method of delivery begins. For this, it is important to determine the position of the fetus, therefore, an ultrasound scan and examination are required!
32 week
Control examination by a doctor with the measurement of all parameters and ultrasound.
30-34 weeks
For the first time, CTG of the fetus is performed, according to the results of which the capabilities of the cardiovascular system of the fetus are assessed and a conclusion is made about the presence or absence of intrauterine hypoxia.
34-40 weeks
Medical examination with constant monitoring of the protein in the urine. An increase in protein levels may be a sign of the development of late toxicosis – gestosis. In the same period, ultrasound is again performed to monitor the position of the fetus, determine the state of the umbilical cord, placenta and clarify the method of delivery.