Preg­nancy CHECKS & TESTS

Rou­tine an­te­na­tal visits with your health prac­ti­tioner are im­por­tant in your preg­nancy

Your Pregnancy - - Pregnancy Files -

DUR­ING YOUR PREG­NANCY, you’ll be of­fered a range of tests, in­clud­ing blood tests and ul­tra­sound baby scans. These tests are de­signed to help make your preg­nancy safer, to check and as­sess the devel­op­ment and well­be­ing of you and your baby, or to screen for par­tic­u­lar con­di­tions. You don’t have to have any tests. How­ever, it’s im­por­tant to un­der­stand the pur­pose of all tests so that you can make an in­formed de­ci­sion about whether to have them. Dis­cuss this with your ma­ter­nity team.

FIRST VISIT AT 6-8 WEEKS

The first visit to the doc­tor will in­volve a thor­ough his­tory tak­ing and clin­i­cal ex­am­i­na­tion to es­tab­lish your cur­rent and past health status, as well as es­ti­mat­ing the due birth date for your baby. You are likely to have a vagi­nal ul­tra­sound scan at your first visit. The ear­li­est ul­tra­sound scans are usu­ally the most ac­cu­rate for de­ter­min­ing the es­ti­mated due date of the preg­nancy and are used in pref­er­ence to later ul­tra­sound scans for dat­ing the preg­nancy. Most women in pri­vate care have a scan at ev­ery doc­tor visit dur­ing preg­nancy. A pap smear will be done if you have not had one in the pre­vi­ous year. This is to check for any ab­nor­mal cells in your cervix (mouth of the womb). ROU­TINE OB­SER­VA­TIONS ■ URINE TEST­ING You’ll be asked to give a urine sam­ple at your an­te­na­tal ap­point­ments. Your urine is checked for sev­eral things, in­clud­ing pro­tein or al­bu­min. If this is found in your urine, it may mean that

you have an in­fec­tion that needs to be treated. It may also be a sign of preeclamp­sia. Pre-eclamp­sia af­fects ten per­cent of preg­nan­cies, and can be­come a se­ri­ous com­pli­ca­tion. This usu­ally only oc­curs af­ter 20 weeks of preg­nancy. ■ BLOOD PRES­SURE The read­ing from the first visit will es­tab­lish a base­line to work from. One to two per­cent of preg­nant women de­velop raised blood pres­sure. If this is associated with headaches, blurred vi­sion, and pro­tein in the urine, it may in­di­cate the pres­ence of pre-eclamp­sia, which re­quires im­me­di­ate treat­ment. Your blood pres­sure will be taken at ev­ery an­te­na­tal visit. It’s very com­mon for your blood pres­sure to be lower in the mid­dle of your preg­nancy than at other times. This isn’t a prob­lem, but it may make you feel light-headed if you get up quickly. Talk to your mid­wife if you’re con­cerned. ■ WEIGHT This is taken to es­tab­lish a base­line and en­sure an ad­e­quate amount of weight gain is achieved through the preg­nancy. Most women put on 10-12.5kg in preg­nancy, most of it af­ter they are 20 weeks preg­nant. Much of the ex­tra weight is due to the baby grow­ing, but your body also stores fat for mak­ing breast­milk af­ter the birth. Dur­ing your preg­nancy, it’s im­por­tant to eat the right foods and do reg­u­lar ex­er­cise. ■ GEN­ERAL OB­SER­VA­TION This will in­clude a gen­eral as­sess­ment to es­tab­lish the well-be­ing of the mother but will also in­clude ob­ser­va­tions of the ex­trem­i­ties for cer­tain signs such as swelling and pres­ence of vari­cose veins, among many oth­ers. ■ AB­DOM­I­NAL PALPATION This is done to as­sess the size of the uterus and later to as­sess the po­si­tion of the baby in the uterus (af­ter 12 weeks). BLOOD TESTS As part of your an­te­na­tal care you’ll be of­fered sev­eral blood tests. These will be done to es­tab­lish your blood group, your im­mu­nity to rubella, whether or not you are anaemic and whether you have been ex­posed to any sex­u­ally trans­mit­ted dis­eases in­clud­ing HIV. Some are of­fered to all women, and some are of­fered only if you might be at risk of a par­tic­u­lar in­fec­tion or in­her­ited con­di­tion. All the tests are done to make your preg­nancy safer or to check that the baby is healthy. BLOOD TESTS DUR­ING THE FIRST TRIMESTER USU­ALLY IN­CLUDE: Full blood count and iron lev­els. Blood group and blood group an­ti­bod­ies (to check whether your blood type is com­pat­i­ble with your baby’s). Im­mu­nity to rubella. Tests for in­fec­tious dis­eases such as syphilis, hep­ati­tis B, hep­ati­tis C and HIV. BLOOD TESTS LIKELY TO BE PER­FORMED IN THE SEC­OND OR THIRD TRIMESTERS MAY IN­CLUDE: Re­peat blood count and iron lev­els. Re­peat screen­ing for Rh an­ti­bod­ies in women who are Rh neg­a­tive. Screen­ing for ges­ta­tional di­a­betes. 12 WEEKS ROU­TINE OB­SER­VA­TIONS At 12 weeks your care­giver will do a scan to check for “soft signs” of Down syn­drome and this will be fol­lowed by a blood test on the same day. This is to de­ter­mine what the like­li­hood is of your baby hav­ing Down syn­drome. The re­sult comes back as a ra­tio. VISITS TO YOUR CARE­GIVER WILL BE MONTHLY UN­TIL 28 WEEKS GES­TA­TION 16 WEEKS ROU­TINE OB­SER­VA­TIONS AS ABOVE Am­nio­cen­te­sis – if in­di­cated by the 12-week scan. 20 WEEKS ROU­TINE OB­SER­VA­TIONS At 20 weeks your care­giver will do a full anatom­i­cal scan, check­ing your baby’s devel­op­ment and growth and anatomy very care­fully. 28 WEEKS ROU­TINE OB­SER­VA­TIONS Fort­nightly visits are done from 28 weeks to 36 weeks. 34 WEEKS ROU­TINE OB­SER­VA­TIONS If you are see­ing a mid­wife you will see your gy­nae at this visit just to check that you are on track for the birth. WEEKLY VISITS FROM 36 WEEKS UN­TIL BIRTH Vagi­nal ex­am­i­na­tion and pelvic as­sess­ment may be car­ried out by some care­givers to as­sess the size of the pelvis and the con­di­tion of the cervix. This is usu­ally done at 38 weeks. ROU­TINE OB­SER­VA­TIONS A swab of your vagina and rec­tum may be taken if you are de­liv­er­ing vagi­nally to test for the pres­ence of group B strep­to­coc­cus bac­te­ria, which, if un­treated, can cause in­fec­tions in new­borns. If you test pos­i­tive for this bac­terium, you will be given an­tibi­otics in labour to pre­vent any prob­lems.

YOU WILL BE WEIGHED IN OR­DER TO ES­TAB­LISH A BASE­LINE FOR YOUR GAIN THROUGH­OUT THE PREG­NANCY

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