Things to know in pregnancy follow-up!
Perhaps the most beautiful thing in human life is to have a healthy baby. The first step is to have a healthy pregnancy.
Studies have shown that infant mortality and maternal problems are less common in pregnancies followed up regularly by a specialist physician. The ideal is to go under the control of a doctor before pregnancy occurs.
If your period is delayed, a urine pregnancy test should be done. For this test, a urine pregnancy test, which you can buy from the pharmacy, will be sufficient. The presence of 2 lines in the pregnancy test indicates the presence of pregnancy at a high rate. However, the absence of pregnancy in a urine test does not always indicate that you are not pregnant. For this reason, it is more appropriate to perform a pregnancy test called beta HCG in the blood as a pregnancy test.
Pregnancy how long does it take and how often should you go for a checkup?
Pregnancy is a beautiful process that takes about 40 weeks and makes changes from hair to toe. In order for you and your baby to go through this process in a healthy way, you should be examined by a gynecologist once a month until the 28th week, once every 2 weeks between 28-36 weeks, and weekly between 36-40 weeks. These checks may be more frequent if your doctor detects a risky situation.
Pregnancy What do you encounter at the first inspection?
At the first beginning of pregnancy, your detailed history will be taken by the physician. You should be asked whether the following conditions exist.
2. Hypertension (High blood pressure)
3. Heart disease
4. Defense system disease
5. Kidney disease
6. Neurology/Epilepsy (Epilepsy)
7. Psychiatric diseases
9. Hepatitis/Liver disease
10. Vascular disease
11. Thyroid disorder
13. Having received blood
14. Blood incompatibility
15. Lung disease (TB, etc.)
16. Seasonal allergies
17. Drug/Latex allergy
18. Breast disease
19. Surgery from gynecological disease
20. History of other surgery
21. Presence of anesthesia problem
22. Abnormal PAP Test
23. Injury to the uterus
25. Consanguineous Marriage
If available, previous abortion, miscarriage, birth and details information are questioned. It is questioned whether the previous baby’s weight, gender, delivery type (Normal birth or cesarean section), premature birth.
Genetic scan query
1. Presence of advanced maternal age (>35 years)
2. Thalassemias (Mediterranean anemia)
3. Neural tube defects (Baby’s open back)
4. Congenital heart defects (Congenital heart defects)
5. Down syndrome (Genetic disease that causes extreme mental retardation)
6. Tay-Sack Disease
7. Canavan Disease
8. Sickle cell disease/carrier
9. Hemophilias and other blood diseases
10. Muscular dystrophies (Muscle wasting diseases)
11. Cystic fibrosis
12. Huntington’s korea
13. Mental retardation/autism
14. Fragile X (The most common genetic cause of mental retardation in women)
15. Inherited/Genetic Diseases
16. History of baby with birth defect
17. Recurrent miscarriages/stillbirth
18. Use of medication after the last menstrual period
Infection disease screening inquiry
1. Contact with a TB person
2. History of Genital Herpes (Herpes in the genital area) (Including Spouse)
3. Postmenstrual viral disease
4. Sexually transmitted diseases (Gonorrhea (Gonorrhea), Chlamydia, HPV, Syphilis (Syphilis))
After this detailed questioning, your doctor will ask you about the first day of your last menstrual period (the day the bleeding started). It will calculate the gestational age based on your last menstrual period. This calculated age must be confirmed by ultrasonography (USG). In the first examination, USG is usually performed and the age of pregnancy is confirmed. If there is a mismatch between the USG and your last menstrual period, your doctor will make this correction and set a new date for your last menstrual period.
You will be asked about the first day of your last period throughout your pregnancy. Make sure to make a note of it.
In the first examination, your weight, height and blood pressure are measured. This should be done and recorded at each inspection. Changes in weight gain should be monitored.
Baby When is it seen on USG?
The baby’s sac can be easily observed in the 5th week with USG performed from the bottom. The baby sac is a well-circumscribed sac filled with water. It is very important for the differentiation of ectopic pregnancy whether it is in the uterus or not. Baby heartbeats can be easily observed at 6 weeks of pregnancy.
First What tests should be requested in the examination?
If you and your spouse’s blood type is Rh(- if you know, it is not necessary), your spouse’s blood group is Rh(+), it means you have blood incompatibility and an indirect Coombs test is requested, complete blood count, liver and kidney functions, urine culture, urinalysis, thyroid gland function, serological tests for hepatitis, rubella and toxoplasma are ordered.
Other very important tests to be done in examinations
Dual test/Combined test (Down syndrome screening) (11-13 weeks)
It is a test used to detect genetic diseases such as Down syndrome (Trisomy 21), Trisomy 13 and 18 performed between 11-13 weeks. It is currently the most reliable test available in current medical practice. If there is an opportunity for patients, it should definitely be done. The nuchal translucency of the baby is measured (although different levels are determined, it should be below 2 mm). Also, blood is given. When donating blood, hunger and satiety do not matter. You should discuss the combined test result with your doctor in detail. This test is not a diagnostic test. It is a screening test. It has an accuracy rate of 85%. There is a 15% margin of error. To give an example, consider 100 pregnant women. May all of their babies have Down syndrome. If we apply a combined test to all of them, the test shows Down syndrome in 85 of them, while in 15 of them the baby shows normal even though they have Down syndrome. If the test server comes back positive, you should discuss it with your doctor in terms of CVS or A/S. The definitive diagnosis of Down syndrome is made by examining the baby’s gene by performing CVS (chorion sampling) or amniocentesis (A/S). The combined test is not a definitive diagnostic test.
Triple test (Down syndrome scan) and AFP measurement (Neural tube defect) (16-19 weeks)
It is the scan for the opening that occurs as a result of the baby’s backbone not closing and the screening for Down syndrome.
Similar to the combined test. The baby’s head width is measured and blood is given. It is a 75% diagnostic test. It is not a definitive diagnostic test. If the test server comes back positive, you should discuss it with your doctor in terms of A/S. Apart from the combined test, it is also used to screen for situations where the baby has an open back.
Detailed (level 2) ultrasonographic examination (20-21 weeks)
The baby is examined in detail with USG. Structural defects are tried to be detected. Even in the best hands, 90% of structural disabilities can be detected with USG. The position of the baby and the weight of the mother decrease this rate.
The baby’s heart is also checked during this period.
Diabetes screening (50 g sugar loading, 100 g sugar loading if necessary) (24-28 weeks)
Diabetes mellitus, called gestational diabetes, which disappears spontaneously after pregnancy, can cause your baby to gain excessive weight and cause some problems. For this reason, 24-28. 50 grams of sugar screening test should be done between weeks. Your doctor will prescribe you 500 milliliters of 30% Dextrose (sugar water). Have a light breakfast in the morning. Honey, jam, sugary things should not be eaten for this breakfast. Bring 1 glass and 1 lemon with you to the hospital. 50 grams of sugar will be measured and given to you by the nurse on duty and you will be asked to drink it. You should donate blood 1 hour after drinking. It is normal for blood sugar to be below 140. If your blood sugar is above 140, your doctor will ask you for a 100 gram glucose test. The 100 gram sugar load test is a diagnostic test. The 100 gram sugar load test is similar to the 50 gram test. There should be 8 hours of fasting for 100 grams of sugar loading. There is no breakfast in the morning. First, blood sugar is checked on an empty stomach. After drinking 100 grams of sugary water, blood sugars are checked at the 1st, 2nd and 3rd hours (Hunger should be below 95, below 180 in the 1st hour, below 150 in the 2nd hour, below 140 in the 3rd hour. If the two values are higher than normal, gestational diabetes is diagnosed. placed).
100 grams of sugar loading can be done in the first weeks of pregnancy in those who are overweight, have diabetes in the family, and have gestational diabetes before. Even if the 100 gram test is normal, 24-28. The 100 grams test should be repeated every week.
In some cases (if there is no diabetes in the 1st degree relatives, under 25 years old, normal weight before pregnancy, normal weight at birth, there is no history of bad pregnancy), 50 grams of screening may not be done.
Uterus preterm labor screening with short mouth measurement
Although it is not always possible to predict preterm birth, a short measurement of the cervix may be a harbinger of preterm birth. The shortening of the cervix is measured by USG.
26-30 special occasion of the week
This 1-month period can be considered as perhaps the most important month of pregnancy. Today, with the technical developments in newborn care, even a baby born at 26 weeks can be kept alive. However, at such a premature birth, undesirable conditions such as deafness and blindness may occur in the baby. In a baby born at 30 weeks, these rates are much less than those born at 26 weeks. During this 1 month period, you should pay special attention to yourself.
Developmental delay in the baby is also seen most frequently between these weeks. Therefore, the patient is also evaluated in terms of developmental delay.
34 post-week relief
Even if your baby is still premature, after the 34th week, your baby’s development and weight are quite sufficient for a healthy life. Therefore, preterm birth after 34 weeks is less risky for your baby.
Each What to do at the inspection
Your blood pressure and weight should be measured at every examination. Although it is not actually necessary, the baby’s weight gain and fluid are usually evaluated with USG at each examination. In babies over 35 weeks, baby heartbeat tracings called NST can be taken.
Birth What shape should it be?
Whether it is a normal birth or a cesarean delivery, birth can now be performed painlessly. The patient can give birth without pain in normal delivery with anesthetizing from the waist. In the cesarean section, the patient is given an conscious birth (without feeling any pain) by numbing the waist, the mother hears the first cries of her baby and can witness the entire birth process.
Normal birth? Caesarean section? You should discuss this important question with your doctor in detail and make a decision together.
Normal birth? Caesarean section? Click here.
Please click here for what you should or shouldn’t do during pregnancy.