Prenatal Visits: Quick Guide
|Care During Pregnancy
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Prenatal Care Information
|How Many Prenatal Checks Will I Have?
Not surprisingly, the regularity and quality of your prenatal appointments makes a significant difference to the outcome of your pregnancy. Women who have regular practitioner care throughout their pregnancy are far less likely to have premature babies or to have serious pregnancy complications. Regular prenatal visits include blood and urine tests, fetal ultrasound scans and occasionally prenatal genetic testing. Once you have chosen your obgyn, whether that involves the family doctor, an OB/GYN or midwife, here is what you can expect to happen at your prenatal visits.
Typically, you can expect the following schedule of prenatal visits:
• Weeks 4 to 28: One visit a month
If you are considered a high-risk pregnancy category, your doctor may ask to see you more often.
This will probably be the longest of your prenatal check-ups, and certainly the most comprehensive. Not only will your doctor go through your complete medical history, but you will probably have lots of your own questions in relation to do's and don'ts, see: Pregnancy tips. You will also receive advice on pregnancy nutrition, supplements and exercising. Although routines may vary from one healthcare provider to another, generally your visit will include:
Confirmation of Pregnancy
Your OB/GYN or doctor will note your pregnancy symptoms and the date of your last missed period (LMP) to determine estimated due date (EDD). He will also examine your cervix and uterus for signs of pregnancy and carry out a blood and urine test to confirm presence and levels of the pregnancy hormone HCG. Up to this point, the only 'medical' confirmation you may have received is from your home pregnancy test. See also estimating pregnancy due date.
Complete Medical History
It is a good idea to come prepared to your first prenatal checkup with details of previous illnesses, allergies, details of any medications you are taking (prescription and over-the-counter), including herbal. Also where possible, come armed with details of your family medical history - paying particular attention to any genetic disorders, chronic diseases, congenital abnormalities and difficult pregnancies. Your doctor will also ask about your own gynecological history, menstrual cycle, age of first period, duration and length of cycle. Your obstetrical history will also be discussed, past births, miscarriages, abortions and contraception use. Your social history may be discussed, your occupation, the environment you live in, the relationship with your partner and if there is any history of violence. You will discuss nutrition, prenatal vitamins, whether you drink or smoke or use recreational drugs. Other factors that are important to mention include information about the baby's father, including ethnicity.
Complete Physical Examination
A general health exam will be performed, checking your weight, height, heart, lungs, abdomen and breasts. Blood pressure will be checked to serve as a baseline reading for further future visits. Your doctor may also examine your uterus (womb) and the cervix, including a Pap test. He may look at your arms and legs for varicosities (see: varicose veins in pregnancy) and swelling, to again use as a baseline for future tests. He may examine the size and shape of your pelvis, through which your baby will finally make an entrance to the world.
Additionally, some of the most routine tests carried out for pregnant women in the first prenatal visit are:
Depending on your healthcare provider and your family history, some genetic testing may be carried out - most commonly for cystic fibrosis, sickle cell anemia, Down syndrome testing and Tay-Sachs (CVS, Chronic Villus Sampling which is believed to detect over 1,000 disorders for which defective chromosomes or genes are responsible). You may also be offered an ultrasound or other screening tests to detect fetal abnormalities. If there is a family history of genetic disorders you may be referred to a genetic counselor for genetic testing during pregnancy.
Other Prenatal Visits
The remainder of your prenatal visits in the first trimester are usually a lot shorter. You can expect the following to be checked:
• Weight and blood pressure.
First Trimester Ultrasound
After many years of studies, no known risks have been identified with ultrasounds, but a great many benefits (particularly in identifying birth defects). That said, most experts still recommend moderate use of ultrasounds - i.e. only to use when a valid indication exists. Some doctors perform an ultrasound in the first trimester, and they can do so as early as week 5 after your last period. A first trimester ultrasound is usually carried out to confirm the viability of a pregnancy, to date it and to determine the number of fetuses.
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