What is Prenatal Care and How Important it is?
Proper prenatal care is the first step towards a smooth pregnancy. However, many expecting mothers are unaware of the type of prenatal examination and their purposes. Here, we will learn all about the necessary tests for prenatal care required during 10-month pregnancy period.
Mandatory Regular Checkups
Within the first seven months after the confirmation of a successful pregnancy, checkups are required to be done once a month. Between the 8th and 9th month, checkups are needed twice a month. And in the final month, weekly checkups are required. At every regular checkup, the weight and blood pressure will be measured along with other tests such as early pregnancy body checkup, uterus examination, positioning and size of ovaries, check for deformities and fetal health.
The check for consistency in weight gain determines if the fetus is developing normally. If the expecting mother does not gain 1.1-1.6 kg a month, special attention may be required. A pregnant woman should gain 1.5 kg monthly during the first three months of pregnancy, 0.5 kg weekly for the following five months and another 0.5-1 kg during the last month. However, if a rapid increase in weight and swelling around the body occur, it may be a sign of abnormalities in the pregnancy.
During a uterus examination, the gyne will place their finger in the expectant mother’s vagina to check the placement and size of the uterus or ovaries. There will be slight discomfort during this examination, so it is important that the patient is relaxed. Uterus examination is usually done during the early stages of pregnancy and the last month, but the frequency to conduct uterus test varies in different hospitals.
The measurement taken from the first blood pressure test will serve as the baseline. Hence, blood pressure results taken during the rest of the examinations will be used to compare against this baseline measurement. The blood pressure should not exceed 144mmHg or fall below 90mmHg. If it does, the expecting mother may be suffering from gestosis.
Ultrasound can determine the fetus’ size, heart rate, ectopic pregnancy, placenta previa, twins, malposition and other conditions. The baby’s gender may also be determined after 24 weeks of pregnancy, but gender checks may not be available at all hospitals.
Fetal Heartbeat Examination
After 11 weeks of pregnancy, the fetus’ heartbeat may be heard from the examination, which is capable of detecting abnormalities as well.
Measurement of Abdominal Circumference and Fundal Height
It is necessary to measure the abdominal circumference and fundal height after five months of pregnancy. From the measurements, the gyne will be able to determine if the fetal development is healthy.
Amniotic Fluid Examination
Before collecting the amniotic fluid sample, first apply local anesthesia and disinfectant on the abdomen. The abdominal wall is punctured via a spinal needle, which is inserted into the amniotic cavity. The amniotic fluid sample is then carefully extracted with the use of syringes. The extracted amniotic fluid sample is then sent for a chromosome examination, and the results will be released after 2-3 weeks.
Frequently Required Diagnostics
Ultrasound – after Five Weeks of Pregnancy
Is the fetus over-developing or under-developing? The extent of fetal growth, twins, location of the placenta, amount of amniotic fluid, health status, vaginal bleeding and other reasons can all be determined by ultrasound examination. Ultrasound scans need to be done regularly after 5 weeks of pregnancy. In addition to detecting fetal congenital malformations, ultrasound scanning also provides useful insights to the fetus’ size and location while in preparation for childbirth. Ultrasound examinations are usually done once every 4 weeks and then once every fortnightly in the last 2 months of pregnancy.
Chorionic Villus Sampling – during the 9th weeks of Pregnancy
Chorionic Villus Sampling is a crucial test for expecting women above 35 years of age, mothers who has given birth to deformed children or women coming from families with high risk of congenital malformations. This process involves the use of ultrasound to determine the position of the fetus and placenta, and the analysis of placental tissue extracted by a plastic cervix needle. Chorionic Villus Sampling is capable of a 99% accuracy detection of any fetal chromosomal abnormalities. No pain will be experienced during this examination so there will not be any usage of anesthesia. However, the expecting woman may experience slight abdominal pain or bleeding after the examination which is normal, and will cease after a few days. Generally speaking, this examination is relatively safe but there is still a 1% probability of it causing a miscarriage.
Syphilis Screening – before Pregnancy to 14 Weeks of Pregnancy
If the expecting mother is suffering from syphilis, the disease will be transmitted to the fetus through the placenta, resulting in a high risk of miscarriage, premature birth or developing congenital syphilis in the child. Hence, syphilis screenings are required to be done prior to or during the early stages of pregnancy.
Alpha-fetoprotein (AFP) Test – Pregnancy Week 15-2O
An alpha-fetoprotein (AFP) blood test checks the level of AFP in the blood of a pregnant woman. AFP is a substance produced in the liver of the fetus. The level of AFP in the blood is used in a maternal serum triple or quadruple screening test. These tests are generally done between 15 and 20 weeks, which determine the levels of three or four substances in a pregnant woman's blood. The triple screen checks for alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and a type of estrogen (unconjugated estriol, or uE3). The levels of these substances, along with a woman's age and other factors, allows the doctor to determine the chances of the baby developing certain problems or birth defects such as spina bifida, down’s syndrome and anencephaly. These examinations, along with amniocentesis, will have a 70% probability of revealing any abnormalities.
Amniocentesis – Pregnancy Week 15-18
Amniocentesis (AFT) is a 99% accurate medical examination used in prenatal diagnosis of chromosomal abnormalities and fetal infections. Expectant women at high risk of developing abnormal fetus need not undergo the AFP test, but undergo amniocentesis directly. If AFP tests detects any abnormalities, an
Amniocentesis is necessary to confirm the presence of fetal malformation.
Glucose Screening – between 24-28 weeks of Pregnancy
A glucose-screening test (also know as a glucose challenge test or GCT) is normally recommended between 24 and 28 weeks of pregnancy to check for gestational diabetes. When you arrive for the test, you are given a sugar-laden drink containing 50 grams of glucose that need to be consumed within 5 minutes. A blood sample will then be taken an hour later to determine the blood sugar level.
If the reading is too high, which happens around 15%of the time, you will be required to come back for another three-hour glucose tolerance test to determine whether you have gestational diabetes. Gestational diabetes tends to cease after childbirth, but 50% of people will develop diabetes within the next 20 years.
Fetal Non-Stress Test (NST) – after 36 Weeks of Pregnancy
This examination determines the fetal health through its heart rate and movement. Pregnant women who are diagnosed with gestosis and diabetes are expected to undergo daily inspections during the last month of their pregnancy.
The fetus’ heart rate will be displayed on the screen during an ultrasound screening. Pregnant women are required to press a button of the ultrasound equipment whenever they feel any fetal movement during the test, to determine the frequency and intensity of the uterine contractions. It is normal for the fetus’ heart rate to increase during fetal movement. This test usually requires 20-40 minutes, and may be prolonged if the fetus is asleep.
Toxoplasmosis Test – Late Pregnancy
If an expectant mother contact parasitic infection that originated from dogs and cats, the toxoplasma will be transmitted to the fetus through the placenta, which may result in a miscarriage, premature birth or fetal abnormalities. Although the chances of contacting toxoplasma is extremely low, toxoplasmosis screening is available in hospitals.
Umbilical Cord Test – after 36 weeks of Pregnancy
A needle is inserted through the abdominal wall and into blood vessels of the umbilical cord for the collection of blood samples required for fetal examination.
The analysis will be done within 72 hours, revealing the fetus’ state of health.
Group B Streptococcus (GBS) Screening – 35-37 Weeks of Pregnancy
10-35% of adults possess such bacteria near the rectum or vagina. Although they do not post serious harm, they may be transmitted to the newborn during pregnancy causing brain inflammation, intestinal abnormalities, pneumonia and stillbirth. In the case of a premature labor, the fetus is very prone to infection if they are exposed for a prolonged amount of time after the amniotic fluid have been drained.
For GBS Screening, a cotton swab is used at the vagina or anal region to collect cells for analysis. If Group B Streptococcus is present, an antibiotics jab will be applied before labor.
List of Prenatal Care Procedures
First Stage (0 to 6 weeks)
Confirming if there is a successful pregnancy through vaginal ultrasound, internal examination and urine examination.
Second Phase (0 to 8 weeks)
Blood test, anemia check, cervical screening, hepatitis, syphilis and measles inspection. To be completed within 8 weeks of pregnancy.
Third Phase (0 to 40 weeks)
Regular Monthly Checkups
Blood pressure and weight measurement are mandatory monthly checkups that must not be missed. These measurements will be able to determine the health status of both the expectant mother and the fetus.
Fourth Phase (6 to 18 weeks)
Necessary examinations must be undergone to check for deformities that may caused by genetic diseases, pregnancy drugs, smoking, radiation exposure, age, artificial insemination, etc.
Fifth Stage (32 to 38 weeks)
Determining the Delivery Mode
The position of the fetus and amount of vaginal secretions must be checked to determine the best mode for delivery. If a pregnant woman is having bag rash or vaginitis, it is highly advisable to opt for Caesarean section.
Sixth Stage (after childbirth)
Newborns are required to undergo metabolism and neonatal screenings to check for any abnormalities. The newborn is deemed to be perfectly healthy if no sign of any abnormalities are detected from these screenings.
Now, those are the examinations needed for prenatal care. It would be beneficial for the couple to know if there is any problem during the early stages of pregnancy so necessary procedures can be done by the gyne.