Antenatal Care

You need to visit your doctor as below:

– Every 4 weeks in the first 28 weeks of your pregnancy.
– Every 2-3 weeks from week 29 to week 36 of your pregnancy.
– Every week from week 37 until the end of your pregnancy.

The total number of visits is often 8 visits if the pregnancy is without complications.

(Numbers of visits can change depending on pregnancy complications).

The following is done in each visit in all trimesters:
– Measuring mother’s blood pressure and weight.
– Checking baby’s position, growth, movement and hear rate.
– Urine test for protein and sugar (preeclampsia, diabetes and infection).

The first visit: (Ideally before week 10)
– Checking mother’s medical history such as twins birth, defects and chronic diseases like diabetes, and medical condition.
– Discussing nutrition and vitamins needed during pregnancy.
– Lab tests for HIV, rubella, chickenpox, hepatitis B, hepatitis C, syphilis .
– Lab tests for blood type RH and Hemoglobin level.
– Pelvic and abdominal examination.
– Due date estimation.
– Ultrasound examination.
– Ensuring that the mother had Pap test.
– Making sure to quit smoking.
– Test of vitamin D might be offered.

First trimester – Second visit:
– Ultrasound check for fetal heart rate.
– Diagnosing chromosomal anomalies such as Down syndrome by blood test or ultrasound (optional), specially in pregnancy in advanced age or family history with the syndrome.

Second trimester (week 13 to week 26):
– Monitoring fetal growth by measuring the uterus height.
– Monitoring fetal heart rate and movement.
– Ultrasound for baby’s anatomy evaluation, by week 20. It can help to show the gender too if requested.
– Check for any physical complaints from the mother such as swelling in hands and feet.
– Blood test for blood count, iron level (anemia) and glucose level for gestational diabetes.
– Cervical length measurement.

Third trimester (from week 27 till the end of pregnancy):
– Examination for the general health of the mother.
– Discussing any signs such as contractions, headache, leakage or bleeding.
– Test for group B streptococcus. Around week 36.
– Checking the frequency of fetus movement.
– Non-Stress Test to check fetal heart beat rate if indicated.
– Making sure that fetus position is head down.
– Tests for anemia and gestational diabetes.
– Ultrasound to check the location of the placenta.
– Measuring cervix dilation.
– Anti D injection might be given if the mother is RH negative. (To read more: Rh Factor and Pregnancy)

Other tests:

There are some tests done to detect chromosomal or genetic abnormalities with the fetus such as Down syndrome if requested by the parents.

• 1. Non invasive prenatal testing (NIPT):

It is the analysis of fetus DNA in blood sample. For chromosome 21, 18 , 13, X and Y.
It also shows fetal gender.
It is accurate.
Done between week 10 and week 13 of pregnancy.

• 2. Nuchal translucency scan:

Ultrasound to measure the thickness of fluid under the skin behind he fetal neck.
It can be used to detect down syndrome and congenital heart problems.
Done between week 11 and week 13 of pregnancy.

• 3. Amniocentesis:

To detect chromosomal abnormalities, neural tube defects, genetic disorders such as cystic fibrosis, Thalassemia, and sickle cells disease.

When a small amount of the fluid from the sac surrounding the fetus is collected, by a needle inserted through the abdomen.

Done between week 15 and week 18 of pregnancy.

Rare risks:
It carries the risk of miscarriage, 1 in 200.
Injury to the fetus or the mother infection is very rare.

• 4. Chorionic villus sampling (CVS):

Detects chromosomal or genetic disorders.
Sample from the placenta is collected by a fine needle through the cervix or abdomen.
Done between week 10 and week 11 of pregnancy.
It carries a risks of miscarriage (1%), and infection.