The first meeting with the doctor who will lead your pregnancy should take place within the first 12 weeks, because the earlier you start to engage in yourself, the less there will be a risk that any unpleasant events will hinder the process.
When you first meet your doctor it is important to find out if you have any problems that could complicate the development of pregnancy. To do this, you will be asked to tell about the formation of menstruation (if they started late and came irregularly, you can assume a lack of female hormones, which in some cases is fraught with miscarriage), about diseases, operations that you had and which may affect the course of pregnancy and childbirth .
Then the doctor will find out if you had any venereal or gynecological diseases (cervical erosion, inflammation of appendages, ovarian cyst, uterine myoma), how you were treated and how you feel now.
A question is usually asked about the age and health of the father of the unborn child. If he is over 50 years old, it is worth doing research to rule out possible malformations of the baby.
The doctor should know whether the future pope suffers from serious chronic diseases or sexually transmitted diseases (for example, syphilis, gonorrhea, sexual herpes, chlamydia).
The next question is addressed to those women who have this pregnancy is not the first. It is important for the physician to know how the previous stories flowed and how they ended: if by childbirth, then for how long, if there were complications, then what.
The data on the height, weight and sex of the child at birth, how it grows and develops now becomes useful. If the pregnancy ended in spontaneous miscarriage, then at what time and in what way, if by artificial abortion, when exactly, were there complications after it (repeated surgery, inflammation of the uterus or appendages).
During the first consultation, you should be weighed, to measure your height, external dimensions of the pelvis and the pressure on both hands. Then the doctor will conduct an examination, which includes an external examination (the type of build and body hair, the shape of the mammary glands and nipples is important) and the examination on the chair. It is important to determine the condition of the walls of the vagina and the cervix, take a smear to study the discharge of the vagina (to exclude gonorrhea, trichomonas coxitis and thrush) and the contents of the cervical canal (find out if a woman has sexually transmitted infections).
In addition, to determine at what period of pregnancy you are, the doctor must examine the size of the uterus and calculate the estimated date of delivery, based on the 1st day of the last menstruation.
To learn more about how you feel now, the doctor will prescribe you a series of mandatory studies.
1. A blood test – it is taken from the finger in the morning.
Before leaving the house, you can afford a light breakfast, the main thing is not to eat fat.
This analysis is appointed during the first visit to the consultation, and then at the 20th and 30th weeks of pregnancy.
2. Urine analysis – he gives up before each visit to the doctor.
This study helps to identify many abnormalities during pregnancy. Firstly, acetone may appear in the urine, it occurs due to vomiting during toxicosis and indicates a violation of the liver.
The second danger – sugar in the urine, in this case, you will be prescribed studies that will help eliminate diabetes. Thirdly, in the 2nd half of pregnancy, protein may appear in the urine, and in combination with increased pressure and edema it all speaks of nephropathy (gestosis of pregnant women).
At the same time, changes in urine analysis may also indicate kidney disease.
How to properly collect urine for analysis? In the morning you should wash, close the entrance to the vagina with a cotton swab and collect a medium portion of urine.
3. Analysis of the Rh-factor, blood group is taken from the cubital vein once.
If you have a Rh-negative blood type and your husband has a positive blood type, then every month you will need to test the blood for Rh antibodies.
4. Blood test for Wasserman (RW) reaction to rule out syphilis. Blood is taken in the morning from a vein, it is better to take it on an empty stomach.
The survey is carried out three times: at the first visit, at the 30th week and before the birth.
5. Test for HIV infection – blood is taken from the cubital vein, preferably on an empty stomach. The study is conducted 2 times – at the first visit and at the 30th week of pregnancy.
6. Blood test for HBS-antigen – it is taken from the ulnar vein once, when you first visit the doctor to determine viral hepatitis B.
7. Ultrasound scanning. The survey is carried out 3 times: for a period of up to 15 weeks, at the 18th – 24th week, at the 32–34th week.
During your meetings, the doctor assesses the results of urinalysis, the general condition, weighs you, determining the weight gain. Then he measures the pressure on both hands, after 14 weeks – the height of the uterus bottom and abdominal circumference, and from 18-20 weeks he listens to the heartbeat of the child, finds out if you have edema.
By the 30th week you need to be re-examined by specialists. After that, the doctor will issue you maternity leave, will issue a sick leave, exchange card and birth certificate.
After the 30th week of pregnancy, doctors will advise you to do preparation for childbirth.
– CARDIOLOGY (for heart disease).
– UROLOGUE AND NEFROLOGIST (kidney problems).
– GASTROENTEROLOG (if there are diseases of the gastrointestinal tract).
– ENDOCRINOLOGY (for suspected diabetes, thyroid disease).
MEDICAL GENETIC. It is recommended to visit those who had inherited diseases in the family, or if the expectant mother is over 35 years old.
He may prescribe further studies to the patient.
At the 8th-11th week of pregnancy, chorionic villi (future placenta) are taken through the cervix, after studying which chromosomal and genetic diseases can be predicted. Another research method is amniocentesis at 17-20 weeks.
Examining the amniotic fluid, you can determine the chromosome set, the sex of the child, do a DNA analysis, determine the content of alpha-fetoprotein, which increases if there are defects in the development of the baby.
Daily analysis of urine at 17 KS (as denoted by the decay products of androgens, male hormones that interfere with the growth and development of the baby).
During the day, the woman collects urine in a 3-liter jar (the first morning urine is poured out, and the last portion is the morning portion of the next day). Then, the total amount of urine excreted per day is measured, this figure fits into the direction of the doctor, and 100 ml of the obtained analysis is delivered to the laboratory.
Before collecting this analysis, doctors advise the expectant mother not to worry (stress increases the release of hormones) and not to eat coloring products (beets, citrus fruits, buckwheat).
Urinalysis for CG (chorionic gonadropine quantitative) is collected 2 times a week between the 5-6th and 11-12th weeks of pregnancy.
It is prescribed if there is a threat of termination of pregnancy in order to choose the right course of therapy. To do this, transfer to the laboratory 50 ml of morning urine.
The study of hormones in the blood (estriol, cortisol and testosterone) – blood is taken in the morning from the cubital vein.
Before the visit to the consultation, you can drink sweet tea.
Urine analysis according to Nechiporenko – to study the condition of the kidneys, for example, with pyelonephritis.
Under a microscope, count the number of leukocytes, erythrocytes in 1 ml of urine.
A sample of Zemnitsky is needed to examine whether the kidneys cope with the volume of fluid that enters the body during the day.
How to collect analysis: during the day a woman collects urine every three hours (from 9 am to 6 am the next day) and each time in a separate container.
Hemostasiogram – the study of blood coagulation.
Blood is taken in the morning from the cubital vein. Before you go to the laboratory, be sure to drink sweet tea.
If you suspect diabetes (if there is sugar in the urine test):
– research on the presence of acetone in the urine;
– blood test for sugar – blood is taken from the cubital vein in the morning on an empty stomach.
The first blood sampling from a vein is done in the morning on an empty stomach, then the woman is offered to drink a glass of water with 50 or 100 g of sugar. Then, at half-hour intervals for 3 hours, her blood sugar level is determined and a curve is drawn.
It demonstrates insulin production by the pancreas, which decreases with diabetes.
ECG (electrocardiogram). Made to study the heart in many diseases, including preeclampsia.
Cardiomonitor control – it is prescribed after the 28th week of pregnancy to study the condition of the baby and the excitability of the uterus.
Roentgenopelviometry is prescribed to women with a narrow pelvis after the 38th week of pregnancy in order to determine exactly how the baby will be born: naturally or with a caesarean section. To do this, a specialist takes a picture of the bones of the mother’s pelvis, along with the bones of the baby’s head.
The computer measures the dimensions of all the planes of the pelvis, the size of the baby’s head and simulates the situation of childbirth.