Here is a small vademecum of the analyzes to be carried out and the appointments to be respected for those who have a belly, quarter by quarter.
Even if the pregnancy proceeds in the best way, there are some tests that it is good to carry out anyway at defined deadlines, and others that are advisable.
So we will always keep under control the progress of gestation and the health of the baby, in order to intervene immediately if something does not go the best way.
Listen to our pharmacist’s opinion on vitamins to take during pregnancy.
The first date as a future mother
Once the pregnancy is ascertained, the first meeting with the gynecologist or midwife should take place within 10 weeks.
During this first visit will be measured:
- our weight (to always keep well controlled!)
- blood pressure
Here we will be able to ask for all the information we need to live the nine months in serenity, have explanations also on the different possibilities of prenatal diagnosis and plan together the different checks to be done.
These include ultrasounds, which must be at least three (one per quarter), with different indications depending on the period.
First trimester: routine analyses
Within the thirteenth week you will have to perform:
- urine test to check renal function and urine culture to detect a possible urinary tract infection;
- blood tests: blood count, blood sugar, transaminases (AST and ALT);
- determination of blood group and Rh factor (if not done previously) and indirect Coombs test which, if the mother is Rh negative, must be repeated every month;
- control of infectious diseases such as toxoplasmosis, rubella (not necessary if immunity is documented), syphilis, HIV.
The first ultrasound (obstetric ultrasound) is usually performed during the first visit to confirm which week of pregnancy you are in, to monitor the fetus and also to establish the number of embryos present.
We also recommend:
- the detection of hepatitis C virus antigen and anticytomegalovirus antibodies;
- the dosage of thyroid hormones;
- a cardiological examination with electrocardiogram;
- Pap smears, if not performed in the last two years
As for prenatal screening (which can be free if the pregnancy is at risk) today we tend to perform chorionic villus sampling or amniocentesis only in case of need and / or risk identified through the combined test.
The combined test should be performed between the 11th and 13th week. It combines maternal age, nuchal translucency and blood tests, greatly reducing the number of invasive tests. Although, if it is negative, it does not completely exclude a congenital defect.
During the trimester you may be asked to repeat some tests (such as urine tests, or rubella and toxoplasmosis if previously negative, indirect Coombs test).
Second trimester
Depending on what emerged in the first trimester, it may or may not be required to repeat exams already performed.
- urine test (however) and urine culture if the presence of significant bacteria has previously been shown (the test is repeated approximately once a month);
- toxoplasmosis if you are not immune (to be repeated about once a month);
- blood sugar and glucose loading curve, recommended if you belong to a risk group for diabetes.
- indirect Coombs test in case of incompatibility with the father’s group.
Between the 20th and 22nd week, the second ultrasound (called morphological ultrasound) is performed to diagnose any abnormalities of the fetus.
It examines the anatomy of the child by estimating its measurements and weight and verifying the presence and functioning of all organs. At this stage it is usually possible to detect the sex of the baby as well.
In addition, during the visit are generally monitored:
- weight
- blood pressure
By the 16th week it is recommended, for women over 36 years, amniocentesis if chorionic villus sampling has not been done before.
Third trimester
At established intervals, which will be indicated by the doctor, during the third trimester you will do:
- urine test (however) and urine culture if the presence of significant bacteria has previously been detected;
- blood test: blood count, blood glucose and minicurve load if necessary
- toxoplasmosis if you are not immune
- HBsAg (for hepatitis B), anti-HCV antibodies (for hepatitis C), HIV if risk factors are present
- indirect Coombs test in case of incompatibility with the father’s group.
Between the 30th and 32nd week, the third ultrasound is performed, to evaluate amniotic fluid and placenta, check fetal growth and highlight any malformations not previously emerged or signs of fetal distress.
In addition, the following are recommended:
- blood pressure measurement
- cardiological examination with electrocardiogram (between the 35th and 37th week)
- vaginal and rectal swab for beta-hemolytic streptococcus group B research, between the 36th and 37th week
- cardiotocography (CTG), around the 36th week if there is hypercontractility or suspected fetal distress or if the fetus is not moved, if not from the 40th week
- Doppler flowmetry of the umbilical arteries and other fetal districts (if amniotic fluid is scarce, CTG detects abnormalities or if pregnancy is still at risk)
At 36 weeks the position of the fetus is verified: if it is still breech, information will be provided on the possibility of carrying out external maneuvers to make it turn.
And for women with Rh negative factor at the first pregnancy, anti-D prophylaxis should be provided within 72 hours after delivery (or in case of threat of abortion with blood loss, miscarriage after the 13th week or if there is a risk that fetal blood will mix with maternal blood).
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.