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Prenatal Care - Care during pregnancy
July 10, 2012 by Dr. Pankaj Shrivastav
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Prenatal Care - Care during pregnancy

Pregnancy is a momentous occasion in a woman’s life. At this time she will experience a lot of physical and mental changes and these can be quite overwhelming, especially for a first time mother. However, the road to motherhood can be an enjoyable experience if she has access to correct information which will allay her fears and anxieties. So if you are a mother to be and want to make your journey a joyous one, read on…

Your preparation should ideally begin in the preconception period itself. A visit to the Gynaecologist should be scheduled when you plan for a pregnancy. Once you are pregnant, proper prenatal care will ensure that you optimize your chances of having a healthy baby.

What to Expect in the first prenatal visit?

Your initial visit with your doctor will most likely be the longest one. This check-up will be very thorough as your healthcare provider needs to become familiar with your past family and medical history and will also perform a series of tests to ensure that everything is progressing properly in your pregnancy. You should inform her of any chronic illnesses that you are suffering from like hypertension, diabetes, thyroid disorders etc. so that appropriate investigations can be ordered and your medications either altered or their dosages modified. You should also let your health care provider know if either of you smoke, drink or take recreational drugs.

Also, be sure to mention any genetic diseases that have shown up in your family history, like cystic fibrosis. If there is a history of genetic disease in your or your partner's family, or if you are over 35-years-old, your health care provider will probably recommend referring you for genetic testing. This is done in order to properly assess your baby's risk for any genetic defects.

Your menstrual history including your last menstrual date and a detailed past obstetric history will be recorded. A thorough physical examination follows to assess your current state of health.

You will then be guided regarding diet and nutrition, folic acid supplementation and any special tests if required.

Why folic acid?

 It is important to start taking folic acid (400 micrograms) right away. As folic acid helps prevent fetal brain and spinal cord disorders.

What will be the nature of further prenatal check-ups?

Future check-ups with your health care provider will consist of routinely checking your weight, blood pressure, and urine. She or he will also order any tests that need to be done as well as address any questions you might have.

After the 12th week of pregnancy, your health care provider will also start listening for a fetal heartbeat. Beginning at about the halfway point, your health care provider will also start measuring your stomach to estimate how much your baby has grown. Towards the end of the pregnancy, your health care provider will begin to feel your abdomen in order to determine the baby's position.

The frequency of your visits will change throughout your pregnancy. Up until the 28th week, you will only need to see your health care provider once a month. After that, it will increase to two visits every month until the 36th week. From the 36th week until the birth, you will have an appointment every week.

If you have a chronic medical condition or have been determined a "high-risk" pregnancy, you may have to see your health care provider more often. Even if you're feeling fine, it is important to go to all of your prenatal check-ups to ensure that you and your baby receive the best possible care.

What is the importance of Ultrasound scans in pregnancy?

Your first USG scan should ideally be scheduled at the 6th gestational week. This is to view the nature and site of the gestational sac, number of gestations to confirm fetal viability, and to rule out an ectopic pregnancy.

Another scan between 11-12 weeks is called a nuchal translucency scan. It is essentially a screening test for Down’s syndrome.

Anomaly ultrasound is performed at 19-21 weeks for a detailed scan to rule out congenital malformations.

Third trimester screening is for fetal wellbeing.

What should be the food and nutrition during pregnancy?

It is important for an expectant mother to eat a healthy diet. Unless you have a specific health problem (e.g. diabetes, high blood pressure or body swelling) common sense nutritional advice should be followed: balancing carbohydrates, proteins and fats; and eating a variety of foods, including dairy products and several fruits and vegetables, daily. A pregnant woman should consult her obstetrician for specific advice.

Calcium and iron are particularly needed by the rapidly growing fetus. Pregnant women should eat enough dairy products (for calcium) and red meat (for iron) if they are not vegetarian. Women are often prescribed iron pills, since many young women get slight anemia. Calcium is effective only if women also obtain enough Vitamin D. The best way to get vitamin D is to be out in the sun each day for 10-15 min. Salmon and fatty fishes are also good sources of vitamin D.

Dangerous bacteria or parasites may contaminate food. To avoid these hazards, hygiene rules should be strictly adhered to: carefully wash fruits and raw vegetables; over-cook remainders, meat and processed meat. 

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