When to cling to your doctor’s coat

During the first trimester, the doctor is every pregnant woman’s best friend and confidant. However, as the pregnancy progresses, women feel more confident to miss their appointments. This is usually because they have access to parallel information, thanks to the Internet, or simply because they take for granted the health of their baby and that of their own.

However, it is important to keep the diary open on these important dates no matter the stage of the pregnancy because at every visit, specific tests and procedures are undertaken to ensure that at the end of 40 weeks, you have a healthy bundle of joy with the least possible complications on your part. The following are what you can expect from your doctor at every appointment.

Trimester One
During the first visit, the doctor will confirm your pregnancy through b-HCG blood test. During the second visit, the blood pressure, weight, height and pulse rate are recorded At this stage, men find it awkward to be in the examination room with their partners just in case the doctor examines her to feel for the enlarged uterus and to ascertain the state of the cervix.

Before the doctor performs this procedure, he/she is likely to ask for the date of your last menstrual cycle, which is usually the first day of the last menses, history of previous pregnancies, blood group type, any current or past illnesses and any known inherited disorders. Various tests are also undertaken after this, namely: analysis of the first urine usually urine-expelled first thing in the morning, red blood cell count to check for anemia, hepatitis blood check (where necessary and applicable) and test for syphilis and HIV.

During the first trimester, an ultrasound can also be taken to assess the pregnancy in the early stages, to rule out ectopic pregnancy, to evaluate the mother closely in case of previous miscarriages, to check on foetal growth and to assess amniotic fluid level. The ultrasound assessment can be done by placing a traducer inside the vagina or on the abdominal wall to view the foetus. However, clear images are obtained from inside. This trans-vaginal scan is usually done as the first scan during which the gestation sac and the foetal heartbeat can be seen. If the scan is done after 10 weeks the legs and arms of the foetus can be spotted.

Trimester Two
You visit the doctor for the second time. For many clients however, this may be the first visit if they have missed the opportunity in the first trimester. The first question asked to the expectant mother is whether she has been experiencing some pain or tiredness. If tests were not done in the first trimester they may be done at this time. Otherwise only essential ones are repeated like urine test. Weight, blood pressure and pregnancy evaluation is done. Anti-malarials, hematinics, nutritional supplements, health education, nutritional counselling and other necessary services may also be given.
An ultrasound scan can also be repeated for the following benefits.

• To confirm the state of foetal well being. The heart beat is evaluated. Congenital malformations are ruled out.
• The mother. may be able to know the sex of her unborn child if the foetus is well positioned.
• The number of foetuses present and where the placenta is attached can be seen.
• The amount and quality of amniotic fluid can be checked.
•  If a Doppler system is used, the heartbeat and blood flow of the foetus are also checked.
• Movement of the foetus and foetal body parts (legs, arms, hands and feet as well as the number of fingers and toes, etc) are observed
• The breathing of the baby can be observed. The amniotic fluid is taken to its lungs and later expelled into a cloud. If you get to see this in real time, then it’s really something to be proud of.
• Several checks are done at this stage through a scan to confirm gestation age and any abnormalities. The length between the head and the base of the spine can give a good indication of gestation age before the 15th week. The actual size and weight of the foetus can also be assessed.

Trimester three
During this trimester, two or three more visits may be necessary before delivery in normal pregnancy. The frequency of visits to the doctor may be increased, however, if there are complications in the pregnancy. Normal pregnancy requires only a total of four visits with two of them having been taken earlier. During these visits, weight gain, pulse rate and blood pressure are closely monitored. A Doppler device or fetoscope is usually used to check the unborn baby’s heartbeat. The position of the baby is usually checked at each session.

Sugar and protein levels are checked and extra test for diabetes, if necessary, is done between weeks 28 and 30 A final ultra scan is performed at about the 31st week to check the baby’s general condition. These last visits are intended to prepare for the birth of the baby.

The tests-in a nutshell

First trimester

• Test b-HCG blood test
• Ultra sound.Rule out ectopic pregnancy
• Blood sugar (if necessary)
• Infections of HIV and syphilis
• Counts the red blood cells
• Diagnosis if the birth canal has infections.

Second trimester

• Checks the movement of the legs
• Sugar level (if necessary)
• How the foetus is breathing
• Number of fingers and toes
• Nutritional supplements
• The size and weight of the foetus
• 2nd ultrasound scan
• Abnormalities.

Third trimester checks

• Blood sugar (if necessary)
• Blood pressure
• Protein level
• Obvious stress
• 3rd ultrasound scan

Prepares the way for the baby.

When should I book the doctor’s appointment?

It is advisable that you contact your doctor as soon as you get pregnant, to schedule your appointments.

END: PG 37 /42-43