Antenatal care or pregnancy monitoring ideally aims to prevent possible medical, psychological and social problems of the pregnant woman in the process that begins with the planning of pregnancy and extends until birth; If they occur, it aims to treat them. The main purposes of pregnancy monitoring and care are to determine the health status of the mother and the fetus, to accurately determine the gestational week, to identify possible and avoidable risks that may cause pregnancy complications and to correct them, and to prepare the mother for pregnancy, birth and breastfeeding.
Pre-Pregnancy Examination
Ideally, a couple planning a pregnancy should consult a physician before pregnancy. This first application becomes important especially in problems where the control of the disease determines the course of pregnancy, such as diabetes, asthma, hypertension, epilepsy (Epilepsy), thyroid diseases (Goiter). Again, if applied before pregnancy, blood thinners, hypertension drugs, some fat-soluble vitamins, and epilepsy drugs that may cause birth defects may be replaced with safer drugs. During this period, women who are not immune to rubella (rubella) and hepatitis B can be vaccinated. Folic acid supplementation should be started for women planning pregnancy. A woman planning pregnancy should consult a doctor in case of menstrual delay.
First Pregnancy Examination
Within the first 6-8 weeks following the menstrual delay. should be done. At the first examination;
a-Diagnosis of pregnancy
*Urine and blood pregnancy tests
b-Determination of gestational week,
c-General physical examination,
*Height
*Weight
*Blood pressure
*Systemic examination
*Gynecological examination and smear taking.
d-Laboratory tests
*Complete blood count,
*Urinine examinations and urine culture,
* Blood type,
*Rubella (Rubella), toxoplasma, Hepatitis B and C, Syphilis screening
*TSH
Down Syndrome Screening
The commonly known double test (First trimester combined screening), which is performed by taking into account the nuchal transparency value measured by ultrasonography between 11-14 weeks of pregnancy and the values of two hormones measured in the maternal blood sample, can determine Down syndrome cases. If you are sick a 11-14. If the patient is admitted during the gestational age and the physician is experienced in nuchal transparency measurement, first trimester combined screening should be performed first. If the patient presents late or the physician has insufficient experience in measuring nuchal transparency, it is recommended to perform one of the triple or quadruple tests (second trimester maternal serum biochemical screening tests) in the second trimester, regardless of age. It is not recommended to perform screening tests consecutively. Genetic diagnosis methods may be recommended for cases that are positive (at risk) according to the screening test performed. Since 2011, screening for chromosomal anomalies can be performed with tests based on the separation and evaluation of the amount of fetal DNA detectable in the mother's blood, starting from the 10th week of pregnancy. Consult your doctor for more detailed information on this subject.
Glucose Tolerance Test
24-28 weeks of pregnancy. A sugar loading test should be performed for gestational diabetes (gestational diabetes). Screening test can be performed within the first 12-14 weeks for pregnant women who have late-onset type II diabetes in first-degree relatives in the family, obesity, large baby birth, unexplained baby death in the womb in the last trimester, and who were diagnosed with gestational diabetes in their previous pregnancy.
Other blood and urine tests to be performed during pregnancy may vary depending on the systemic diseases of the pregnant woman before pregnancy. However, pregnant women who do not have any complaints and whose pregnancy follow-up is normal should have a routine complete urinalysis, urine culture and complete blood count every 3 months.
Which Pregnant Follow-Up Examinations? Should It Be Done Frequently?
The first examination should be performed within the first 6-8 weeks following menstrual delay. After that, monthly until the 32nd week of pregnancy, 32-36. Pregnancy checks should be performed every 2 weeks between weeks of pregnancy and weekly after the 36th week of pregnancy.
Examinations That Should Be Done Regularly During Pregnancy Follow-Up
At each examination, the baby's growth and well-being, maternal health, identification of possible risks, screening tests, within the scope of preventive medicine Vaccination practices should be carried out.
Measurement of Arterial Blood Pressure:
Fundus-Pubis Measurements: Sixteen-36. Between weeks of pregnancy, the height of the fundus, that is, the top of the uterus, indicates the week of pregnancy. However, in order to make accurate measurements, the bladder must be empty before measurements.
Fetal (Baby's) Heartbeats: Starting from 18-20 weeks of pregnancy, the heartbeats of a baby in the womb can be detected with special tools called fetoscopes. In a normal fetus, the heart rate varies between 120-160 beats/min,
Leopold Maneuvers: It is used to determine the posture of the fetus in term pregnancies and whether it has entered the birth path.
Edema Examination: While lying on your back, it should be checked whether there is a swelling between the ankle and the knee that collapses and slowly returns to its previous position by pressing with the finger.
Trace Elements During Pregnancy and Vitamin Support
Ideally, when planning pregnancy, 0.4 mg of folic acid should be given daily to the expectant mother. This folic acid support should continue until the 12th week of pregnancy. Folic acid supplementation becomes more important in women with a history of neural tube defects (brain and spinal cord anomaly) and women using antiepileptic drugs. Similarly, pregnant women are 16-20 weeks old. It is recommended by the World Health Organization (WHO) to take iron preparations containing 30-60 mg of elemental iron starting from the week of pregnancy and continuing until the 3rd month after birth.
Vaccination During Pregnancy
Live viral vaccines should not be administered during pregnancy. Tetanus vaccine can be administered to pregnant women in two doses administered 1 month apart. Be sure to consult your doctor for situations that require vaccination.
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