Before pregnancy, women who are planning pregnancy should:
- If they smoke, they should quit smoking or reduce it to less than 3 cigarettes a day.
- They should be screened for Hepatitis B and rubella before pregnancy and If necessary, they should complete their vaccinations.
- For women who are overweight, they should lose weight.
- They should use 400 micrograms of folic acid per day. For women with a history of babies with anomalies (neural tube defects) in previous pregnancies, 4 mg per day. It is recommended that they take folic acid,
- Families who are carriers of hereditary diseases such as Mediterranean anemia and cystic fibrosis, or whose families have such diseases, receive genetic counseling.
Hair dyeing during pregnancy. and make-up, sexual intercourse until the last weeks of pregnancy (except for the threat of premature birth or bleeding), swimming in the pool or the sea, traveling by plane (a doctor's report is required after the 26th week of pregnancy), driving (until the last month), sports. There is no scientific evidence that doing so, using computers and mobile phones, or passing through security doors with metal detectors is harmful. For plane rides shorter than two to three hours, frequent movement, calf exercises and plenty of fluid intake are sufficient. For longer journeys, it is recommended to wear compression socks. Pregnant women who have had vascular problems and varicose veins are advised to consult their doctor before the trip. Cruise travel may cause an increase in nausea and vomiting, especially in the early stages of pregnancy. All kinds of dental treatment can be performed during pregnancy.
Iron medications are necessary for women who had anemia before pregnancy or who developed anemia after the 26th week of pregnancy.
The risk of fetal anomaly during pregnancy is 2%. is. 10-14 weeks of pregnancy. 40% of fetal anomalies detected by ultrasound in weeks 22-24. 80% can be determined within weeks. The point to remember is; In 10% of the screening tests performed during pregnancy, it may appear that there is a problem with the baby, when in fact there is no problem.
In order for your pregnancy to continue in a healthy way and to diagnose and prevent problems that may occur during pregnancy in the early period, you need to be followed up at the intervals recommended by your doctor during pregnancy. . a problem before pregnancy The generally recommended follow-up method and necessary examinations for women who are not pregnant are as follows:
First examination: Ultrasound to detect the gestational sac (5th-6th week of pregnancy) and the baby's heartbeat (7th week of pregnancy). Following the 8th week), blood pressure and body weight are measured and recorded. In order to determine whether the pregnancy is a risky pregnancy, information about previous pregnancies, complaints arising during this pregnancy, previous diseases and surgeries of the expectant mother, medications used, smoking and alcohol use, whether there is a hereditary disease in the couple's family and whether there is a consanguinity between the spouses should be questioned. Fasting blood sugar, blood group and hepatitis tests are requested. If the expectant mother is HBs Ag positive, the baby should be vaccinated and given immunoglobulin immediately after birth to prevent transmission to the baby during birth. The vaccine should be repeated in the 2nd and 6th months. If the pregnant woman does not have a smear test within the last year, it is recommended to take a smear from the cervix. In couples with blood incompatibility (mother Rh -, father Rh +), an indirect Coombs (IDC) test is requested to determine whether the baby is affected. After birth, the baby's blood type and direct Coombs are checked. If the baby's blood group is Rh+ and the direct Coombs test is negative, Anti IgD vaccine is given to the mother within the first 72 hours after birth to prevent negative effects on subsequent babies.
Second examination: 11-14. In addition to body weight and blood pressure measurement, repeat ultrasound is required during the pregnancy weeks. To screen for Down syndrome with ultrasound, nuchal skin thickness measurement and the presence of nasal bone (nasal bone) are checked; Blood is taken for PAPP-A and f-beta HCG measurement. With this test, 90% of babies with Down syndrome can be detected. Rh – IDC test is repeated in pregnant women. 16-18. The risk of the baby having Down syndrome is determined by evaluating the HCG, estriol and alphafetoprotein levels in the mother's blood during the gestational weeks together with the mother's age and gestational week (triple screening test). With this test, 64% of babies with Down syndrome can be detected. This test only shows the risk, and for a definitive diagnosis, a sample (CVS) is taken from the baby's partner in the first 3 months of pregnancy, and a sample is taken from the fluid around the baby (amniocentesis) in the second 3 months.
Third examination: 22-24. week of pregnancy Following body weight and blood pressure measurement, blood is taken for a complete blood count. If the hemoglobin value is below 11, iron medication is recommended. During these weeks, a detailed ultrasound examination, in which all the baby's organs and heart are examined in detail, and, if your doctor deems necessary, a Doppler ultrasound examination, which examines the blood flow in the uterine vessels, should be performed. 24-28 weeks of pregnancy to screen for gestational diabetes, which occurs in 4% of pregnancies. A 50 gram oral glucose challenge test should be performed between weeks. In this test, blood sugar is checked 1 hour after drinking 50 grams of glucose on an empty or full stomach. If it is above 140, diabetes is diagnosed by performing a loading test with 100 grams of glucose. Rh - IDC test is repeated in pregnant women.
Fourth examination: In addition to blood pressure and body weight measurement at the 32nd week, ultrasound should be performed to evaluate the development of the baby. Rh - IDC test is repeated in pregnant women.
Fifth examination: This is the last visit to be made at the 38-39th week of pregnancy to plan the type of birth depending on the estimated birth weight of the baby and the suitability of your bone structure. In addition to measuring blood pressure and body weight, the baby's weight and water status are measured with ultrasound, and the baby's heartbeat is evaluated with NST. After the 38th week of pregnancy, NST and ultrasound follow-ups continue until birth as often as your doctor deems appropriate.
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