Your first visit to a doctor during pregnancy
Once your pregnancy is confirmed, contact your midwife to "schedule" a visit to the doctor. It should take place between 8-12 weeks, and it should not be missed.
In this visit, a flurry of questions will pour on you, but if you prepare for them, you will probably be less dumbfounded. Your doctor will probably start with a review of your health, your partner, your current and past, and then a series of checks, such as your weight and blood pressure, will follow. You will be asked to take urine and blood tests, which will be taken from the vein for various laboratory tests. At the end of the visit, you will be given a schedule of the following visits to the doctor, which will depend on your medical condition.
Case file
Collecting information about your health and health status of your partner - is one of the goals of the attending physician on the first visit. Such a survey process is called "compilation of the medical history".Your doctor will ask you various questions about all aspects of your life, so pay attention to the questions shown in the box on p.88.
It is important to be honest and accurate, as all the details you give will help create a complete picture of your health history, which will facilitate the definition of "risk areas".Do not be embarrassed when answering personal questions and do not get discouraged when you need to disclose information of a certain kind( for example, about miscarriages that you had earlier), as the attending physician should know everything about the health of the pregnant woman. If you can not remember all the details of a previous pregnancy, give the doctor as much information as possible and he will try to supplement it with other sources.
Physical Examination of
Most women do not need a full examination, but there are some aspects of your health that the attending physician will want to "access".First, he will need to listen to your heart and lungs to make sure that they are strong and healthy, and also to check your breasts. Discuss the question of lactation, especially if you are concerned about something, for example, think that your breasts are too small, nipples of unusual shape or you have suffered a surgical( including plastic) operation on your chest.
It may be necessary for the physician to perform an examination of the pelvic area to determine the size of the pelvic floor and uterus. To determine the duration of pregnancy or the presence of twins, you may be offered to conduct an ultrasound examination. If you have not already given a cervical smear, you will be asked to enroll in this check in the postpartum period.
Weighing
The first time you visit a doctor you will be weighed. After that, the doctor will weigh you only if you are underweight or overweight during pregnancy or if you do not pick it up at the right pace. Too much weight will not allow the doctor to determine how a child develops, and it is more likely to cause complications such as gestational diabetes. Lack of weight also refers to abnormal phenomena-if your weight is below average, then the doctor will want to monitor the development of the child more carefully, because a child can grow differently than expected.
Blood pressure
The doctor will check the blood pressure at each visit, which is an important part of prenatal care, since the usual complication is high blood pressure, especially in later stages of pregnancy. The measurements obtained at the first visit to the doctor will be the starting point from which the subsequent ones will be compared. You should get acquainted with the numbers registered in your card, for example 120/70.Blood pressure is measured in millimeters of mercury, which is written as mm Hg. The first digit is systolic pressure( that is, when the heart is contracting), the second is diastolic pressure( i.e.,
Your first visit to the doctor will be successful and productive if you prepare it in advance. In addition to the questions below, it's good to talk toyour mother to find out about her pregnancies Ask your spouse to get the same information from his mother
1 How are you with your health than you were sick in your family or in the family of your spouse were there any hereditary diseases?with the operation and, therefore, anesthesia, whether you were in the hospital for a long time? Do you have any allergies to any medications?
2 Do you have any chronic medical conditions? Do you take medicines and did you take them when you found out you were pregnant due to a chronic illness like asthma and hypertension?
3 If this is not your first pregnancy, when was the previous one? Was it a healthy normal pregnancy or did it occur with complications? You should also inform your doctor about any abortions or miscarriages you have.
4 Do you exercise regularly? How much do you stick to the principles of healthy eating? Do you smoke? How much and how often do you consume alcohol? Do you use any relaxing medications?
5 What is your ethnic background? Since certain medical conditions prevail in some ethnic groups, your health care provider may want to know where the family members from you and your spouse come from.
6 What do you do for a living? Does your work have any risks and dangers to the unborn child? Do you work with chemicals or X-rays? Do you work at high or low temperatures? Do you often have to travel elsewhere? Do you have a busy schedule?
7 Do you have a quiet permanent place to live? Is it clean? Is it safe?
8 When was the first day of your last menstrual period? The day of your birth is calculated exactly by this date, How regular are your menstruation, how much are they separated from each other?
9 Did you use any contraceptive when you found you were pregnant? If you have an intrauterine contraceptive, inform your doctor about it, since it carries a potential risk of complications. If you took pills, when you found that you were pregnant, this should not damage your pregnancy and your baby, but the timing of conception and childbirth may be inaccurate.
when the heart is at rest).Your pressure is likely to decrease in the first 24 weeks of pregnancy, with the systolic pressure dropping by about 5-10 mm Hg.st., and diastolic - by 10-15 mm Hg. Art. In the third trimester, however, the pressure should return to its pre-pregnancy level. If it continues to increase, you will be checked for pre-eclampsia. Sometimes doctors prescribe medications to lower blood pressure.
Analyzes of urine
Changes in your body can mean that during pregnancy you become more prone to infections of the kidneys and urinary tracts -about 4% of women in urinalysis show bacteria. It is important to recognize and then cure the infection while you are carrying the baby at an early stage, because these types of infection can lead to premature birth.
Usually urine is not sent for analysis to microorganisms until the indicator shows a possible infection or the presence of white blood cells, blood or protein. The analysis on microorganisms can be carried out against women who have had recurrence of urinary tract infections, kidney disease, diabetes or sickle cell anemia.
REGULAR BLOOD ANALYSIS
Your doctor probably explained what a blood test is and why it is taken, but if you do not understand something about a special test, ask for clarity. At the first
visit to the doctor you will be asked to donate blood from the vein;during pregnancy, it may be still necessary such tests, but it depends on your health condition or the detection of any complications. Fortunately, to make all the tests, one blood sampling is enough.
Rubella
It is possible that you have rubella or been vaccinated against it as a child, so you will not be infected again, and your child will not get sick. If you have rubella at the beginning of pregnancy, which is very rare, your child is seriously threatened, for example, learning difficulties. If it is found at the examination that you are not immune, then you can get an inoculation after the birth of the child, in order to be protected in subsequent pregnancies. Most women are recommended to abstain from pregnancy within three months after vaccination. If you become pregnant during this period, do not worry, as there is no record of the adverse consequences for the born children in such situations.
About hypertension of "white coats"
In some women, blood pressure rises only from the fact that they are in the hospital or in the doctor's office. If your attending physician assumes that high indications are due to the environment, you may be offered a blood pressure tonometer to measure pressure at home. In such a tonometer, an automatic cuff is used, which measures every 15 minutes during the day. If you have high blood pressure or there is a risk of pre-eclampsia, you may have to measure the pressure daily.
Complete blood test
As is clear from the headline, this blood test checks the level of all blood cells: red( oxygen-carrying), white( fighting infections) and platelets( responsible for blood clotting).If you have, say, anemia, then the level of red blood cells, and therefore hemoglobin, in which iron is the main component, is low, the doctor will prescribe to you the iron-containing drug. You may also be advised to include in food more iron-rich foods, such as dark green leafy vegetables, red meat, including a small amount of liver, shellfish, especially marine, dried fruits, vitaminized cereals, pasta and bread, eggs. Since iron deficiency anemia mainly develops after 20 weeks and especially in the third trimester, a survey for low iron levels usually repeats with an increase in the gestational age.
Blood type and Rh factor
This blood test, performed at the beginning of pregnancy and repeated in the third trimester, allows you to determine your blood group, I, II, III or IV, Rh factor, positive or negative, antibodies,including rhesus. Knowing the blood group is important in case you need a blood transfusion during childbirth. The Rh factor is vitally important, because if your child has a positive and you have a negative, perhaps you are producing antibodies to your baby's red blood cells. If you become pregnant again and your next child has a positive rhesus, the antibodies you developed can destroy his blood cells. This creates a risk of the child developing a serious form of anemia, called hemolytic disease.
However, due to modern methods of treatment, this disease is extremely rare. Mothers with negative rhesus are immunized with Rh immunoglobulin( anti-D), it is absolutely safe and prevents the formation of antibodies that attack your baby's blood cells.
Hepatitis In
In , all future mothers are now offered testing for hepatitis B. If you are a carrier of a virus, your child needs a vaccine and an immunoglobulin to prevent hepatitis.
Although you can not test for HIV without your consent, all pregnant women in the UK are offered HIV testing. Such information is important to obtain, since immediate treatment can reduce the risk of transmission of the virus to the child, as well as support the health of the mother. If you think you could be at risk of a disease in the past - sex without security or sharing needles, - should be tested for the sake of the child.
If the response to HIV is positive, you will be referred to a specialist who will watch you during pregnancy. The likelihood that your child will be infected will decrease significantly - from about 1: 4 to 1:50 - due to the currently used antiretroviral treatment of and taking into account the choice of cesarean section. After giving birth, you will be advised not to breastfeed, as the virus can be transmitted with milk.