Monitoring pregnancy from conception to delivery

Pregnancy is a special period in a woman’s life associated with a plethora of corporeal and emotional changes. Pregnancy is filled with moments of excitement and bliss for both the parents and the OB/GYN consultant that follows the entire growth process of the fetus. The expecting mums always have common questions and fears related to the pregnancy: Is the baby healthy? Could anomalies appear?… Today, with the development of modern technology and methods for fetal check-ups, it is very realistic to say that giving birth to a healthy baby is almost guaranteed.

During the first check-up, when the patient thinks she might be pregnant, we would do an echo ultrasound check-up to confirm intrauterine pregnancy, the presence of an embryo or fetus in the womb and the degree of the pregnancy and whether it corresponds with the date of the last menstrual period.  The OB/GYN specialist would also check for fibroid formations or ectopic pregnancy. The expecting mum would then be measured for height, weights and blood pressure.

You should inform the attending gynecologist about your menstrual cycles (regularity, duration, flow etc.), about any previous pregnancies and their outcome, if you’ve had miscarriages and on the manner of previous childbirth (if you have any).

You should inform your doctor about previous diseases or surgery, if you have any acute or chronical conditions, pollen, food or medication allergies, if there are cases of diabetes, hypertension, kidney or brain ailments or cardiovascular diseases.

It is recommended to provide us with a blood analysis, SE, glycemia, Fe, blood type and Rh-factor test result. If the patient hasn’t done these tests, we could arrange them to be done in our hospital laboratory.  The expecting mum is advised on the supplements she should be taking, their dosage and amount.

If this is your first pregnancy, we recommend to have 10 check-ups, if you already have offspring, you could have 7 check-ups during pregnancy. If there are unwanted complications and/or high-risk pregnancy, the number of check-ups could increase. Your attending OB/GYN would monitor your weights, blood pressure, blood and urine analysis and the fetus’ growth. In addition to these regular check-ups, other, more specific examinations might be required.

First trimester – At the beginning of pregnancy we would do an OB/GYN check-up during which we would take detailed anamnesis about the previous surgery, diseases or conditions of the expecting mum, the inoculation she has received and possible disease and conditions in the family. During this semester we would advise doing the microbiological swabs and a microbiological analysis of the urine. Vaginal infections raise the risk of premature birth and of the baby getting an infection, so it is very important to detect and treat any possible infections early on. Blood and urine analysis should be done once a month. A blood type and Rh-factor test could also be done. In the period between week 11 and week 14 the first ultrasound screening should be done in order to rule out any chromosome anomalies. The ultrasound check-up should be done in this period because we would look at certain parts of the body that have telltale signs of possible abnormalities, signs which usually disappear after week 14. Should you miss this first ultrasound check-up, there is no possibility to determine the Down syndrome marker, which points to an untreatable condition but which cannot be detected at a later point in the pregnancy.

Second trimester – From week 18 to week 22 we would do an ultrasound screening to check the fetus’ growth, to look at its anatomy in detail, every organ etc., in order to rule out genetic anomalies and possible birth defects, whether its something cosmetic or the more difficult type of defect that could affect the baby’ life. We would analyze the umbilical cord, the placenta, the cervix length etc., in order to determine the risk or a premature childbirth. Between week 24 and 28, we advise a gestational diabetes test to be performed.

Third trimester – Between week 30 and 34 we would do an ultrasound check-up to confirm the fetus is developing proportionally and correctly. We would detect if there is a stall in the fetus’ development, which might indicate issues with the placenta. A doppler test would determine whether the circulation of matter through the umbilical cord is sufficient or if not, what time would be ideal to instigate childbirth, all with the goal of getting a healthy baby. The check-ups in month 9 are more frequent and we would also start with the CTG fetal monitor, which monitors the fetus’ heartbeat. The CTG monitor also detects if there are any uterine contractions, their duration and intensity. It allows us to evaluate the condition of the baby and whether the contractions are preventing enough oxygen and feed to get to the fetus. We would do a microbiological testing as well, looking for GBS streptococcus infection, which is a common bacterium usually found in the colon, harmless to adults but could create complications for the baby. This test is done by swabbing the vagina and the perineum. If the test is positive, you would given antibiotic treatment the moment the delivery process starts in order to protect the baby from getting infected with it.