Antenatal Care

A Journey.....

Planning for Pregnancy?

Congratulations and best wishes on the very first thought.

• Start a healthy diet and exercise
• Stop alcohol, smoking, vaping
• Consult a doctor if you are on any drugs or have any chronic medical problem for a gynecology evaluation.
• Your doctor may do a gynecology checkup, order some tests like blood sugar, or thyroid test based on your medical history
• Start taking folic acid tablets.

Pregnancy is a natural state but a very delicate situation as it comes with bouquets of changing symptoms and signs throughout 9 months.

This journey can be quite fascinating, but good family support, obstetric care, and hospital facilities can ease your anxiety.

Generally, in normal pregnancy without medical issues or complications, you will have 8-10 visits till delivery and on each visit, the gynecologist looks for your general condition, assess the baby’s growth, and advises relevant tests and scans with medications.

Between WEEKS 8 to 12:

A gynecologist takes a detailed history of the menstrual cycle and tries to get an estimated date of delivery.
She will enquire about health issues by taking detail of past medical, surgical, and family history.
She may order first-trimester ultrasound with genetic testing and routine blood tests are ordered.
Supplements with folic acid and concerns like nausea, vomiting, and bleeding constipation are addressed and taken care of.

Between WEEKS 12-16:

During this visit you may know the expected date of delivery, you may know you are carrying more than one baby and whether they are sharing a common placenta or not.
Your gynecologist can try and investigate if your baby is suffering from any genetic abnormalities, such as Down syndrome.

Between WEEKS 18-21:

During these visits, you will be advised anomaly scan to check whether there are any physical abnormalities in the baby.
In some countries where legal gender disclosure can be done around this time.
She orders any missed-out investigations and refills supplements.

Between WEEKS 24-28:

Apart from routine checkups, you will be advised for screening tests for gestation diabetes if you are not known as diabetic already.
Your blood pressure and urine protein will be checked.

Between WEEKS 28-32:

Your obstetrician may conduct blood tests to check for anemia and any antibodies in the blood. In case you are found to be Rh-ve, you may be advised Anti D injections.
A growth scan may be ordered if you have a history of a previous low birth weight baby or have Diabetes or Hypertension.

Between WEEKS 32-34:

Your Blood pressure and Urine are checked apart from a routine antenatal checkup.
A growth scan may be ordered if not done at 28 weeks.
T Dap vaccine will be offered.

Between WEEKS 35-37:

Routine Antenatal checkup for fetal wellbeing.
Your obstetrician will take a vaginal swab to screen for Group B streptococcal bacteria colonization in the vagina.
You may be offered antennal classes about how to breastfeed your baby, how to take care of your health after delivery and you may be told about post-partum depression and blues.

WEEK 37 Onwards:

You are close to your delivery. So, keep your bag packed as you may attend the hospital anytime on the onset of labor symptoms. You will be told about symptoms of labor, fetal movement monitoring, and when to attend the emergency department.
A vaginal examination is done after 37 weeks to check for the favorability of vaginal delivery or induction and a plan of delivery may be discussed.
Most patients go into labor by 38-40 weeks only 4 % reach up to 40 weeks.
If a woman wishes to continue a lot of parameters are looked into like medical conditions, baby growth, and liquor assessment. Her willingness of thorough monitoring is also required.

Induction of LABOUR:

Many women are offered induction of labor based on medical conditions, and previous and present pregnancy events by possibly 36-40 weeks.
In some cases of previous surgery on the uterus like Caesarean section, or fibroid removal, there will be a collaborative discussion about time and mode of delivery as per international guidelines and hospital protocols.

Referral to a Higher Centre:

Some patients may need a timely referral to a higher center like a feto-maternal center or a center with the facility of pediatric surgery if the baby is suspected to have congenital defects.