All the information you should know about the revisions of the pregnant
Congratulations: the test has been positive. You are waiting for a baby! Now, you have to take care of yourself and avoid anything that could harm the baby that is forming inside you.
To control the development of the fetus and the well-being of the pregnant woman , a different medical tests are carried out during the pregnancy . Therefore, you must request an appointment as soon as possible with the doctor, to confirm the pregnancy and send the first tests.
At the first appointment, the gynecologist will send you a complete blood and urine test to confirm the pregnancy, know your health status, rule out infectious diseases such as HIV, Hepatitis B or syphilis, and check if you have rubella and toxoplasmosis (a mild illness for adults, but very serious for the developing fetus) and a cytology to rule out vaginal infections.
In Social Security, usually, you have to go through the family doctor to meet with the gynecologist who will carry the pregnancy. To save time, the doctor usually sends these first blood tests and also the cytology (done by the midwife of the health center).
Whether you go for public health or for private, once the pregnancy is confirmed, the gynecologist will make an exhaustive medical history to know your antecedents and if there is any special condition that must be taken into account (diabetes, heart problems, serious diseases, etc).
Then, he will recommend taking the supplements he considers necessary: folic acid (if you were not already taking it), and iron or iodine if you had deficiencies. After this first visit, you will often go to the gynecologist to follow up on the pregnancy. In all the visits, the specialist will control the tension and the weight of the mother and will solve the doubts that arise on the pregnancy and the necessary cares . In private health, the reviews are monthly.
In the Social Security can be spaced a little more depending on the autonomous community, and even the hospital to which it belongs, but it is usually complemented by the follow-up with the midwife of the health center.
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Ultrasounds are very useful to control the development of the baby and its well-being inside the uterus. They are non-invasive tests that have no negative effect on the fetus, so you can perform all that the doctor considers necessary.
In the Social Security protocols establish a minimum of three scans, one per trimester , although more are performed if necessary. In private medical insurance, ultrasound control is usually more frequent. Some doctors do ultrasound every month. In addition, an ultrasound is usually done to confirm the pregnancy.
In all ultrasounds, the size of the baby is measured, its movements and beats are evaluated, the amount of amniotic fluid, the position of the placenta and the probable date of delivery is calculated.
Ultrasound of the first trimester: Towards week 12
In this ultrasound, which is usually vaginal, it is checked if there is more than one baby and the nuchal fold of the fetus is measured to assess the risk of chromosomal abnormalities.
Ultrasound of the second trimester: In week 20 of gestation
The internal organs of the fetus are observed to verify that the baby is developing well. Normally you can discover the baby sex, if you are in a posture that lets you see it.
Ultrasound of the third trimester: Around week 34
The growth of the fetus is re-evaluated and its position is watched for the delivery. If it is breech or crossed, another ultrasound is usually done later to see if it has been placed upside down.
There is another type of ultrasound reserved for special situations:
3D or 4D ultrasound
They are used as a complement to traditional ones. Both allow to see the fetus with volume, and the 4D, in addition, in movement . With them, skin problems or deformities of the cleft lip can be detected, but they do not provide information on other abnormalities detected by normal ultrasound scans. They are very exciting for future parents, because they can see their baby much more accurately.
In Social Security they are used in some hospitals, and whenever it is considered necessary. Some private insurances include 3D scans, but 4D must be paid separately.
Ultrasound with Doppler technology
It is done when it is necessary to observe the circulation in the fetus, the umbilical cord and the uterus, since it allows to detect heart problems or blood circulation.
During pregnancy, at least one blood and urine test is performed per trimester.
In addition, there are some special analytics to detect possible problems:
Test of Coombs:
If the mother is Rh negative and the father is Rh positive, the first blood test checks if the fetus has antibodies in the blood against Rh positive. The test is repeated again in case it has created antibodies and, in addition, as a precaution, in week 28 of pregnancy the mother is given an anti D gammaglobulin, which is repeated after delivery if the baby is Rh + protect future pregnancies.
In the 24th week of pregnancy a special blood test is done to assess the concentration of blood sugar and detect early gestational diabetes that could cause problems in the fetus. If the test is positive, a glycemia curve is made (oral glucose overload) to confirm the diagnosis.
All these tests are included in public health and private health insurance.
In Public Health protocols establish a minimum of three scans, one per quarter. In private medical insurance, ultrasound control is usually more frequent.
One of the things that most worries to the future parents is the possibility that their baby undergoes some genetic alteration. Between the 10th and the 14th week, prenatal diagnostic tests are carried out to calculate if there is a risk and if it is convenient to do other invasive tests (such as amniocentesis ).
In the first trimester blood test the amount of certain hormones and proteins related to some chromosomal abnormalities such as Down syndrome is measured.
The results are assessed together with the ultrasonography of the nuchal fold and the personal circumstances of the mother, such as age. If the risk is high, the doctor may advise amniocentesis (between weeks 14 and 18).
Before making that decision, private insurers can perform another non-invasive test, with an additional cost: the non-invasive prenatal test that, through a blood test, detects Down syndrome and other abnormalities such as Patau or Edwards syndrome. This fetal DNA blood test is now offered in some public hospitals.
About four weeks before the expected date of delivery, around week 36 of pregnancy, the mother is given a vaginal and rectal culture to rule out the presence of a bacterium called streptococcus agalactiae. If it exists, the mother is given antibiotics during delivery to prevent the baby from catching an infection.
Towards week 40 (in the Social Security) or from the 37 (in the private insurance), begin to control the contractions in the mother and the heartbeat of the baby on a weekly basis with a technique called monitoring .
Pregnancy usually lasts 40 weeks, but it is normal for the baby to be born between week 37 and 42. Ideally, it should come to the world naturally, but if week 42 has not shown signs of wanting to leave, it will be program the induction to childbirth.
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