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A visit to your obstetrician
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Here are tests that are usually conducted to ensure the well-being of mother and baby
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FIRST TIME There are certain questions the doctor will ask you
Dhanalakshmi is excited. She suspects that she is pregnant. She and her husband have fixed an appointment with her obstetrician. She has discussed obstetrician's visits with her friends who have already delivered. She has apprehensions that she hopes her obstetrician will allay.
The first visit
At your first visit, your obstetrician will first ask you some questions. She will find out any symptoms you have due to the pregnancy. She will also ask you about your family history. This will let her know if you are at any risk for developing complications during the pregnancy. If you have been pregnant before, she will ask you about the kind of delivery you had. She will then confirm the pregnancy. She will perform an examination to determine the size of your uterus, which will tell her how pregnant you are.
Examination of the uterine size
In early pregnancy, the first visit usually involves assessment of the uterine size to determine if the pregnancy corresponds to the dates that you have given. Your obstetrician will do an internal examination and feel the size of the uterus. After the third month of pregnancy, the examination is usually of the abdomen only. This is because after the third month of pregnancy, the uterus is felt abdominally. The doctor will examine the size of the uterus and know whether the baby is growing well or not.
Tests
At the first visit, you will undergo some tests. These blood tests are:
{bull} Haemoglobin and hematocrit — to find out if you are anaemic.
{bull} Blood group and Rh type — particularly important if you are Rh negative.
{bull} VDRL or RPR are tests for syphilis because though it is rare, it can cause abnormalities in the baby.
{bull} Hepatitis B and HIV are infections which can be transmitted to the baby and therefore it is mandatory to test you for these infections so that measures can be taken to prevent it spreading to the baby.
Later in pregnancy, you may be tested for diabetes in pregnancy since it is particularly common in Indian women.
Testing for Down syndrome
Down syndrome is the commonest cause of mental retardation in humans.
It is caused by the presence of an extra chromosome. Since it can occur at any age, all women should ideally undergo testing for it. The risk for Down syndrome increases with age therefore women 35 years or older should definitely ask their obstetrician about this test. It is a combination of a blood test and an ultrasound. If the test comes as positive, you will have to undergo a test of the amniotic fluid inside the womb. This test is called the amniocentesis.
Listening to the foetal heart
Using an electronic device called the foetoscope, the foetal heart can be heard from the third month of pregnancy. If your obstetrician uses a regular foetoscope, the heartbeat can be heard from the fifth month onwards. Listening to the foetal heart beat reassures us that the foetus is healthy and well.
Checking your blood pressure
At every visit, your blood pressure will be checked. The obstetrician looks for an abnormal rise in the pressure. There is truly no condition called `low blood pressure'. The normal blood pressure for Indian women ranges between 90/60 mm of Hg and 120/80 mm of Hg. When the blood pressure is 140/90 mm of Hg and higher, high blood pressure is diagnosed.
Checking your weight
Your weight will be recorded at every check-up. It is normal to gain half to 1 kilo during each month of your pregnancy. It is normal to gain 10 to 12 kilos during the pregnancy. If your weight gain is poor, the size of the baby may be small. If you gain too much weight, it will be difficult to lose it after the delivery.
Checking your urine
You will be asked to give a urine specimen at each visit. The urine is tested for the presence of albumin and sugar. Albumin can be present in a certain complication of pregnancy called `pregnancy induced hypertension' or `pre-eclampsia'.
Ultrasound examination
Your obstetrician will ask for an ultrasound examination to get an idea about how the baby is growing. Usually, the scans are done in the third month and between the fifth and the sixth months.
Repeat visits
Usually you will be asked to come for a monthly check-up till the 32ndweek of pregnancy. After that, you will have a check-up every 2 weeks.
In the last month of pregnancy, you will be asked to come for weekly checkups.
GITA ARJUN
(The author is a Chennai-based obstetrician and gynaecologist with a special interest in women's health issues)
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