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Prenatal care in First Trimester

When you are pregnant, book an appointment and visit your doctor as soon as possible. He will determine the due date of delivery. He will ask you for the first day of your last menstrual period to calculate your due date. There are two methods used. Counting 40 weeks from the first day of your last menstrual period, or adding seven days to this date and then subtracting 12 weeks. If you cannot remember it accurately, he will perform an ultra sound to confirm the gestational age of the baby.

Your medical history is also very important. History of genetic diseases, previous pregnancies and chronic disease are necessary in deciding on the best method to manage the pregnancy.

The doctor will examine your blood pressure, weight and height. He may evaluate your overall health and the ability to carry the pregnancy to term. He will conduct blood tests to check your blood group and Rhesus factor. Sexually transmitted diseases such as HIV may also be investigated.

You will be advised on importance of exercises, balanced diets, supplementary vitamins and subsequent prenatal visits.

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Prenatal Care in Second Trimester

Prenatal care during the second trimester focuses on your blood pressure, weight and fundal height. Using a Doppler, the doctor will listen to your baby’s heat rate. Ultra sound may be performed to visualize the baby and determine the sex.

The fetus has noticeable human organs. Fetal movements known as “quickening” are felt. This occurs between the nineteenth and twenty first week. Variations occur especially on women who have conceived before. They may experience quickening movements much earlier. Consult your doctor if you do not feel these movements at this time. The placenta is fully formed and functions adequately. The fetus starts to secret insulin and may pass out urine. The reproductive organs are clearly discernible into either male or female.

The doctor may perform blood tests to diagnose chromosomal disorders and malformations such as spina bifida.


Fundal Height

Fundal height determines the growth of the baby and the gestational age. It is the height between the pubic bone and the top of the uterus (fundus) measured in centimeters. Normally, after 12 weeks of pregnancy, the fundal height reading corresponds to the week of pregnancy. If you are 25 weeks pregnant then the fundal reading should be 25 cm. Variances show presence of fibroids, excess amniotic fluid (polyhydramnions), inadequate amniotic fluid (oligohydramnios), abnormal fetal growth or a baby positioning in a breech. Sometimes if you have a full bladder, slim body or when you are carrying multiple babies then you may have abnormal fundal height reading.

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Prenatal Care in Third Trimester

In the third trimester, your doctor will schedule your prenatal care more frequently. He will check the following:

  • Heartbeat of the baby
  • Blood pressure
  • Weight
  • Fundal height
  • Position and size of the uterus

Group B Streptococcus Bacteria (GBS)

Infection of the baby with group B streptococcus bacteria (GBS) is common especially when the baby is delivered prematurely (before 37 weeks). Inform your doctor in advance if your previous baby was affected by these bacteria. The doctor will screen you for group B streptococcus. If the swabs taken from the vagina are positive, then during labor, you will be given intravenous antibiotics to prevent transmission to the baby.

Pelvic Examination

The pelvic examination will reveal the position of the baby. Your doctor will feel the head of the baby in the lower abdomen or at the top of the birth canal. The best position is head facing the birth canal. If not it is called a breech and the doctor may recommend a caesarean section to deliver the baby. He may advice you to engage in physical activity that can make the baby turn or try external cephalic version (ECV). ECV involves exerting pressure in the abdomen to turn the baby. It is a very risky procedure. Placental hemorrhage can occur during ECV which can lead to demise of the fetus.


Cervical Examination

Cervical examination will reveal dilation and thinning of the membrane. Dilation is measured in centimeters and thinning (efface) is measured in percentage. During delivery, the cervix will be 10 cm dilated and 100% effaced.
Disclaimer: Information contained on this Web site is intended solely to make available general summarized information to the public. It should not be substituted for medical advice. It is your responsibility to consult with your pediatrician and/or health care provider before acting on any advice on this web site. While OEM endeavors to provide up-to-date and accurate information, it is not liable for any advice whatsoever rendered nor is it liable for the completeness or timeliness of any information on this site.
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