At the first antenatal visit, your complete medical history will be taken, the dates of the pregnancy established and various tests will be discussed including ultrasounds. Ultrasounds can be performed at the rooms when indicated. Print outs of images can be done, or if you have a clear USB flash drive, electronic images and video can be taken for you. Depending on your dates, the first visit may involve a discussion on screening tests for Down’s syndrome and other genetic issues as well. I will outline the management plan for your pregnancy based on the initial history and examination.
Prior to 20 weeks antenatal visits do not have to be particularly frequent – this increases after 20 weeks to approximately once a month but this may vary. I recommend fortnightly visits between 30 and 36 weeks and then weekly from 36 weeks onwards. I recommend a postnatal visit at 6 weeks after your baby has been born.
The following investigations are recommended during your pregnancy :
Initial tests (sometimes done by your GP)
Full blood count, blood group and antibodies, Syphilis, Rubella (German Measles) Hepatitis B and C, HIV and a urine culture.
Testing for Varicella (Chickenpox), Toxoplasmosis, Parvovirus, Cytomegalovirus is optional – some GP’s may do it up front anyway.
First Trimester Ultrasound
First trimester ultrasound is recommended to determine the dates of the pregnancy, particularly if there is any question over the menstrual cycle dates. I can do this in the practice rooms during the initial visit.
Screening for Down’s Syndrome and Other Chromosomal Issues
This is generally done with a blood test and nuchal translucency ultrasound between 11 and 14 weeks. The ultrasound has to be done in an accredited facility. The pros and cons of screening for these conditions will be discussed with you at the first visit. NIPT (Non-invasive Prenatal Testing) is now available through various pathology companies.
This is a routine ultrasound recommended at 18 to 20 weeks which examines the baby’s anatomy and the placenta. It has to be done in an accredited ultrasound facility. You can find out the sex of the baby at this ultrasound if you wish.
Diabetes in pregnancy is more common in women over the age of 35, who are overweight and have a family history of diabetes. Birth outcomes can be more serious in this group of women. I recommend a screening test after 20 weeks.
I recommend routine folate supplementation during the first trimester of pregnancy to prevent spina bifida. There are a number of multivitamins available which provide adequate folate and other vitamins and minerals. I strongly encourage routine exercise during pregnancy and a healthy lifestyle, all of which are beneficial for your pregnancy, labour and baby