Often once women find out they are pregnant they are confused about the next step and where to go forth in terms of medical care. Once a pregnancy has been confirmed by a pregnancy test it is usual for a doctor’s appointment to be made. It is up to the GP to refer the pregnant women to a midwife where follow up appointments for maternity care will be made.
First Antenatal Appointment
The first antenatal appointment is known as the booking appointment, it is a chance for the midwife to gather history about you, your partner and family members so that she/hecan figure out the best care for you. It is important that the midwife be made aware of any health conditions faced by either family as some may have a bearing on the pregnancy. It is also an opportunity for you to ask any questions in which you need to and get information on things which you may be concerned about. The official booking in to the local maternity hospital is done then so the pregnant women can be scheduled for her antenatal appoints at the hospital. The booking appointment with the midwife should be done between 8-10 weeks leaving enough time for the first scan to be scheduled for between 10-13 weeks pregnant.
The next appoint that is usually scheduled is at the hospital in the maternity care. This will usually be the first appointment at the hospital, and various tests including a dating scan will take place. A dating scan is an ultra sound scan that looks at the measurements of the foetus and predicts around when the time of delivery will take place, the due date. This will take place before 14th week of pregnancy but usually not before the 10th week unless there have been problems. This will give the couple chance to see their first glimpses of the foetus/baby. At the scan abnormalities can be checked for if you wish this to happen. Aswell as the dating scan a nuchal translucency scan can take place which can estimate the likelihood of the foetus having Down’s syndrome. The scan is combined with a blood test to detect for indicators for Down’s syndrome. Other blood tests maybe also done on this day to check for immunity of rubella, iron levels, blood group, rhesus type. Optional screening for Down’s syndrome and spina bifida. Tests for HIV and hepatitis B will also be tested for unless asked not to. Urine will be checked for protein to rule out urinary infections, kidney problems, high blood pressure and diabetes. And finally blood pressure to will also be checked.
If the screening tests for Down’s syndrome show that the foetus is at high risk for having Down’s syndrome and maybe other complications then further tests are offered. The nuchal translucency (NT) scan and the blood test for Down’s syndrome are only screening tests and cannot give certain and definite answers. To get a definite answer a diagnostic test is needed. Chronic Villus Sampling (CVS) and an Amniocentesis can be performed to give an almost certain answer.
A second appointment with the midwife will take place and this is a chance to discuss any results from the time of the dating scan. If all the results come back normal then the next appointment needing attending will be at the hospital for the anomaly scan. If there were any problems with the tests conducted then further investigation would be needed and all will be explained thoroughly by the medic team.
This scan will take place before 21st week of pregnancy but not before the 18th week. The person performing the scan is the sonographer and they are looking at how the foetus is growing and if the uterus looks how it should. Primarily the scan is to check if all parts of the foetus are developing as they should, that there are no complications or abnormalities with any part of the foetus including the organs. The scan can also look at the placenta to ensure it is in the right place. At this scan the gender can be predicted but it is not 100% accurate. This scan is important as it is looking out for various conditions some that maybe life threating once the foetus is born and others that may just need treatment. The scan is vital so that both the parents and the medics can be prepared if any of the conditions are present. The life threating conditions are very rare and most of the treatable conditions are not common but it is always best to be prepared so having the information to hand is important. If any complications are flagged up then they will be looked in to thoroughly by the medic team and investigated. It is essential to remember that a huge majority of babies are born normal.
Follow up Antenatal Appointments
After the anomaly scan and if all is well no more appointments at the hospital are needed just appointments with the midwife will take place usually at weeks, 25, 28, 31, 34, 36, 38 40 and 41 weeks if still pregnant. If this is not a first pregnancy then fewer appointments are needed and they will vary. At these appointments any questions or concerns are discussed. Blood pressure is taken as this shows how well the body is coping with the pregnancy and is an indicated if pre-eclampsia maybe present. Urine is also checked for protein again looking for signs of pre-eclampsia or urine infections. As the pregnancy progresses the pregnancy bump is measured to ensure that the baby is growing correctly. If there are any issues at these appointments the midwife may refer you back to the maternity hospital to be checked out.
Tests and appointments vary depending on different areas, medical history and backgrounds.