Analysis Required During Pregnancy
1. Hemoglobin and hematocrit;
2. Blood grouping and Rh (also for husband);
3. reaction or other serological test for syphilis;
4. Examination of vaginal secretion;
5. Urine analysis;
6. Determination of glucose from blood;
7. Serological tests for infectious diseases;
8. Ultrasound is especially advisable if the obstetrician does not have reliable data provided by history, if uterine size is greater or less than pregnancy age, if pregnant presents a risk factor;
9. Depending on the age and history of the couple there is recommended genetic exam, preferably preconception, amniocentesis and fetal measurements.
So, first prenatal exam sets if the pregnant has a physiological pregnancy or a pregnancy with increased obstetrical and fetal risk, the latter requiring intensive supervision. Pregnant should be informed of her situation, be informed about hygiene measures and the possible risks.
Subsequent prenatal consultations
The consultations should be done monthly in the second quarter and bi-monthly in the third quarter. Some authors argue that after week 36 pregnant women should be examined weekly. The frequency of subsequent prenatal consultations depends by complications that can occur during pregnancy.
Subsequent consultations appreciate overall condition, with special attention to general clinical examination and especially to the curve of weight, blood pressure and edema.
After general physical examination there is performed obstetrical exam with evaluation of uterine fundus height, abdominal circumferen
ce, is noted the first appearance of fetal movements and in the last quarter the fetal heart rate is listened. After week 36 is needed at every appointment a vaginal tact.
Urine analysis is performed at each prenatal consultation and in between weeks 30 -32 of gestation hemoglobin and hematocrit are repeated. In case of AB0/Rh incompatibility the antibodies are dosed between weeks 24 -28 and antepartum.
Ultrasound is valuable in determining gestational age, weight, fetal growth and condition.
In pregnancies with high risk for fetal monitoring can be used a series of biochemical and biophysical tests.
Biochemical tests (determination of urinary estrogen, the HPL, the alfa-fetoprotein) are now replaced by biophysical tests, which include:
– Antepartum cardiotocography.
Further, between weeks 20 -40, is established the prenatal furlough, the place where the birth will take place.