Analysis required during pregnancy – prenatal consultations
1. Hemoglobin and hematocrit;
2. Blood grouping and Rh (husband too, if it is possible incompatibilities);
3. Bordet-Wasserman reaction or other serological test for syphilis;
4. Examination of vaginal secretion;
5. Urine analysis;
6. Determination of glucose;
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 woman presents a risk factor;
9. Depending on the age and history of the couple there is recommended genetic exam, preferably preconception, amniocentesis.
So, first prenatal consultation sets whether the pregnancy is physiological or has an increased obstetrical and fetal risk (requiring intensive supervision). Pregnant woman should be informed of her situation, be informed about hygiene measures and the possible risks.
Subsequent prenatal consultations
They 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 on complications that can occur during pregnancy.
Subsequent consultations appreciate overall condition, with special attention to general clinical examination and especially following the curve of weight, blood pressure and edema.
After general physical examination is performed obstetrical exam to assess uterine fundus height, abdominal circumference, is noted the first appearance of fetal movements and in last quarter the fetal heart beats are listened. After week 36 there will be made at every appointment a vaginal tact.
Urinalysis is performed at each prenatal consultation and in weeks 30 -32 of gestation is repeated the hemoglobin and hematocrit. In case of incompatibility between AB0/Rh, the antibodies are dosed between 24-28 weeks and also before birth.
Ultrasound is valuable in determining gestational age, weight, fetal growth and condition.
In pregnancies with high risk for monitoring the fetal condition there can be used a series of biochemical and biophysical tests.
Biochemical tests (determination of estrogen elimination by urine, the HPL, the alfa-fetoprotein etc.) are now replaced by biophysical tests, including:
– antepartum cardiotocography.
Further, between weeks 20 -40 is established the prenatal confinement and the place where the birth will take place. It is made rickets prophylaxis and tetanus vaccination and psychological preparation for the birth.