Medical care should begin early in your pregnancy. It is important during the last three months to be examined often by your doctor, nurse practitioner or midwife, who will be able to update you on the progress of your pregnancy. If there is any sign of a problem, you will be given advice and told about any treatment necessary.
Your blood pressure is important and will be checked at each visit. An abnormal increase may be a sign of problems that can affect you and your baby. Low blood pressure is rarely a reason for concern.
It can occur temporarily when you lie on your back. In that position, your enlarged uterus puts pressure on several large blood vessels. You may feel dizzy or sweaty, or notice a pounding of your heart. Lying on your side, preferably the left, may help.
Weight gain of 10-15 kg is considered normal during pregnancy. Your doctor will advise you about how much is good for you. Your body may also store some extra water in the tissues, and you may notice a little ankle swelling. However, any rapid or unusual weight gain or swelling should be reported to your doctor.
Urinalysis provides your doctor with valuable information about how your body is functioning. Diabetes and early signs of many problems in pregnancy can often be detected by testing the urine for sugar and protein. Kidney and bladder infections can occur more frequently during pregnancy and are diagnosed by urinalysis. Collect
a clean, mid-stream amount of urine to ensure an accurate result.
During early doctor’s visits, you probably had blood samples taken to determine your blood type and Rhesus (Rh) factor. If you are Rh-negative and your baby’s blood is Rh-positive, you may form antibodies. These antibodies may attack the baby’s blood. This is called Rh disease.
Rh disease may cause your baby’s red blood cells to break down and cause anaemia. The doctor may give you anti- RhD immunoglobulin around 28 weeks of gestation and always within 72 hours after delivery to prevent formation of antibodies against your baby’s Rh-positive blood.
With each subsequent pregnancy, the risk of sensitisation increases. If not treated with anti-RhD immunoglobulin, the baby can develop neonatal jaundice in mild cases. In severe cases, the baby can be still-born.
Your doctor will also check for anaemia or diseases like syphilis, hepatitis B, HIV and rubella. Other tests, such as AFP (alpha-fetoprotein), may be done to screen for certain birth defects. There may also be tests to determine the risk of Down Syndrome in the foetus. Some of these tests may be repeated as your pregnancy progresses.
Sonograms are often used to check for the number of pregnancies (single or multiple), whether the baby is in the womb or outside (ectopic pregnancy), foetal heart condition and size (due date). Later in the pregnancy, ultrasound scanning is used to detect any abnormalities, the position of the placenta, the amount of amniotic fluid and the presenting position of the baby.
Women aged 35 and above have an increased risk of abnormal births. Special tests,eg. amniocentesis (sample fluid in the womb) or chorionic villus sampling (to examine placenta cells), may be recommended to check the baby’s chromosomes.
Your breasts may be examined on your first prenatal visit. If you plan to breastfeed, ask about breast and nipple preparation.
The size of your uterus, which shows the growth of your baby, will be measured. The baby’s position will also be checked. Starting at the third month, your baby’s heartbeat can be heard with a monitor during your doctor’s visits.
A vaginal examination is usually done at your first prenatal doctor’s visit. If this is your first baby, your doctor will evaluate the size of your birth canal. Unless your doctor considers it necessary, you probably won’t have another pelvic exam until shortly before your baby is born. It is performed then to detect changes that commonly occur when labour is about to begin, such as softening, thinning and dilation of the cervix.
Source: MIMS HealthToday Malaysia