Pregnancy Questions

The third quarter of pregnancy

Each time visiting doctor, you should give urine test.

During 7^th to 8^th month period you should visit the doctor one time in 2 weeks, on 9^th month of pregnancy – once a week. Also before everyone arrivals to the doctor it is necessary to hand over the urine analysis.

The doctor will check the arterial pressure, the protein and sugar level in the blood, uterus position, heart activity and attitude of fetus.

Vaginal test also double should be checked.

Certain test like: blood test, AIDS test, syphilis, the biochemical analysis of the blood is taking one more time.

You should pass one more ultrasonic test between 34^th and 36^th weeks. It is to check the placenta (how old is the placenta), estimation and the condition of the baby.

Another test is cardiotocography. This test allows to track heart activity of the baby and uterus muscle activity.

You need to discuss with the doctor some issues concerning childbirth, for example when to call medical care service, when or how to choose the maternity hospital etc.

Some recommendations how to be ready for medical examinations and tests:

1. Many tests required an empty stomach (biochemical test, on hormones, syphilis, a hepatitis etc.). Last food intake should be not less than 8 hours before the test. Even a cup of juice or tea is not allowed.

2. Before giving blood test eat simple food, avoid using sugar, fried and fatty food.

3. Do not run or walk in a fast way blood test.

4. Try to not be nervous during tests because your mood is transferred to the baby.

Second quarter of pregnancy

You can not miss any medical examination during second quarter os pregnancy.

The specialist may direct you to give blood test (to figure out human alpha-fetoprotein, HAFP). At this level doctors are capable to bring out such abnormality like Down’s syndrome, spinal cord development damages, hydrocephalus and other chromosome disturbances.

Another additional ultrasonic scanning will be between 24^th and 26^th weeks.

At this time doctors will look to baby body construction, if there are any internal organs problems, and to see the sex of baby, quantity and quality of fetal (amniotic) fluid, the place and condition of placenta.

The blood test will show the level of hemoglobin and consequently presence or absence of anemia.

It is very essential to determine your weight each time you visit the doctor, and check your blood pressure, baby pulse and uterus position. You will be asked to give urine test each time you visit the doctor.  

First quarter of pregnancy

As you attend your first maternity consultation, as a rule your healthcare professional will send you to give certain medical examination. Normally you will be checked for following categories:

AIDS
Syphilis
Hepatitis B type and C type
Blood test and hormones test
Rhesus factor test (in case if mum has negative Rhesus factor and father has positive one, it will be necessary to give blood test each 2 weeks).
General biochemical blood test
Vagina test
Urine test

Ultrasound test on 10-12 weeks. At this time it is possible to see how many children over there and to figure out exact period of pregnancy. Also it is possible to find out abnormality, and risky pregnancy (chromosome pathology).

You may be asked to pass following tests: rubella (German measles), herpes, cytomegalovirus infection, toxoplasmosis and Chlamydia trachomatis infection.
Gynecologist will direct you visit: the oculist, physician, otolaryngology specialist, dentist and to do some electrocardiogram (ECG).
Your healthcare provider will measure your weight and pelvis and will take anamnesis information.
You have to visit the gynecologist one a month, each time you will give urine test. This is to evaluate your kidney action.

Laboratory examination

1. Blood test to figure out any of following diseases: syphilis, AIDS, and hepatitis.
2. Biochemical blood test. To count erythrocytes (red cells) and hemoglobin quantity. Later this information will be used to prevent anemia.
3. Sugar level in the blood and in the urine.
4. Rhesus factor and blood group test.
5. Uterine neck test and urination channel (external part) test. These procedures are to exclude sexual infection.
6. Some smear will be taken from nose and from throat. This examination is carrying out to find any pathogenic staphylococcus (usually 2 times).
7. Urine examination each time you visit the clinic.
8. Excrement basic examination (to find intestinal worm) one time during pregnancy.

After reception of all laboratory examination results, pregnant woman will be directed to following specialists:

1. Physician (therapeutist). Additional electrocardiogram.
2. Oculist (eyes examination, condition of the eyes).
3. Dentist (it is better fix teeth problem before pregnancy)
4. Neuropathology specialist.
5. Otolaryngology specialist.

Obstetrics analysis allows to count the pregnancy period, approximate fetus weight, the position of fetus in the womb, and to expose hydramnion and polycarpous pregnancy.

Usual tape measure is the tool to measure belly circle at belly-button level, and obstetrics caliper used to measure pelvis dimensions.

More accurate data about fetus provides ultrasonic examination.

From 28^th week the position of fetus on the womb became very essential for prospective birth. Doctor will detect the fetus position each time you visit the clinic since this period.

There are certain expressions that doctors used to explain the fetus position.

Fetus location: this is the quotient of fetus axes to womb axes. The normal location of fetus is longitudinal position. Unlikely locations of fetus in the womb are diametrical and slantwise. Natural childbirth in these cases is not possible, only via cesarean section.

Fetus position: this is quotient of fetus spine to left (first position) or right (second position) sides of womb.

Previous part of fetus: it is the part of fetus that first goes into the womb in the first part of pregnancy, or into vagina in the second period of pregnancy. Physiologically it is the head part, and in most cases it is back part of the head (sometimes it could be facial part or forehead)

Pelvic presentation: (breech presentation or foot presentation) in modern obstetrics as a rule it is deviation (deflection) from standard pregnancy, and basically it leads to caesarean operation.

Componential position of fetus: it is positions of upper and lower extremities to body and head. Basically it looks like curve or arc form, and sometimes observed other situations when fetus extends legs along the body or unusual position of the head.

So called unstable position observed when the fetus has small size and it is moving in the womb. As fetus grow up, he (she) takes certain position, and it is very essential for the doctor to know for birth execution.

Fetus heartbeat auscultation: stethoscope is a special obstetrical tool to do this. There are 3 main characteristics for fetus heartbeat: frequency, rhythm and clarity (clearness). Normally it should be about 120 to 160 rhythmic heartbeats per minute.

Pelvis dimensions measuring

Pelvis dimensions also plays huge role for childbirth prediction and tactics. As we mentioned before, there is special tool to measure the pelvis.

Three main dimensions of pelvis are:

1. The spacing between most separate points of pelvis iliac bones – it should be 26 cm.
2. The spacing between most separate points of pelvis iliac bones cristae part – it should be 28 cm.
3. The spacing between thigh-bone skewer parts should be not less than 30 cm.
4. And distance between 5^th spine vertebra and upper side of pubic bone should be about 20 cm or little bit more.

When pregnant woman first time visit the doctor, the mandatory measurement is the pelvis dimensions. In some cases additional measurement of pelvis might be at childbirth time.

Pregnant woman weighing

Maternity clinics practicing weighting of pregnant woman each time she visit them, because even little weight change is an data for doctors to track for the baby development. Doctor consider the following factors: the age, beginning weight, weight changes during toxicosis, height, diet characteristics and pregnant woman occupation.

Mostly since 32^nd week pregnant woman should gain about 50 gram weight each day (about 350-400 grams a week, or 1.0 – 1.5 kg in a month). Totally during pregnancy it is about 10 – 12 kg of additional weight.

If this number is higher, you may have later edema or toxicosis.