Essential Prenatal Checkups: A Comprehensive Guide for Expectant Mothers - Dr Samhitha Moturi
The most important checkup for the young mother is the first ever visit to the doctor after confirming pregnancy at home. At their first visit mostly at 5 to 6 weeks of pregnancy, we do an ultrasound scan which is called a dating scan, to make sure the fetus is in the uterus (womb), and not in the fallopian tubes (called ectopic pregnancy) and this scan also gives us a viability or the fetal heart rate, and the age of the fetus noted in weeks.
That is followed by blood check up with complete blood count, to ascertain haemoglobin and platelets, blood grouping and typing and serology to tule out infectious diseases like HIV and HbsAg. Screening blood glucose is done in the form of RBS and HbA1c.
The following check-up will be within 11–14 weeks, for NT scan. It is a very important scan, not to be missed because, the NT measured will indirectly tell you whether the baby has any congenital anomalies or risk factors for birth defects, combined with that mother's blood is taken for double screening test which will predict risk for birth defects and syndromes.
Thyroid function test can be done any time in the first trimester, and abnormal values need to be corrected.
Height and weight of the patient is calculated, and BMI estimation is done at the first visit. For a healthy pregnancy, there will be an increase of 9 to 10 kg of weight, maximum weight gain experienced in the third trimester.
The most important scan at checkup is at 20 weeks, where an anomaly scan is done, which will tell us any birth defects for the baby in detail. The heart, lungs, brain and other vital structures are formed by then. At 22–24 weeks of pregnancy, a fetal echo is done to check baby's heart for any abnormality.
In a regular normal pregnancy with no complications such as GDM (sugar) and hypertension (high BP), heart disease, a check-up to see the height of the uterus, and checking baby's heartbeat every four weeks is enough. Complicated pregnancies have to be followed up closely. Taking TT vaccine and vitamins supplements such as iron and folic acid, calcium are essential.
The patient should come between 28–30 weeks of pregnancy, for a growth scan, to check for amniotic fluid levels also called liquor, and growth and weight of the baby. The blood supply to baby's heart and brain is checked in the form of dopplers.
After 32 weeks, a visit every two weeks is important for an NST or a non-stress test, which can be done on an OPD basis, which will tell baby's heart rate and pattern. 37 weeks which is called term pregnancy, frequent visits are mandated till mother develops pain.
