Pregnancy Tracking
Pregnancy follow-up is the regular and periodic checks of the expectant mother during the 40-week period (from the date of the last menstrual period) from the detection of pregnancy to the birth.
Pregnancy follow-up begins as soon as the diagnosis of pregnancy is made. In the beginning, monthly check-ups should be done, but they should be increased in the last 3 months according to the condition of the pregnant woman.
At each control, weight measurement, blood pressure measurement, abdominal examination and ultrasonography are used to monitor the growth of the baby and the current complaints of the pregnant woman, if any, are evaluated.
If not done in the pre-pregnancy period, complete blood picture, routine biochemistry measurements, fasting blood sugar, hepatitis markers, infection screening tests (Ig M and Ig G antibodies for Toxoplasma, rubella (rubella) and CMV, VDRL and HIV tests are performed for syphilis) blood group determination, vitamin B12 level and urine culture. Periodic complete blood count is observed, the pregnant woman is questioned regularly for vaginal and urinary tract infections, and if necessary, infection is tried to be ruled out with culture tests.
The role of the last menstrual period in determining the gestational age is indisputable. Gestational week and expected delivery date are determined by the last menstrual period.
If the last menstrual date cannot be remembered, it can be detected by early embryo measurements in USG.
Pregnancy Follow-up in the First 3 Months
The determinant in the follow-up period is the risks and health status of the pregnant woman.
• The use of folic acid in the first 3 months protects your baby from a disease called Neural Tube Defect, which can cause serious disability, along with the opening of the backbone.
• Drugs, radiation, etc. that you will be exposed to in the first 3 months. harmful effects can cause serious injury to your baby. Do not use any medicine without consulting your doctor.
• The ideal weight gain in the first three months is 0.5-1 kg per month.
Common problems during this period:
Nausea
Up to 70% of pregnant women may experience changes such as nausea, loss of appetite, and sensitivity to smells in the first three months. In early pregnancy nausea and vomiting; There are many reasons such as hormones secreted from the placenta, psychological problems of the mother, lack of vitamin B6, changes in the gastrointestinal system due to pregnancy, and the thyroid glands working harder than normal. It may be more severe in multiple pregnancies, those with goiter, and first pregnancies.
Especially when we get up in the morning, the salty and dry foods we eat will suppress nausea.
Be careful not to starve, as low blood sugar will increase nausea. Eat little, often. Avoid oily foods and fried foods.
If you have symptoms such as excessive vomiting, no feeding, nausea that continues after the 12th week, fever, diarrhea, abdominal pain along with nausea, consult your doctor.
Constipation and Bloating
Constipation often appears in the first months.
Increasing the intake of plenty of liquid and pulpy food increases bowel movements. Plenty of vegetables, fruits, salads, whole grain products are recommended. Another way to increase bowel movements is to exercise the abdominal muscles. Half an hour of regular and brisk walking a day may be sufficient.
Heartburn
Reflux; Just like constipation, it is due to the escape of stomach acid into the esophagus with the effect of progesterone.
Eat little and often. Fries, pastries, carbonated drinks increase reflux; stay away. Do not lie down for at least 2 hours after eating, slightly raise your pillow.
Fatigue – Fatigue – Sadness
Changing hormonal balance may cause complaints such as depression, excessive irritability, and excessive desire to sleep during pregnancy.
3 months of pregnancy is the period of adaptation to pregnancy and these problems will gradually disappear as the person adapts to pregnancy.
Headache
Consult your doctor if the headache is severe, accompanied by nausea and is prolonged.
Vaginal Bleeding
Vaginal bleeding is abnormal at any stage of pregnancy. Be sure to consult your doctor.
Sleep Changes
Gum and Nose Bleeding
11-14.Week Pregnancy Follow-up
11-14. The double screening test, which is the first step of fetal chromosomal anomaly screening, should be performed between weeks and weeks. It is a test that investigates the presence of Down Syndrome (trisomy21) and trisomy 18. With the ultrasonographic evaluation, the nuchal thickness of the baby and the presence of the nasal bone are checked. Maternal age, beta hCG and PAPP-A values in the blood are determined and combined with ultrasonographic findings. As a result of the test, the individual risk ratio is determined.
Diagnostic testing (CVS or amniocentesis) is the only way to be absolutely certain that the baby does or does not have Down’s Syndrome. CVS is performed between 11-14 weeks and is the process of taking a small amount of tissue sample from the placenta. Amniocentesis is performed after the 15th week and is the process of taking a sample of the fluid in the baby.
Both provide a sample that carries the same genetic material as the baby and a detailed examination of the baby’s chromosomes. However, the problem with these diagnostic tests is that they can cause abortion even if the baby is completely normal, and the miscarriage rate is 1/300 on average.
Extracellular fetal DNA test, which has been used in recent years, can be performed by taking blood from the expectant mother from the 10th week of pregnancy and the results can be obtained in 1 week. It should be kept in mind that extracellular fetal DNA test cannot replace amniocentesis or CVS in terms of diagnosis. However, it should be considered as an advanced screening test.
16-18.Week Pregnancy Follow-up
These tests are generally used in pregnancies that missed 11-14 weeks of screening. First of all, triple or quadruple tests can be done to help us identify some chromosomal anomalies, especially Down syndrome (mongolism), which is the most common. The reason why it is called triple test is that it evaluates three pregnancy hormones in the blood (beta-hcg, AFP and Estriol), and the reason why it is called quadruple test is that it evaluates four pregnancy hormones in the blood (beta-hcg, AFP, Estriol and inhibin-A). The evaluation also includes maternal age, ultrasonography. The baby’s head diameter (BPD measurement) is checked. Which one is to be done is decided according to the possibilities of the laboratory. In these tests, chromosomal disorders such as trisomy 18 and trisomy 13 are also examined and the risk of neural tube defect (closure disease of the spine) is determined.
20-24. Week Pregnancy Tracking
These weeks, especially 20-22. This is the period in which detailed organ scan of the baby is performed by ultrasonography by the perinatology (risky pregnancy) department in the first weeks. All possible internal and external physical anomalies of the baby can be detected. Regardless of your first trimester screening test (double test) result, we strongly recommend you to have this ultrasound, in which the anatomical structure of the baby is evaluated in detail.
In addition, 2 doses of tetanus vaccine are administered at 16 and 20 weeks, if 5 doses of tetanus vaccine have not been previously administered.
24-28. Week Pregnancy Tracking
50 grams of gestational diabetes screening in these weeks. Glucose test is applied to all pregnant women. In cases above the standard values, 100 gr. glucose test is used. In this test, if two values or more are high, gestational diabetes is accepted or a single step 75 g glucose test can be applied. In these tests, those diagnosed with gestational diabetes (gestational diabetes) are consulted to an endocrinology physician and dietitian under blood sugar monitoring and their daily calorie intake is calculated. Few patients require insulin use.
If you have risk factors for diabetes or have had gestational diabetes in a previous pregnancy, screening may be done in the first trimester of pregnancy.
Pregnancy Tracking from 28th Week
Blood pressure and weight should be monitored, the measurements of the baby should be recorded, findings suggestive of preterm labor should be screened, routine blood and urine tests should be performed, cervical length should be measured with USG, vaginal discharge should be questioned, and a vaginal culture should be taken if there is a change in character. This is the period when gestational blood pressure (preeclampsia) can also begin. For this reason, edema, blood pressure and weight of pregnant women should be followed very closely and patients at risk should be called for more frequent controls.
36th Week Pregnancy Follow-up
It is the week when the first pelvic examination is made and the mode of delivery begins to be planned. Medical diseases of the mother, 4000 gr. If there is no obstacle to normal birth such as a baby, breech presentation and similar birth, the birth should be planned as a normal vaginal delivery. Normal vaginal delivery is healthy and physiological for both the mother and the baby. Cesarean delivery is never an alternative to vaginal delivery. It is a surgical procedure used in cases where normal delivery will not occur or may occur with complications.
With the 36th week of pregnancy, the nonstress test (NST) test, which shows the well-being of the baby in the mother’s womb, is started. NST tests, which are performed once a week, are performed every 2-3 days after the 40th week.
40th Week Pregnancy Tracking
It is now the expected birthday (based on the last menstrual period). If the labor does not start on its own, the waiting period is a maximum of 1 week in practice. In pregnancy, if the pregnancy is seen every 2-3 days and the labor does not start, the partner is hospitalized for induction (artificial labor) on a determined date and labor is performed. The method used in artificial pain is that the hormone oxytocin, which is normally found in the mother’s blood, is administered in the form of serum in a controlled manner and triggers uterine pain. It is no different from normal labor pain. In pregnant women who do not have head pelvis incompatibility and umbilical cord problems, this process ends with a very high rate of delivery.
Every expectant mother deserves a good pregnancy follow-up and a physiological delivery.
Just trust your body!
