In Sants Gynecological clinic in this section we have seen fit to put at your disposal the most fundamental and basic to consider:
1. Prenatal Consultation
I. What is it?
Prenatal care is the query that must perform before getting pregnant. So if you decide to get pregnant you should consider the following:
1. Purpose of this consultation: The purpose of this consultation is to prepare to deal with an optimal level of health conception. So its objectives are:
-To Detect and treat diseases associated with poor reproductive process.
-To value the risk of pregnancy (particularly those at high risk).
-Preparation Of the couple for pregnancy, birth and newborn care.
II. What does it consist of?
It is to achieve the above objectives by:
- Complete clinical history that includes additional tests such as:
- Blood type and Rh factor
- Blood count and basic biochemistry
- Serology: rubella, toxoplasmosis, syphilis, HIV.
- Other analyzes, ultrasound, etc.
- Preconception advice
- Folic acid: It really is the only medication that every woman should take before getting pregnant to prevent neural tube defects.
- If the medical history of these diseases can be corrected and controlled but as in the case of chromosomal abnormalities will be given the right advice to follow is detected.
- Wanting pregnancy after certain situations:
- After an abortion: We recommend a rest period of three to six months (depending on age, mental state, etc.).
- After you stop taking oral contraceptives believe it goes without a rest period.
- After removal of an IUD: believe it goes without a rest period.
2. Monitoring of pregnancy
I. What is it?
Are all medical procedures that are performed throughout pregnancy and childbirth. They are important to achieve a reduction in maternal and fetal morbidity and mortality.
Assumptions: It is necessary that if you think you are pregnant (menstrual delay of more than five days’ pregnancy test urine positive “that you can apply at the pharmacy or make yourself buying the kit) you come quickly to the first visit to :
-Valuation Ultrasound gestational age will be more accurate the earlier the visit.
-Valuation Individual risk and determine what level of care is most appropriate for your monitor.
II. What does it consist of?
It is to perform:
Doctor visits: one visit per month until 36 weeks and suggest a biweekly to 40 weeks.
During these visits he will control:
-The Weight, blood pressure, albuminuria, edema, circulatory disorders.
-The Fetal heartbeat after 14 weeks.
-Situation And fetal position after 28 weeks.
– We will ask ultrasound and analytical relevant.
-Valuation Symptoms, ultrasound, laboratory you have in each visit and its corresponding treatment, or request other tests if required.
Ultrasound controls: During normal course of pregnancy are recommended to make four ultrasound examinations.
- Initial Ultrasound should be performed at the first visit to:
- Diagnose pregnancy
- Determine gestational age
- Assessing the number of embryos.
- Assess whether the egg or gynecological pathology associated pathology.
- Check the vitality of the embryo
- Ultrasound to detect chromosomal markers (especially the nuchal translucency)
Second trimester ultrasound: You must be between 19-20 weeks and in a highly specialized ultrasound center and the ultrasound inspection in these weeks is essential for the diagnosis of bad training shortcomings.
Ultrasound of the third quarter: You must be between 34-36 weeks to assess:
- First trimester ultrasound: You must be between 12-14 weeks for:
- Proper fetal growth
- Study of fetal anatomy
- Location and placental aging
- Amniotic fluid volume
- Welfare fetal (fetal movement, breathing movements, fetal tone)
III. Routine analytical controls:
On the first visit should be sent: Complete blood count, blood group and Rh factor, blood sugar, serology (syphilis, toxoplasmosis, rubella and HIV if the previous immune status is unknown), urinary sediment.
At 15 weeks of pregnancy (according to ultrasound) should be sought sreening triple for risk assessment of Down and neural tube defects syndrome. It consists of a simple blood test and if the results are high risk, then performing amniocentesis which is what will give us the diagnosis is necessary.
Between 24-28 weeks and should be sent: CBC, Sullivan test and if positive blood glucose curve (used to detect a possible gestational diabetes), indirect Coombs test (if you are Rh negative), toxoplasmosis should be (if the previous quarter was negative) and urinary sediment.
Between 32-34 weeks and should be sent: CBC, coagulation indirect Coombs test (if you are Rh negative), hepatitis serology and urinalysis.
At 35 weeks it should be requested vaginal culture.
- Medication during pregnancy:
Iron supplement: only if they are necessary according to the results of the analyzes.
- Fetal monitoring: This is done to assess fetal well-being and the first shall be made at 38 weeks, then 39 weeks, 40 weeks and from there every other day until 41 weeks 3 days (in the case it did not come childbirth, you will cause).
- Amniocentesis involves aspiration of a sample of amniotic fluid for diagnostic tests of fetal wellbeing (malformations, chromosomal abnormalities, fetal infections, metabolic disorders, etc.) with a 1% risk of causing abortion.
- Rh negative women: If a woman is not sensitized, a full dose of anti D immunoglobulin at 28 weeks will be administered. If the newborn is Rh positive, you need to repeat the dose in the first 72 hours after birth.