Pregnancy: regular examination

If you suspect that you are pregnant, you can take a pregnancy test at home, which should be done one day after the delay in the expected menstrual cycle. Pregnancy is measured in weeks from the first day of the last menstrual cycle. You can count the weeks of pregnancy in several ways.

Once you understand that you are really pregnant, make an appointment with a doctor. Your first visit will help him to get all the necessary information that can be used during the entire pregnancy.

Good care during pregnancy includes regular prenatal examinations. During each visit, you will be weighed, measure the volume of the abdomen, prescribe an urine test and check your blood pressure. Do not forget to ask your doctor questions. At certain periods of pregnancy, you will receive several additional examinations and tests. Some of them are planned, and some are prescribed in case of occurrence of certain risk factors.

The first prenatal examination and analysis includes a medical history, physical examination and a blood and urine test.

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The decision to undergo testing for birth defects in a child

Discuss with the doctor the possible delivery of tests for congenital defects in the fetus. There are several types. If you have concerns, take tests at an early stage of pregnancy. If the risk of having a child with congenital defects is small, you can refuse such testing. On the other hand, if the results do not affect your decision to give birth to a child, you can completely abandon it.

Screening test with para-aminobenzoic acid (test for detection of the latent form of the disease): a blood test and ultrasound show the presence of fetal pathology. In some medical centers, Down syndrome is screened at the end of the first trimester using a blood test and an ultrasound measurement of the fold thickness of the fetal occiput. This diagnosis can also be carried out at the beginning of the second trimester of pregnancy, and it is considered quite safe for the mother and fetus.

Diagnostic testing reveals fetal defects if the results of screening show a high risk of developing fetal pathologies. In this case, a chorionic villus biopsy or amniocentesis is performed. If you have a family predisposition to fetal pathology, you can immediately carry out diagnostic testing without first screening. You just need to remember that amniocentesis and chorionic villus biopsy slightly increase the risk of miscarriage.

First trimester examination and tests

Include ultrasound examination of the fetus, with which you can determine the condition of the child and the placenta. At the end of the first trimester, non-invasive screening for Down syndrome is performed using a blood test and ultrasound thickness measurement of the folds of the fetal nape. A biopsy of the villus chorion is performed earlier than amniocentesis (in the second trimester).

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Inspection and analysis of the second trimester of pregnancy

May include fetal ultrasound and electronic fetal monitoring. At its very beginning, you can do a triple or quadruple analysis. It shows the level in the blood:

• alpha - fetoprotein;
• human chorionic gonodotropin;
• estrogen (estriol);
• inhibin A (only a quadruple analysis).

If you are at risk for developing fetal defects or a triple or quadruple screening indicates a problem, you need an amniocentesis. Later in the second trimester, you need to pass tests for the presence of gestational diabetes (oral test for glucose tolerance). If you have a negative Rh factor, a blood test will determine the presence of antibodies, after which you will most likely be injected with an immunoglobulin.

Inspection and analysis of the third trimester

Include ultrasound of the fetus, tests for hepatitis B and streptococcal infection. All pregnant women should be tested for HIV. But sometimes this research is carried out only at the request of a woman.

What should I think about?

When you want to conduct genetic testing, you need to remember about the time that suits you.

• A biopsy of the villous chorion is carried out in the first trimester of pregnancy (usually 10-12 weeks), whereas amniocentesis is performed at 15-20 weeks. The test results will affect the decision of a woman to give birth to a child or to terminate a pregnancy. Biopsy results are known in a few days, but amniocentesis - in 2 weeks.
• A biopsy of the villous chorion does not allow the detection of defects in the cerebral tube, so it is also recommended to do an alpha-fetoprotonin test, which is part of the triple screening.
• Chorionic villus sampling and amniocentesis represent a minor threat to pregnancy, as the integrity of the fetal bladder is compromised. According to the data, one in 400 cases of pregnancy ended in miscarriage as a result of this testing. The risk is reduced if the procedure is carried out by highly qualified specialists.