Registration with a gynecologist in the first weeks of pregnancy

The most common question for a woman in the situation is: "When will I register for pregnancy and what do I need?". The registration with a gynecologist in the first weeks of pregnancy is usually carried out 2-4 weeks after the first delay in menstruation and the fact of pregnancy (a positive pregnancy test or hCG analysis). In this case, the obstetric term will be 6-8 weeks. For registration, you need to contact a women's consultation, which is located in the local polyclinic at the place of residence.

At the same time you need to have a passport with you and preferably a medical card. What can you do if you do not live in the place of residence? To register with your place of residence, you can do two things. First: go to a women's consultation at the place of residence and get a referral to the clinic at the place of residence, while writing a statement. The second: go to a women's consultation on the residence meter, write a statement and pay a fee for out-of-town people. In a women's consultation, you will be assigned to a gynecologist who will observe the course of pregnancy right up until the birth. If the gynecologist for some reason did not arrange, then it can be changed to another, having previously written the application.

So, you came to your gynecologist who will watch you. What next? And then you will receive a huge number of questions, manipulations, directions for analysis and examination, strange incomprehensible words, recommendations and tips about which we will describe in detail below.

At the first admission and registration on the first weeks of pregnancy, the gynecologist fills in a special card of the pregnant woman (exchange card), in which all planned receptions, results of tests, additional examinations, factors aggravating pregnancy and others will be recorded. The entire procedure can be divided into five stages: 

1. Anamnesis; 
2. Measurement of physiological data; 
3. Gynecological examination; 
4. Provision of referrals for analyzes and additional examinations; 
5. Recommendations.

[1]

Gathering of an anamnesis at registration at the gynecologist in the first weeks of pregnancy

At this stage, the gynecologist interrogates and records the data in the pregnant woman's card about: the already existing pregnancies, the methods of their delivery, miscarriages, abortions, the patient's general health, the transferred diseases, operations, the presence of acute and chronic diseases in the pregnant woman and her relatives, bad habits, place of work, type of work, living conditions and social status of the family. All this information will help to give certain recommendations and build an individual plan for managing pregnancy in order to maximize the health of the mother and child.

Measurement of physiological data when registered with a gynecologist in the first weeks of pregnancy

At this stage, the gynecologist measures:

• weight and height of the pregnant (to control weight gain during pregnancy). It is believed that the normal increase for 9 months is about 12 kg. But this number is relatively relative. Each organism is individual. Weight gain in the first weeks of pregnancy is approximately 2 kg. But if a woman has toxicosis, then perhaps weight loss.
• the pelvis of the pregnant woman (to assess the possibility of self-delivery). Usually, the pelvic dimensions are measured using a special tool, similar to a large forceps tweezer. Indicators of the size of the pelvis indicate the Latin names: Distantia spinarum, Distantia cristarum, Distantia trochanterica and Conjugata externa. Accordingly, the normal parameters of pelvis size are: 25-26 cm / 28-29 cm / 31-32 cm / 20-21 cm. Also take into account the difference between the first three indicators, it should be 3 cm.
• the height of the standing of the uterine fundus of a pregnant woman (to assess the normal increase in the uterus). This parameter is measured in the supine position and, usually, in the first weeks of pregnancy, it is 8-9 cm. An increased index may indicate a multiple pregnancy, an incorrect pregnancy period and polyhydramnios. A reduced indicator may indicate a delay in the development of the fetus or an improper gestation period.
• girth of the abdomen (to assess the positive dynamics of fetal growth). Also, the size of the abdominal circumference is used in later terms of pregnancy to determine the approximate mass of the fetus.
• blood pressure (to exclude hypertension). Most often in pregnant women in the first weeks of pregnancy, low blood pressure and rapid pulse are observed. If at such rates the patient feels normally, then this is not considered a pathology. But high blood pressure is very dangerous. Hypertension can lead to a condition such as preeclampsia, which can cause placental abruption, bleeding and even fetal death.

Gynecological examination when registered with a gynecologist in the first weeks of pregnancy

When registering with a gynecologist in the first weeks of pregnancy, a gynecological examination on the chair is mandatory. In this procedure, a gynecologist examines the walls of the vagina, the cervix and takes a swab of flora. By smear, you can determine the presence of certain infections (trichomoniasis, thrush, gonorrhea) and, if they are available, prescribe treatment in a timely manner. There is such a myth that gynecological examination on the armchair during the first weeks of pregnancy can not be carried out. Actually this is not true. The doctor does not produce a rough examination, but realizing that you are in a position to do everything delicately.

Delivery of referrals for tests and additional examinations when registering with a gynecologist in the first weeks of pregnancy

When you register, the doctor will give you many directions for different tests, namely:

• a general blood test - to assess the level of hemoglobin and eliminate anemia, as well as to identify hidden inflammatory processes in the body of a pregnant woman;
• general urine analysis - mandatory analysis to assess the general state of kidney function and exclude acute and chronic diseases of the urinary system (cystitis, pyelonephritis, glomerulonephritis), as well as control the level of acetone in toxicosis;
• analysis on RW - mandatory analysis to exclude the presence of syphilis, in the presence of syphilis, the probability of miscarriage or the birth of a dead child is high;
• blood test for HIV - mandatory analysis to identify the risk of contracting the fetus with this disease;
• blood test for hepatitis B - mandatory analysis, to identify an increased risk of fetal infection;
• a blood test for hepatitis C is not an obligatory analysis, but recommended, to detect the possibility of intrauterine infection of the fetus;
• analysis for thyroid hormones and antibodies to them - not an obligatory analysis, but the recommended, normal TSH index is very important for the full formation of the organs and systems of the child;
• a blood test for sugar - to exclude diabetes mellitus;
• analysis for the blood group and Rh factor of the mother - mandatory analysis to exclude the possibility between the mother and child of Rh-conflict and conflict by blood groups;
• analysis for blood biochemistry - mandatory analysis for diagnosis of liver and kidney function and elimination of their pathologies;
• coagulogram - not an obligatory analysis, but recommended, with poor hemostasis the probability of miscarriage is high;
• analysis of blood for antibodies to TORCH-infections (toxoplasmosis, rubella, cytomegalovirus, herpes - mandatory analysis, all these diseases directly affect the normal development of the fetus;
• bacteriological culture of urine - not mandatory analysis, but recommended, to identify bacteriuria and timely treatment.

Similarly, a gynecologist can prescribe such additional examinations as:

• ultrasound examination - to determine the uterine or ectopic pregnancy, to clarify the period of pregnancy, identify aggravating factors such as tone and others.
• Cardiogram - examination of the heart of the mother.

The doctor gynecologist at the first reception will give directions for routine examination of such narrow specialists as:

• ENT - to exclude chronic ENT infections;
• ophthalmologist - to assess the vision of a pregnant woman, with a large visual impairment, the question of delivery by caesarean section may be;
• endocrinologist - to assess the result of tests for thyroid hormones and blood sugar and exclude thyroid and pancreatic diseases;
• dentist - to assess the health of teeth and eliminate diseases, as during pregnancy, calcium and phosphorus are washed away;
• therapist - to identify and treat co-morbidities.

[2], [3]

Recommendations for registration with a gynecologist in the first weeks of pregnancy

At the first arrival to the women's consultation, the gynecologist will prescribe special vitamins for pregnant women and other (if necessary) drugs, answer all the questions you are interested in, assign the following turnout and send them to the school of expectant mothers, where you will learn a lot of interesting information about the correct balanced nutrition and lifestyle during pregnancy. Similarly, a gynecologist can, if necessary, arrange a sick leave and write a certificate of ease of the regime.