PREGNANCY IN GENERAL
Pregnancy is an exciting time as you bring a new life into the world. At Women’s Care you will find an excellent team with years of experience in helping their patients to build the families of their dreams.
Once you receive your good news, your pregnancy advances quickly as your body changes to accommodate a growing fetus inside you. To make sure that you and your baby are healthy, the team at Women’s Care provides comprehensive prenatal care throughout your pregnancy to make sure important developmental milestones are met.
Typical pregnancy lasts 40 weeks from the first day of your last menstrual period to the birth of the baby. It is divided into three stages, called trimesters: first trimester, second trimester, and third trimester. The fetus undergoes many changes throughout maturation.
The early changes that signify pregnancy become present in the first trimester. A missed period may be the first sign that fertilization and implantation have occurred, ovulation has ceased, and you are pregnant. Hormonal changes will affect almost every organ in the body.
Other changes may include:
- Extreme tiredness
- Tender, swollen breasts. Your nipples might also stick out.
- Upset stomach with or without throwing up (morning sickness)
- Cravings or distaste for certain foods
- Mood swings
- Need to pass urine more often
- Weight gain or loss
Second trimester (week 13–week 28)
Most women find the second trimester of pregnancy easier than the first. But it is just as important to stay informed about your pregnancy during these months.
You might notice that symptoms like nausea and fatigue are going away. But other new, more noticeable changes to your body are now happening. Your abdomen will expand as the baby continues to grow. And before this trimester is over, you will feel your baby beginning to move!
As your body changes to make room for your growing baby, you may have:
- Body aches, such as back, abdomen, groin, or thigh pain
- Stretch marks on your abdomen, breasts, thighs, or buttocks
- Darkening of the skin around your nipples
- A line on the skin running from belly button to pubic hairline
- Patches of darker skin
Third trimester (week 29–week 40)
You’re in the home stretch! Some of the same discomforts you had in your second trimester will continue. Plus, many women find breathing difficult and notice they have to go to the bathroom even more often. This is because the baby is getting bigger and it is putting more pressure on your organs. Don’t worry, your baby is fine and these problems will lessen once you give birth.
Some new body changes you might notice in the third trimester include:
Shortness of breath
Tender breasts, which may leak a watery pre-milk
Your belly button may stick out
The baby “dropping”, or moving lower in your abdomen
Contractions, which can be a sign of real or false labor
As you near your due date, your cervix becomes thinner and softer. This is a normal, natural process that helps the birth canal (vagina) to open during the birthing process. Your doctor will check your progress with a vaginal exam as you near your due date. Get excited — the final countdown has begun!
Tests to monitor the health of the mother and the baby
Pregnancy care involves regular appointments with your doctor to monitor your pregnancy and the baby’s growth. Care includes tests that check on the health of both you and your baby, and help to identify any problems with the pregnancy.
Routine prenatal tests may include:
blood tests at different stages of the pregnancy, such as blood group, iron levels, checks for maternal diabetes and infections
ultrasound (first trimester) – a painless, non-invasive scan done within the first three months of pregnancy. This can be used to confirm the number of babies and helps to calculate the date you are due to give birth. This is known as your estimated due date.
Early pregnancy ultrasound
This ultrasound aims to determine the number of embryos, the probable date of delivery and whether the pregnancy is developing normally within the uterus. This test can be carried out through the abdomen, or transvaginal (via the vagina). The ultrasound is harmless for both the fetus and the mother.
Nuchal translucency is the ultrasound appearance of subcutaneous accumulated fluid behind the fetal neck during the first trimester of pregnancy in all embryos. The size of fetal nuchal translucency increases normally with gestational age .The greater the nuchal translucency measurement gets, the greater the risk of chromosomal and structural abnormalities in the fetus becomes
This is a detailed ultrasound at 20-24 weeks of gestation, with recommended gestational age at 22 weeks.
With the anolmaly scan we examine each part of the fetal body, we determine the position of the placenta and we evaluate the amount of amniotic fluid and the development of the fetus, calculating its weight.
Particular attention is given to the brain, face, spine, heart, stomach, intestine, kidneys and extremities, to eliminate anomalies. Anomaly scan cannot guarantee that your baby is normal, but it reassures significantly, both yourself and your treating physician, since it decreases further the chance of a poor outcome of the pregnancy.
Congenital heart disease is present at about 8-9 among 1,000 births. It is still one of the most serious abnormalities in the fetus and therefore their prenatal identification makes it possible to have better counseling for the couple a nd significantly improves the perinatal outcome.
Assessment of fetal development takes place at any stage after 24 weeks of gestation. If there is no reason to perform the ultrasound earlier, the proposed gestational age is about 32 weeks in all pregnant women.
This ultrasound aims to determine the growth and health of the fetus by:
Measuring the size of the fetus (head, abdomen, femur) and calculating the weight estimate of the fetus
Examination of fetal movements
Assessment of placental position
Evaluation of the placenta composition
Measuring the amount of amniotic fluid
Assessment of blood flow to the placenta and the fetus (mean cerebral flow, umbilical artery flow, flow of uterine arteries) with colored Doppler ultrasound
Screening tests can provide an estimate of how likely it is that a baby is affected by a range of conditions but cannot make a diagnosis. If a screening test suggests an increased risk, further tests are available to confirm that result.
Examples of screening tests include:
- Combined first-trimester screening – this test combines information from a first-trimester ultrasound (for example, a measurement taken from the back of the baby’s neck known as the nuchal translucency) and a blood test from the mother (first-trimester maternal serum screening) to calculate risks for a group of chromosome problems, including Down syndrome.
- Second-trimester maternal serum screening – this is a maternal blood test that helps to determine the risk of some conditions that may affect the unborn baby, such as chromosome abnormalities (including Down syndrome) or neural tube defects (such as spina bifida).
- Non-invasive prenatal testing (NIPT, also known as cell-free DNA screening) – this is a relatively new blood test that looks at the baby’s genetic material (DNA), which can be found in the mother’s bloodstream. It can provide information about the risk of conditions such as Down syndrome and some other chromosome problems, and can be done any time from 10 weeks into the pregnancy.
Diagnostic tests include:
- ultrasound – may be used to check the health of the baby in the case of unusual pregnancy symptoms, such as vaginal bleeding or lack of fetal movement
- chorionic villus sampling (CVS) – a test that checks for specific medical conditions by taking a sample of the placenta. The placenta was originally formed from the same cells as the baby, so testing a small sample of placenta can provide information about the baby. To collect the sample, the doctor inserts a slender needle through the mother’s abdomen. The needle is guided with the help of ultrasound. The tissue (known as a chorionic villus sample) is then examined in a laboratory.
- amniocentesis – a doctor inserts a slender needle through the abdomen to withdraw a small amount of amniotic fluid, the fluid which surrounds the baby in the womb. This fluid sample contains some of the baby’s cells which have been shed as the baby grows, and these are then examined in the laboratory.