Underscoring The Importance Of Medical Care And Observation During Pregnancy

Most women discover they are pregnant (or at least, begin to suspect they might be) between the 4th and 7th week. That means it's time to schedule your first visit with an obstetrician or midwife, which usually occurs between the 8th and 10th week of pregnancy. These visits are very important for the health and well-being of both you and your baby. During the earlier months of pregnancy, the visits may be once a month, becoming more frequent as your due date approaches. This initial appointment will be one of the longest. A thorough exam will be done. Your height and weight will be recorded. Information regarding any allergies that you may have will be documented. Your blood pressure will be taken, and you will be asked to provide a urine sample. Your health history, psychosocial history and medication history will be reviewed, as well as the health history of close relatives, such as parents, grandparents and siblings. The answers to these questions will help your obstetrician or midwife determine any potential risk factors that may be present. Based on this information, your doctor will develop a plan of care. During your first prenatal visit, information will be given to you regarding important topics, such as:

• Safe use of medications
• Avoiding alcohol and drugs
• Smoking cessation (Do not take any medications without asking your physician)
• Common discomforts and measures to relieve them
• Warning signs of a potential problem, including:
  • Vaginal bleeding
  • Nausea and vomiting that is persistent
  • Fever
  • Difficulty urinating, burning on urination, difficulty voiding

If you experience any of these signs, you should call your doctor or midwife immediately.

What Tests Will Be Performed During The First Few Visits?

Let's look at the testing first. During your initial exam, a Pap smear will be done, and cultures for gonorrhea and chlamydia will be obtained. Blood work will be ordered to test the following: A complete blood count (CBC) is a blood test that is used to evaluate your overall health. A CBC includes:

• Hemoglobin count: Protein molecules in your red blood cells that carry oxygen from your lungs to tissues in your body, and carries carbon dioxide from your tissues back to your lungs
• Hematocrit count: Total number of red blood cells in your blood
• Platelet count: Number of platelets in your blood, which is necessary for clotting your blood if you are bleeding
• Mean corpuscular volume: The average volume of red blood cells in your blood

Additional blood work:

• Blood type and Rh factor
• Rubella (German measles) screen for immunity
• Varicella (Chickenpox) screen for immunity
• Hepatitis B surface antigen
• HIV (Human immunodeficiency virus)
• Syphilis screening (RPR/VDRL)
• Sickle cell screen for African-Americans
• Hepatitis C for individuals with increased risk factors
• Tuberculosis for individuals with increased risk factors
• Glucose (random)
• Hemoglobin A1c for women with risk factors for diabetes
• Lead level for individuals with an increased risk due to exposure to lead
• Thyroid function for individuals with a history of thyroid disease or a history of miscarriage
• Routine urinalysis: Urine is tested for the presence of red blood cells, white blood cells (possible urinary tract infection), protein (possible sign of pre-eclampsia) and glucose (possible sign of diabetes).
• Urine culture if bacteria are present in the urine, in order to identify the bacteria.

At your first visit, a urine sample will be taken. A urine dipstick will be done to test for the presence of protein. In addition, the urine will be sent to the lab for a urinalysis and urine culture.