PREGNANCY CARE

It is a blessing to be a mother. The biggest happiness for any couple is a positive urine pregnancy test. And with the happiness comes apprehension, doubts, questions and concerns. It is crucial to take care of the mother and the baby at this time and requires expert medical supervision.

Pregnancy care or antenatal care is a systematic care given in the pregnancy to monitor the well being of the mother and the growth of the baby in the pregnancy. It involves specific blood tests at suitable periods of pregnancy, ultrasounds, physical checks, dietary advice, advice on exercise, travel, work, prevention and early detection of any problem.

Pregnancy is divided into three trimesters

  1. First trimester – till 14 weeks
  2. Second trimester – 14 to 28 weeks
  3. Third trimester – 28 weeks till delivery.

FIRST TRIMESTER

This is a period of organ development of the baby and hence is a very important period of pregnancy. At the first visit, the mother is fully investigated the basic investigations include:

  • Blood group
  • Haemogram
  • Blood sugar
  • Viral markers
  • Serum TSH
  • Haemoglobin electrophoresis – to rule out thalassemia
  • Rubella
  • Urine routine
  • Basic ultrasound

The mother is given regular folic acid supplement . This folic acid supplement reduces the chances of neural tube defects in the baby and ideally should be started before pregnancy.

It is advisable to wear loose comfortable cotton clothing since you may feel a little hot . This is because of the thermogenic effect of the pregnancy hormones.

Against the common belief it is really not necessary to eat for two at this time. In the early pregnancy , in fact the appetite is usually decreased and there may be a feeling of vomiting or you may have some vomiting. It is usually advisable to eat small frequent meals to keep your energy levels up. Have plenty of fluids but avoid carbonated drinks that is no soda and cold drinks for you!

At around 11 to 12 weeks it is necessary to get an ultrasound done for nuchal thickness and nasal bone. This is followed by a double marker test. This ultrasound and blood test form the first step to rule out any birth defects in the baby (though you need to remember that all birth defects cannot be picked up antenatally).  You also have a choice to get an NIPT test done instead of double marker.

SECOND TRIMESTER

  • This is the best period of pregnancy. All the first trimester symptoms vanish and are replaced by a feeling of well being. The appetite increases and you need a proper diet in pregnancy. The key is to have a balanced rainbow diet in pregnancy. It should contain different food stuffs and be rich in proteins, vitamins and minerals. In order to avoid constipation in pregnancy, there should be a lot of fibre in your diet and you should drink plenty of water. You can read my blog on diet in pregnancy.
  • Around 15 to 16 weeks a quadruple marker is done and around 18 weeks a detailed ultrasound is done to rule out any congenital anamolies in the baby.
  • Cool, comfortable cotton clothes, regular exercise, good diet, plenty of fluids, stress free life, regular iron and vitamin supplements, timely visits to the doctor will help you sail through this period comfortably.

THIRD TRIMESTER

This is the last trimester of pregnancy. Regular ultrasounds may be required in this period. Usually, one scan at 28 weeks , another at 32 weeks and one just before delivery are required. Some regular blood tests may also be required. This trimester can be both physically and emotionally challenging period.

  • Swelling of the feet is very common in this period. This swelling usually disappears on rest. If the swelling persists even after rest or there is swelling on the face, hands etc you should contact your doctor.
  • You may feel an occasional random tightening of the uterus called Braxton Hicks contractions which are completely random and usually not painful.
  • Increased frequency of urination, heartburn are common in these months.
  • Staying active, plenty of rest, good diet, regular exercise will help make this period comfortable.
  • Remember that pregnancy is a physiological process and with proper guidance you can easily sail through pregnancy.

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