Pregnancy Digest – Part 4

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Hope you have fun reading my Pregnancy Digest . Here presenting the Pregnancy Digest to solve all your queries about Pregnancy. In this part of  Pregnancy Digest you will read about types of test required to be performed during pregnancy.

Routine Investigation during pregnancy  would lead to maternity care . This involves the initial confirmation of pregnancy and first laboratory tests.  This article provides guidance on appropriate testing in early pregnancy, throughout pregnancy and information about common changes to testing reference ranges during pregnancy.
When a woman becomes pregnant, it is recommended that she receives a range of standard investigations. A first antenatal screen is required even if the woman is considering termination of pregnancy.
Note: the information below is a general guide only. The arrangements, and the way tests are performed, may vary between different hospitals. Always follow the instructions given by your doctor or local hospital.
Routine investigations during pregnancy:

Complete blood count (CBC) – Blood test like  – Haemoglobin , ABO , Rh grouping, VDRL are done ( blood glucose in selected cases ) . This gives information on a number of haematological parameters, but generally in pregnancy the most useful are the haemoglobin, platelets and white blood cell count. Most laboratories will provide pregnancy adjusted reference ranges to enable easier interpretation.

Urine test – for protein , sugar and pus cells . It is recommended that all women have a mid-stream urine culture at the time of the first antenatal screen, again at the second antenatal screen and then at 36 weeks gestation, to exclude a sub-clinical urine infection (asymptomatic bacteriuria).

Test for Gestational diabetes -Gestational diabetes affects 5–8% of pregnant women and is associated with hypertensive disorders, macrosomia, shoulder dystocia, increased rates of caesarean delivery and the development of maternal diabetes later in life.

Serological test for rubella, hepatitis B virus and HIV

  • Rubella antibody status – All pregnant women should be screened for rubella antibodies. Contracting rubella during pregnancy presents a high risk of harm to the foetus.
  • Hepatitis B serology –Up to 85% of infants born to mothers infected with hepatitis B (particularly mothers who are HBeAg positive, i.e. with active infection), will become carriers and will be more likely to develop chronic liver disease, including cirrhosis, liver failure or liver cancer
  • HIV screening -All pregnant women should be screened for HIV. Women who are HIV positive can be given treatment to reduce the risk of HIV being transmitted to their infant (risk reduced from 32% to less than 1%).

Ultrasound examination  –It can be either Transabdominal ( TAS) or Transvaginal ( TVS ). USG used to identify many conditions that would be harmful to the mother and the baby.

Obstetric ultrasound is primarily used to:

  • Date the pregnancy (gestational age)
  • Confirm fetal viability
  • Determine location of fetus, intrauterine vs ectopic
  • Check the location of the placenta in relation to the cervix
  • Check for the number of fetuses (multiple pregnancy)
  • Check for major physical abnormalities.
  • Assess fetal growth (for evidence of intrauterine growth restriction (IUGR))
  • Check for fetal movement and heartbeat.
https://en.wikipedia.org/wiki/File:Embryo_at_5_weeks_5_days_with_heartbeat.gif
Embryo at 5 weeks and 5 days of gestational age with discernible heartbeat P.C.

USG at first trimester 

  • Transvaginal USG is performed to determine the gestational age of foetus . CRL in USG shows fetal age between 7- 12 weeks
  • Gestational sac and yolk sac at 5 week
  • Embryonic movements at 7 weeks
  • Fetal cardiac activity by 10 week

In the first trimester, a standard ultrasound examination typically includes:

  • Gestational sac size, location, and number
  • Identification of the embryo and/or yolk sac
  • Measurement of fetal length (known as the crown-rump length)
  • Fetal number, including number of amnionic sacs and chorionic sacs for multiple gestations
  • Embryonic/fetal cardiac activity
  • Assessment of embryonic/fetal anatomy appropriate for the first trimester
  • Evaluation of the maternal uterus, tubes, ovaries, and surrounding structures
  • Evaluation of the fetal nuchal fold, with consideration of fetal nuchal translucency assessment

Second and third trimester:

In the second trimester, a standard ultrasound exam typically includes:

  • Fetal number, including number of amnionic sacs and chorionic sacs for multiple gestations
  • Fetal cardiac activity
  • Fetal position relative to the uterus and cervix
  • Location and appearance of the placenta, including site of umbilical cord insertion when possible
  • Amnionic fluid volume
  • Gestational age assessment
  • Fetal weight estimation
  • Fetal anatomical survey
  • Evaluation of the maternal uterus, tubes, ovaries, and surrounding structures when appropriate
This post is for Day 7 of NaBloPoMo 
Disclaimer : this post is based on average research and indication purpose only . It’s highly recommend to concern your doctor before proceeding further .
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2 Comment

  1. This is very useful series.A lot of people will be helped.

    1. Dew Cool says: Reply

      Thanks for stopping by
      🙂

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