Pregnancy Care
It is a blessing to be a mother. The biggest happiness for any couple is a positive urine pregnancy test. Along 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 wellbeing of the mother and the growth of the baby in the pregnancy. It involves specific blood tests at suitable periods of pregnancy, ultrasounds, physical check-ups, dietary advice, advice on exercise, travel, work, prevention and early detection of any problem.
Pregnancy is divided into three trimesters
- First trimester – till 12 weeks
- Second trimester – 13 to 28 weeks
- Third trimester – 29 weeks till delivery or full term i.e. 40 weeks
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
- Hemogram (Haemoglobin)
- Blood sugar in fasting state as well as 2 hours post meal
- Viral markers- HIV, HbsAg, HCV, VDRL
- Thyroid test (Serum TSH)
- Haemoglobin electrophoresis – to rule out thalassemia
- Urine routine
- Ultrasound -to confirm healthy live pregnancy in uterus
Which vitamin is prescribed in early pregnancy
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.
What kind of clothing should be worn
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 hormone- Progesterone.
Dietary advise
-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 unpredictable and there may be a feeling of nausea or you may have some vomiting.
-Woman may desire to eat many things but when food actually arrives, she may find herself unable to eat.
-It is usually advisable to eat small frequent meals to keep your energy levels up.
-Avoid eating outside junk food. Home cooked foods are best for you.
-Spices and oil should be used in moderation.
-Those who take non-vegetarian food and eggs can continue to do so but it should be preferably home cooked
-Have plenty of fluids but avoid carbonated drinks that is no soda and cold drinks for you!
Special tests
-At around 11 to 13.6 weeks it is you can 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 genetic defects in the baby (though you need to understand 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 safe & best period of pregnancy.
-Most of the first trimester symptoms vanish and are replaced by a feeling of wellbeing.
-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.
-Between 18 weeks- 20 weeks of gestation a detailed ultrasound is done to rule out any structural anomalies in the baby. This sonography can be 2D scan or 3D-4D scan.
– Iron and calcium supplements are started in this trimester.
Cool, comfortable cotton clothes, regular exercise, good diet, plenty of fluids, stress free life, timely visits to the doctor will help you sail through this period comfortably.
THIRD TRIMESTER
This is the last trimester of pregnancy.
-Regular ultrasounds for growth monitoring are required in this period.
-Usually, one scan at 28 weeks, another at 32 weeks and one just before delivery are required.
-In last ultrasound-colour doppler studies are also done.
-Some blood tests are repeated in this trimester before delivery like Haemoglobin, blood sugars & viral markers.
-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 occasional random tightening of the uterus called Braxton Hicks contractions which are completely random and usually not painful.
-Increased frequency of urination, heartburn is 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.