Pregnancy Care
Though pregnancy is a normal physiological phenomenon, it is important to know about the changes happening at this time and how best we can tackle any problems .By and large, we maintain a doctor’s visit and checkup schedule to once every month till the first 7 months, then once in 15 days till 36 weeks and weekly till delivery. In exceptional situations or high-risk pregnancy sometimes we may ask a pregnant woman to visit the doctor more frequently.
It is important to take folic acid supplementation in the first three months of pregnancy (ideally the supplementation should start 3 months before you conceive) to avoid certain problems in the baby.
If you are overweight or vegetarian and mostly stay indoors then you should also take at least 10 micrograms of vitamin D supplementation.
You would be given some diet related advice during your first visit. Please see our “Diet tips in pregnancy” section…
As soon as your baby’s heart activity is established or by 8-10 weeks of pregnancy, you will be asked to get your blood and urine tested. The common investigations that are ordered in a normal healthy pregnancy are:
1) Blood group (if you are Rh negative then your husband’s blood group should also be checked)
2) Full blood count to check for anemia and its type.
3) HPLC (this takes care of sickle cell anemia, thalassemia and the 3 monthly blood sugar values)
4) HIV
5) Australia antigen to rule out hepatitis B
6) Glucose challenge test or random blood sugar
7) Urine routine to rule out infection.
If you are a high-risk person to develop diabetes in pregnancy, (family history, being overweight, previous gestational diabetes or history of heavy babies in the past) then you would be asked to get a Glucose tolerance test in the beginning only instead of Glucose challenge test.
You may be asked other specific tests if you are suffering from a particular medical condition.
It is recommended that you have an ultrasound test between 11 to 14 weeks of pregnancy to check the baby’s Nuchal translucency and nasal bone. At the same time getting a blood test for double markers(combined test- Nuchal translucency, serum beta-HCG,PAPP-A measurement) gives us an idea of Down’s syndrome. If you miss this time window then Down syndrome screening can be done by Triple test at 15-18 weeks. A detailed anomaly scan should be done between 18-20 weeks to rule out any major abnormality in the baby.
At around 28 weeks you will be asked to get your hemoglobin, sugar and urine tested again to pick up any missing cases. If required, you may be asked to get an ultrasound done again at any time in pregnancy to check for the baby’s growth.
I’ve added a few important conditions and concerns for your benefit:
Exercise During Pregnancy
Sexual Intercourse in Pregnancy
How can I take care of myself during pregnancy?
I’ve made a list of the common complaints during pregnancy and some tips for handling them:
Morning Sickness
Tiredness
Leg Cramps
Constipation
Urinating more often
Heartburn
Vaginal discharge
The amount of discharge from the vagina increases normally during pregnancy. So you may feel more wet, but if there is no bad smell or itching then most of the times there will be nothing to worry.
Talk to your doctor about any unusual discharge or concerns.
Bleeding Gums
Brush and floss regularly, twice a day and see your dentist for cleanings.
If you have any dental procedure pending then you must get it done, but be sure to tell your dentist that you’re pregnant.
Nose bleeds
Nosebleeds are more common during pregnancy as the blood supply to nose increases under the effect of pregnancy hormones. Avoid going out in harsh sun and keep your blood pressure under control.
Swelling in your legs
Rest often with your legs up. Lie on your side; either left or right while sleeping so blood flows from your legs back to your heart better.
Diuretics should only be taken under the supervision of a doctor.
Painful defecation
Avoid straining for stools and do not sit on the pot for a prolonged period of time.
Avoid constipation by eating sensibly.
Sitting in the warm bath (Sitz bath) may decrease the pain.