What tests should a woman who becomes pregnant have?
Once you have received the happy news that you are pregnant because you have done a urine test at home that confirms your pregnancy, it is important that in the next two weeks, you go to your gynecologist to confirm the pregnancy by ultrasound. The ultrasound is a transvaginal ultrasound in which we see that there is a uterine sac with a gestation and a heartbeat inside the uterus. This confirms that you are pregnant and the following tests that we are going to do in that trimester are going to be the first trimester screening in which we will see the possibilities or the risk that you have of having a baby with Down syndrome, in which we do an ultrasound to measure the nuchal fold of the baby along with an analysis that determines some hormones. All this makes up a formula that will indicate the risk index you have of having problems. If this index is low, then the pregnancy is out of risk, but if the index is high is when we would have to do an amniocentesis, which consists of a small puncture in the belly to remove amniotic fluid and check the baby’s chromosomes to rule out Down syndrome and other chromosomal problems. Once we know that you are pregnant, that the baby is in the right place and that the risk of Down syndrome is very small, we still have the baby’s anatomy test, which is a morphological ultrasound at week 20, in which we will determine that all the baby’s anatomy is correct and that there are no malformations of any kind.
What tests are done from the second trimester onwards?
It is important that in the second trimester you already have a good relationship and trust with your gynecologist, that you establish a good rapport to be able to ask him/her all the questions that will come to you, plus all the questions that will come to you from external people. In this second trimester we will determine that the mother is well. At the beginning we have already determined that the pregnancy was fine and without risks at the beginning, now we are going to see that your blood pressure is fine, that your weight is being adequate and that you are managing your blood sugar well with a test called the O’Sullivan test that will tell us if you have gestational diabetes or not. The next thing will be an ultrasound scan of the baby’s growth around the 30th-34th week, in which we will see that the babies that are outside the range in certain percentiles are either very large or very small and between the 2 ranges, between the 90th percentile and the 10th percentile, is the normal growth of babies. The 50% would be the middle stripe, to determine the growth lane in which the baby will be in the future weeks.
What tests are done at the end of the pregnancy?
Now we have already had a pregnancy control in which there have not been any problems or we have been able to address the problems that have been caused. We still have to determine if you are a carrier of a bacterium called group B streptococcus that could contaminate the baby and cause problems once it is born, and the next thing that is done is to establish the fetal well-being by means of straps that monitor the baby’s heartbeat, the fetal movements of the baby and the contractions that you may have. These straps that we make towards the end, when you are already fulfilled, will determine if the baby is well and we can continue to wait or if a previous intervention is necessary.
What care should you follow?
The normal care that common sense dictates. You do not have to do anything special, you are not in a process of disease, but in a process of gestation. You have to eat normally, for you, not for two, there will be a fattening of about 10 kilos, from 9 to 15 kilos, depending on the previous weight you had, you can exercise, have sex, lead a normal life. At the beginning it is easier, at the end the discomfort of carrying the belly determines a little back pain, indigestion… You can discuss all these issues with your gynecologist, but you have to lead a normal life.
When do you know that labor is about to begin?
That is always an anxious process but when you have regular contractions, every 5 minutes, or your water breaks, where the amniotic fluid when the amniotic fluid comes out and your legs get wet, that will determine that you have to go to the delivery room for the midwife to assess you and, if the cervix has been effacing and dilating, she will de- termine that you are already in labor and that the process has started.