Pregnancy Monitoring
Pregnancy follow-up aims to control the health of both mother and baby from the first day of pregnancy until the birth is completed. Pregnancy is diagnosed after a blood and urine test performed by a specialist doctor. After 2 weeks following the diagnosis of pregnancy, the gestational sac can be visualised by ultrasound. With this ultrasound examination, it is checked whether the gestational sac is inside or outside the uterus. 1-2 weeks after the pregnancy is in the uterus, the baby's heartbeat can be heard with the help of vaginal ultrasound. After all these examinations, the health status of the mother and baby continues to be monitored with the necessary examinations throughout the pregnancy.
Pregnancy follow-up is extremely necessary for the baby to complete its development in a healthy way during this period and to keep the mother's health under control. Every pregnant woman should spend this period under the control of a specialist doctor. Factors such as the age at the time of conception, the expectant mother's disease history, weight and current health problems directly affect the course of pregnancy. In order for the baby to be born smoothly and healthily, the tests and examinations requested by the specialised doctors should be performed completely.
How often should pregnancy follow-up be done?
If the baby is single in the womb, it is ideal to have a doctor check every 2-3 weeks for the first 3 months. After the first 3 months, monthly medical examination is recommended. In multiple pregnancy, these periods should be even shorter. Pregnancy follow-up aims to keep the health of both mother and baby under control during pregnancy.
Pregnancy Checks According to Weeks
There are tests and examinations that should be looked at every period of pregnancy. These tests ensure that the mother's health is kept under control, while at the same time ensuring that the baby's development in the womb is completed completely. The controls that should be done according to the weeks of pregnancy are as follows:
- Ultrasound examinations are very important in the 10th-14th weeks of pregnancy. In the ultrasound examination performed during these periods, the nuchal thickness of the baby is checked. This imaging gives an idea about whether there is a risk of Down Syndrome in the baby.
- During the first 14 weeks of pregnancy, the mother's personal information, disease history, weight/height, pulse rate, blood pressure, etc. are recorded and general body examinations are performed. During the examinations, the following laboratory tests are requested from the mother
- Urinalysis
- Blood test to measure haemoglobin, indirect coombs, blood group, ferritin values and TSH analysis
- Fasting blood glucose
- Chromosomal aneuploidy screening tests
After the above tests are performed, pregnant women are given various supplements if deemed necessary. Applications such as iron, vitamin D, infection treatment if any, hepatitis B and tetanus vaccination can be performed if deemed necessary.
- A triple screening test is requested from the mother at 16-18 weeks of pregnancy. If the triple screening test is high in the baby imaged by ultrasound, amniocentesis is performed.
- At 20-24 weeks, the baby's organ development is almost complete. With detailed ultrasonography, it can be determined whether there is any abnormality in the baby's organs.
- In the 24-28th weeks of pregnancy, it is checked whether the mother has gestational diabetes. Since gestational diabetes poses a risk for both mother and baby, sugar loading test is applied to mothers in these weeks of pregnancy. In addition, mothers with blood incompatibility are given a blood incompatibility test at 28 weeks.
- In the 28-36th weeks of pregnancy, the mother's weight and blood pressure are monitored more closely. The baby's controls are continued with ultrasound examination.
- After the 36th week, it is decided which way the birth will be done. NST test is applied to determine the general condition of the baby. In these weeks, the NST test is performed once a week, while from the 40th week onwards, the NST test is performed every 2-3 days.
- After the 40th week of pregnancy, doctor controls are every 2-3 days. If labour does not start in these weeks, the mother is hospitalised and labour is initiated with medication.
What is Sugar Screening in Pregnancy? How is it done?
Gestational diabetes can be seen in expectant mothers at 24-28 weeks of pregnancy. Since gestational diabetes poses a risk for both mother and baby, sugar screening is recommended. Sugar screening is given to the mother by dissolving 50 grams of pure glucose in water. After drinking this sugar water, postprandial blood sugar is measured 1 hour later. If the PPG, Postprandial Glucose value is high, a sugar loading test called 100 grams oral glucose tolerance test is performed.
The pregnant woman who is asked to fast for 12 hours is then given 100 grams of glucose dissolved in water. Blood glucose is measured in the 1st, 2nd and 3rd hour following this application. If two or more results are high in these measurements, gestational diabetes can be diagnosed.
What is Triple Screening Test?
Triple screening test, 16-20 weeks of pregnancy. Weeks of pregnancy. After the first ultrasound examination of the pregnant woman, a blood test is requested. Alpha Fetoprotein (AFP), B-HCG and u-E2 values are analysed in this blood sample. The results and information such as the mother's last menstrual period, age, weight and smoking habit are entered into a computer and analysed. With the triple screening test, results such as Down Syndrome, Edwards Syndrome and neural tube defects can be obtained in the baby.
What is the Quadruple Screening Test?
The quadruple screening test has the same purposes as the triple screening test. In addition to the tests performed in the triple screening test, inhibin-A values are also wanted to be checked. Compared to the triple screening test, the success rate is much higher. The success rate for detecting a foetus with Down syndrome in the quadruple screening test is 80%. This is not a definitive diagnosis. It only indicates that there is a high risk of Down syndrome in the baby. For expectant mothers who do not have a double test, NT measurement or combined test in the first trimester of pregnancy, the quadruple screening test is even more important.
In pregnant women over 35 years of age, amniocentesis is performed directly without a quadruple screening test due to the high risk. Amniocentesis is the sampling of the water in which the baby develops with the help of a fine needle. Since the amniocentesis procedure performed by a specialist doctor is extremely reliable, there is no reason for panic.
What is Premature Birth Screening?
Premature birth screening is requested in cases where the expectant mother has had a premature birth before, has had cervical surgery before pregnancy, has abnormalities in the uterus and multiple pregnancies. In this screening, the length of the cervix is measured by transvaginal ultrasound. A cervix length of 25 mm or less indicates that there is a risk of preterm birth. A cervical length of 27 mm or more is a comforting result. As the length of the cervix shortens, the risk of preterm labour increases. Looking only at the length of the cervix for suspicion of preterm labour can lead to misleading results. For this reason, all necessary tests and examinations should be performed completely in all weeks of pregnancy. Since the cervix is a dynamic structure that can shorten due to contractions, it is sufficient to keep pregnant women at risk of preterm birth under control. In addition, in recent years, the risk of preterm birth can be prevented with progesterone support given to pregnant women with a short cervix.
Frequently Asked Questions About Pregnancy Monitoring
How Many Weeks Is Pregnancy Follow-up Performed?
If the baby is single in the womb, the first three months should be checked every 2-3 weeks and monthly in the following periods. In multiple pregnancies, these periods can be even shorter.
When Does Pregnancy Monitoring Start?
Pregnancy follow-up should be started from 6-8 weeks of pregnancy after the onset of pregnancy. It should be started from the week. Since different tests and examinations are performed in each period of pregnancy, these examinations should be performed weekly in certain periods of pregnancy and monthly in certain periods of pregnancy.
Is Pregnancy Follow-up Mandatory?
Pregnancy follow-up is extremely important in order to keep the health of both mother and baby under control. While many of the tests that need to be done in this process are mandatory, many of them can vary according to the mother's request. However, it is recommended to have the tests requested by the doctor for a healthy pregnancy process.
