Everything you need to know about antenatal consultations

According to international guidelines, your first doctor’s appointment should take place around between weeks six to eight of your pregnancy, ideally before week 10. At this appointment, you’ll be getting to know your designated obstetrician, planning out your future visits, and getting routine antenatal blood tests to check for your blood group, complete blood count, syphilis, rubella, varicella, hepatitis B, and Human Immunodeficiency Virus (HIV) status. By running all these tests at once, you will be prepared for a host of possibilities early on the pregnancy.

Photo credit: Meryl Spadaro (via Unsplash)

In this visit, your obstetrician will check your body weight, blood pressure, and perform tests such as urine screening for protein and sugar. Blood pressure and urine screening are important indicators of your chances of developing pre-eclampsia, which is a serious condition that affects both mother and baby.

Besides that, your obstetrician will perform an ultrasound scan to determine the size of your baby and assess your baby’s nuchal translucency (a fluid-filled space at the back of your baby’s neck), which might be an indicator of a chromosomal abnormality if the thickness of such space increases. Matilda also offers non-invasive prenatal testing (checking your baby’s DNA in the mother’s blood) to screen for genetic disorders like Down Syndrome due to its high sensitivity and specificity. Following your blood tests from the previous appointment, the doctor will also go over your results and identify any potential risk factors.

At 18 to 21 weeks, your baby is capable of yawning, kicking, and sucking its thumb. Beyond your normal check-up, this is also the time when you’ll also get an important ultrasound, also known as the “20-week structural scan,” during which the obstetrician will check to see if your baby has any abnormalities in the growth or development, including in the heart, spine, stomach, kidneys, and limbs. It is important to know that while many abnormalities are picked up by this scan, not all of them are. The obstetrician can often tell if you are having a boy or a girl, with about 95 percent accuracy.

If you prefer to wait until the birth to find out the sex of your baby, it’s a good idea to ask the obstetrician not to mention it. Besides, the obstetrician will observe the position of the placenta, the umbilical cord, the amniotic fluid around your baby, and your uterus and your cervix. If your placenta is positioned low in your uterus, the obstetrician will inform you that you have a low-lying placenta. Usually another ultrasound is recommended in the third trimester to ascertain that your placenta has moved away from your cervix.

You’re now in the final trimester! On top of your regular antenatal check, you’ll be getting an oral glucose tolerance test (OGTT) to determine whether you have gestational diabetes. While we know the pregnancy cravings are incredibly strong at this point, you’ll need to fast overnight for between eight to 10 hours to ensure the efficacy of the test. Your blood will be drawn at the start, after which you’ll have a glucose drink and rest for one to two hours before having more blood samples taken. This test is especially important as gestational diabetes does not necessarily occur in women who are already diabetic, and can lead to problems such as a difficult birth, premature labour, pre-eclampsia, and low blood sugar or jaundice in your baby.

The beginning of the final trimester is also a good time for you to get vaccinated against whooping cough (pertussis). The rate of whooping cough has risen sharply in recent years and babies who are too young to start their vaccinations are at greatest risk. Young babies with whooping cough are often very unwell and most will be admitted to hospital because of their illness. When whooping cough is particularly severe, it can even prove to be fatal.

Scientific evidence has shown that pertussis vaccines are very safe for pregnant women and their babies. Getting vaccinated while you’re pregnant is highly effective in protecting your baby from developing whooping cough in the first few weeks of their life. The immunity you get from the vaccine will pass to your baby through the placenta and provide passive protection for them until they are old enough to be routinely vaccinated against whooping cough at 8 weeks old.

Group B Streptococcus (GBS) is a type of bacteria which normally lives in the intestine, urinary, and reproductive tracts of men and women. It can be found in 10–30 percent of pregnant women’s vagina or rectum and it is not a sexually transmitted disease. Most pregnant women who are colonised with GBS generally have no symptoms or health effects, but it can be dangerous to newborn babies if they get infected. At week 36, your obstetrician will run a GBS screening test for you during your check-up. The test involves a swab of both the vagina and the rectum. The procedure is quick and should not be painful. If you test positive, you’ll simply have to receive intravenous antibiotic injections during labour to avoid passing it onto your baby. Your baby will be under the paediatrician’s care after birth.