It is best to contact an antenatal clinic for registration at 6–8 weeks of pregnancy. To register, you must present a passport and a compulsory health insurance policy (CHI). By the way, if you register early (up to 12 weeks), you are entitled to a one-time cash benefit. During a normal pregnancy, it is recommended to visit a gynecologist at least seven times during the entire period of bearing a child. In the first trimester - once a month, in the second trimester - once every 2-3 weeks, from 36 weeks until birth - once a week. Also, during pregnancy it will be necessary to undergo three screening ultrasound examinations: at 11–14 weeks, 18–21 weeks and 30–34 weeks.
At the first appointment, the obstetrician-gynecologist examines the woman, confirms the fact of pregnancy, and assesses the condition of the vaginal walls and cervix. The doctor also measures weight, height, blood pressure and pelvic size expectant mother– in the future, these parameters will be recorded at each inspection. In addition, the doctor fills out Required documents, gives recommendations on nutrition and taking vitamins, writes out referrals for tests and to other specialists.
Flora smear during pregnancy. The doctor must take a smear for flora and cytology for microscopic examination. A repeat smear for flora during pregnancy is taken at the 30th and 36th weeks. The analysis allows us to determine the development of the inflammatory process and identify infections. For any deviations from the norm, additional tests are prescribed, for example, a test for sexually transmitted diseases (STDs). If they are detected, the doctor decides on the advisability of treatment. Some infections pose a danger to the normal development of the fetus and can lead to chromosomal abnormalities, damage to the placenta and various organs of the child - it makes sense to treat them. Among medications, topical agents that do not contain antibiotics (suppositories, creams) are most often used; starting from the second trimester of pregnancy, the doctor may prescribe antibacterial drugs.
General urine test during pregnancy. Allows you to quickly assess the general health of a pregnant woman and the functioning of her kidneys. In the future, it is carried out at every visit to the doctor during the entire period of gestation. You need to collect urine in a special Plastic container(you can buy them at the pharmacy) in the morning, immediately after waking up. At night, the kidneys work more actively, as a result, the urine becomes more concentrated - this allows for more accurate diagnosis.
Normally, urine should be light yellow and almost transparent. Dark, cloudy urine is a sure sign of abnormalities in the body. This could be, for example, kidney disease, genitourinary system diseases, the development of infections or diabetes, and much more. A doctor will be able to more accurately determine what exactly is wrong after studying the results of a urine test. Based on changes in some indicators, one can suspect the development of gestational pyelonephritis (infectious inflammation of the kidneys, often occurring in pregnant women due to obstructed outflow of urine) or gestosis (a complication of pregnancy, which is manifested by increased pressure, swelling and the appearance of protein in the urine). Thus, regular urine testing allows you to timely monitor the occurrence of many serious diseases and begin their treatment.
General (clinical) blood test during pregnancy. One of the most informative tests, along with a urine test, allows you to assess the woman’s health as a whole, indicating the presence of problems in the functioning of certain body systems. A blood test during pregnancy is taken three times: upon registration and then in each trimester (at 18 and 30 weeks), and more often if necessary. This allows the doctor managing the pregnancy to monitor the dynamics of the patient’s condition and monitor important indicators. Based on the results of a clinical blood test during pregnancy, the number of leukocytes, platelets, hemoglobin is determined, ESR and other indicators are assessed. For example, a high level of white blood cells and neutrophils indicates that there is an inflammatory process in the body. A low hemoglobin level indicates iron deficiency in the body and the likelihood of developing anemia. This disease is dangerous because the fetus does not receive enough oxygen, this negatively affects its development, and the risk of miscarriage and premature birth also increases. High ESR (erythrocyte sedimentation rate) indicators indicate the possible development of several serious illnesses, up to oncological ones, in this case additional studies are carried out to clarify the diagnosis. Platelets are responsible for blood clotting, so high levels indicate there is a risk of blood clots.
Coagulogram. How the blood coagulation system works is also judged by a coagulogram; this analysis is done once every trimester, if there are no deviations. The indicators here are normally higher than before pregnancy, since during pregnancy the activity of the coagulation system increases.
Biochemical blood test during pregnancy. It is usually done at the same time as other blood tests. It helps to identify malfunctions in the functioning of various organs. For example, high levels of creatinine and urea indicate impaired kidney function. High bilirubin indicates possible liver problems, including the development of jaundice in pregnant women. A very important indicator is glucose level (blood sugar test). Allows you to evaluate the functioning of the pancreas and not miss the onset of the development of a fairly common pregnancy complication - gestational diabetes. This happens because during pregnancy the pancreas puts a lot of stress on it. Elevated blood glucose levels indicate that the gland is not coping with its tasks.
Analysis for blood group and Rh factor. Doctors are required to do this test, even if you have had it before. It is very important to accurately determine the blood type of the expectant mother, since in the event of large blood loss or unscheduled surgery, doctors may urgently need this information, and there will be no time to do the analysis. If a woman has a negative Rh factor, and the child’s father is positive, a Rh conflict may occur when the mother’s body perceives the child as a foreign body and produces antibodies to eliminate it. This can have serious consequences: cause the development of anemia, miscarriage or intrauterine fetal death. Therefore, if it turns out that a woman has a negative Rh factor, the child’s father donates blood. If he has a positive Rh factor, the expectant mother is regularly tested to monitor the appearance of antibodies: once a month until the 32nd week of pregnancy, and after this period and until the end of pregnancy - twice a month. If this is the first pregnancy and antibodies have not appeared before the 28th week, doctors suggest administering a special drug that blocks the production of antibodies in the future.
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. The incubation period of these diseases is long, they may not manifest themselves immediately or not at all during pregnancy, and test results may also be negative for some time. Therefore, blood is checked for HIV and hepatitis twice – at the beginning of pregnancy and at 30–35 weeks. To diagnose syphilis, the Wasserman reaction test (RW) is used - it is done upon registration, at 30–35 weeks and 2–3 weeks before the expected date of birth. If any of the listed serious diseases is detected at an early stage, the option of terminating the pregnancy is possible; if at a late stage, the doctor will prescribe treatment if possible.
Blood test for . These include: toxoplasma, rubella, cytomegalovirus, herpes and some other infections. They are dangerous not so much for the health of the mother as for the development of the child. If a woman before pregnancy suffered from diseases that cause the listed infections, then she should develop immunity to TORCH infections that are potentially harmful to the fetus, and special antibodies will be present in the blood - their presence is what this test allows to identify. If there are no antibodies, the doctor will tell the expectant mother about the preventive measures that she must follow.
Also, in the first two weeks after contacting the antenatal clinic, a woman will need to visit a therapist, endocrinologist, ophthalmologist and otolaryngologist, and have an electrocardiogram done. If the expectant mother has health problems or any chronic diseases, consultations with other specialists and additional examinations during pregnancy may be necessary.
If the pregnancy is late or there are other indications, between the 10th and 12th weeks the doctor may prescribe a chorionic villus test (CVS) - a study of placental tissue to determine chromosomal abnormalities in the embryo.
"Double test"
At 11–14 weeks, according to the pregnancy examination plan, the first screening, or “double test,” is performed. It is also used to find out whether the fetus is at risk of developing chromosomal abnormalities such as Down syndrome. Screening includes ultrasonography, a blood test to determine the level of human chorionic gonadotropin (hCG) and a protein that is produced in plasma (PAPP-A).
Pregnancy examinations: second trimester (14th to 27th week)
In the second trimester, it is recommended to visit a gynecologist once every 2-3 weeks; from the 16th week, during an examination, the doctor begins to measure the height of the uterine fundus and the volume of the abdomen to determine whether the child is developing correctly. These parameters will be recorded at each visit. At 18–21 weeks, a second screening or “triple test” is performed. It again determines the presence of hCG, alpha-fetoprotein (AFP) and free estriol (a steroid hormone). Together, these indicators allow doctors to make a fairly accurate prognosis. However, even if it turns out that the risk of developing a pathology in a child is high, this is not a death sentence. In this case, additional clarifying studies are carried out, for example, analysis amniotic fluid(between 14th and 20th weeks).
Also, in the period from the 18th to the 21st week, a second planned ultrasound is performed, during which the condition of the placenta and amniotic fluid is assessed, the child’s development corresponds to the norms, and it is also possible to determine the sex of the baby.
Pregnancy examinations: third trimester (28 to 40 weeks)
As a rule, at the 30th week, the antenatal clinic doctor arranges maternity leave and issues an exchange card to the pregnant woman. From the 30th to the 34th week, an ultrasound is performed for the third time - to determine the height and approximate weight of the fetus, its position in the uterus, the condition of the placenta, the quantity and quality of amniotic fluid, and the presence of umbilical cord entanglement. Based on these data, the doctor makes recommendations regarding the method of delivery.
At 32–35 weeks, cardiotocography (CTG) is performed - a work study of cardio-vascular system embryo and its motor activity. Using this method, you can determine how well the child feels.
From the 36th week until birth, the doctor carries out routine inspection every week. During the entire period of bearing the baby, the gynecologist may prescribe additional tests or send the expectant mother for consultations with other doctors - it all depends on the characteristics of the pregnancy.
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Exchange card is the most important document of the expectant mother
An exchange card is issued at the antenatal clinic at 22–23 weeks, and it is better to always have it with you. This is an important medical document for a pregnant woman, which will be needed when registering for a maternity hospital.
The exchange card consists of three parts (coupons):
- Information from the antenatal clinic about a pregnant woman. Here, the obstetrician-gynecologist, who monitors the woman throughout the entire period of pregnancy, enters basic information: personal data of the expectant mother, blood type and past and chronic diseases, information about previous pregnancies and births, results of examinations, tests, screenings, ultrasound, CTG, conclusions other specialists. After reviewing these data, the doctor in the maternity hospital will be able to find out all the necessary information about the characteristics of this pregnancy and assess the woman’s health status.
- Information from the maternity hospital about the woman in labor. Filled out by the doctor before the woman is discharged from the maternity hospital - he enters information about how the birth and the period after it went, about the presence of any complications, and makes notes about the need for further treatment. This part of the card will need to be given to the antenatal clinic doctor.
- Information from the maternity hospital about the newborn. Here all the baby’s parameters are recorded: height, weight, Apgar score (a summary analysis of five important criteria for the baby’s condition) and others. This part of the card will need to be handed over to the pediatrician who will monitor the child, he will create a medical record and transfer all the necessary data there.
Approximate schedule for examination during pregnancy:
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Upon registration (8–12 weeks) |
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| Within 2 weeks after registration |
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| 11-14 weeks |
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| Week 16 |
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| 18-21 weeks |
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| Week 20 |
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| Week 22 |
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| Week 24 |
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| Week 26 |
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| Week 28 |
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| 30 weeks |
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| 30-34 weeks |
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| 32-35 weeks |
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| 36 weeks (and then once a week before giving birth) |
|
Monitoring and management of pregnancy from the moment of its onset until birth is carried out by an obstetrician-gynecologist in the antenatal clinic. After establishing the fact of pregnancy, the woman is registered at the dispensary. Registration in the early stages of pregnancy (up to 12 weeks) allows you to promptly identify and eliminate possible dangers to the mother and fetus, predict childbirth and effectively prevent possible complications.
The pregnancy management program includes planned diagnostic measures carried out at certain gestation periods. Currently, standards have been adopted in gynecology, according to which during a normal pregnancy a woman should visit a gynecologist on average 10-12 times: in the first half of pregnancy - once a month; after the 20th week - once every 2 weeks; from the 32nd week - 1 time per week. If there is the slightest change in health, a pregnant woman should come for an appointment without waiting for the appointed date. The pregnancy management program also includes special physical exercises, breathing exercises, self-massage training, and trainings.
Normal pregnancy
Comprehensive pregnancy management allows you to predict the course and outcome of the gestation period, as well as prevent possible complications. At the first visit to an obstetrician-gynecologist, the fact of pregnancy and its timing are established, as well as the correspondence of changes in the woman’s body to the gestational period. The pregnant woman's medical history is carefully collected, the date of her last menstruation is specified, a general examination is carried out, the development and condition of the mammary glands is assessed, body weight and height are measured, and blood pressure is measured in both arms.
Usually, during the first consultation of a pregnant woman, the pelvis is examined by palpation, inspection and measurement of external dimensions with a special instrument - a pelvis meter. The study of the structure and size of the pelvis plays an important role in predicting the course and outcome of childbirth. When conducting a vaginal examination to enlarge the uterus in volume, the gestational age is specified, the condition of the body and cervix, appendages, pelvic capacity is determined, and the diagonal conjugate is measured. When registering, swabs are taken to determine the degree of purity from the urethra, cervical canal and vagina.
During the first visit, the pregnant woman is given directions for clinical blood and urine tests, ECG, blood testing for the Wasserman reaction (RW), HIV infection, hepatitis B and antibodies to hepatitis C, blood type and Rh. When a pregnant woman is determined to be Rh negative, her husband's Rh factor is tested. If the husband’s blood turns out to be Rh positive, then during pregnancy the development of Rh conflict cannot be ruled out, causing death or severe pathology - hemolytic disease of the fetus. Therefore, when determining Rh-negative blood in a woman and Rh-positive in her husband, the pregnant woman’s blood is tested monthly for the presence of antibodies, and if they are detected, the woman is sent for hospital treatment.
The examination program for a pregnant woman in the first trimester includes consultations with a therapist, dentist, ophthalmologist, otolaryngologist and other specialists according to indications, who provide recommendations on the management of pregnancy and delivery. If the pregnant woman is over 35 years old or there are hereditary diseases in the family, a genetic consultation is carried out. Repeated consultations with a therapist and ophthalmologist are carried out in the third trimester of pregnancy.
According to the pregnancy management program, ultrasound examinations of the fetus are performed at least once in each trimester. Ultrasound screening allows us to determine whether the size of the fetus corresponds to the gestational age and monitor the normal development of all organs. In the third trimester, Doppler measurements are performed to assess the adequacy of uteroplacental blood flow. After the 32nd week, fetal cardiac monitoring (CTM) is performed to determine the state of the cardiovascular system.
At each consultation during pregnancy, an external obstetric examination is performed, the abdominal circumference, the height of the uterine fundus are measured, the position and presentation of the fetus are determined, and its heartbeat is listened to. The pregnant woman is also regularly weighed and blood pressure measured in both arms.
Before each scheduled visit to the gynecologist, a general urine test with protein determination is performed, which is necessary for the timely detection of signs of toxicosis. The frequency of conducting a clinical blood test is at least 3 times, more often if indicated. In the third trimester, the blood is retested for RW and HIV, and vaginal smears are taken for microbial flora. The pregnancy management program also includes a one-time blood test for TORCH infections (rubella, cytomegalovirus, chlamydia and toxoplasmosis), PCR diagnostics of the cervical canal (for chlamydia, herpes, mycoplasma, ureaplasma, HPV).
A pregnancy management program may include classes at a pregnancy school aimed at preparing for childbirth and learning how to care for a newborn. At 30-32 weeks, an exchange card is issued with information about the course of pregnancy, the results of all examinations, which remains in the woman’s hands until delivery. Some clinics include monitoring of women during childbirth and the postpartum period in their pregnancy management program.
Complicated pregnancy
Management of pregnancy occurring with pathology and pregnancy resulting from in vitro fertilization (IVF) requires increased attention and more careful monitoring. The high-risk group also includes women with extragenital pathology (kidney diseases, cardiovascular diseases,
One of the main activities of the MEDOC antenatal clinic network is pregnancy management. In our clinics you can sign a contract for pregnancy management.
The MEDOC antenatal clinic network has created the most comfortable conditions for expectant mothers.
When choosing a antenatal clinic, a woman must take into account many criteria, which not all clinics meet. After all, we are talking not only about your health, but also about the health of your unborn child.
What criteria are paramount in choosing a antenatal clinic?
All the criteria mentioned below are based on a survey of pregnant women who chose the MEDOC clinic as their antenatal clinic.
The doctor who will manage the pregnancy
- The doctor must know not only the general principles of pregnancy management, but also practice individual approach to pregnancy management, because every pregnancy is unique. What is important here is an individual approach to each patient.
The doctor leading the pregnancy must, first of all, be an expert in his field. He should know everything about pregnancy.
Direct antenatal clinic.
1. Technical equipment.
The antenatal clinic should be equipped with modern equipment that meets modern requirements. This applies primarily to:
Treatment room:
- sterile wipes and disposable gloves.
fast deadlines performing analyzes,
convenient time work of the treatment room,
disposable instruments,
vacuum systems,
Doctor's office: one office - one gynecologist, disposable instruments.
Ultrasound room: ultrasound machine, two sensors and another sensor for longer periods, the doctor shows the image to the patient, carefully performing screenings.
2. Location of the antenatal clinic.
- The ability to always get an appointment at a convenient time.
The antenatal clinic should be located near your home, within walking distance. A pregnant woman should not push into public transport or driving while pregnant, much less stuck in traffic jams.
Women who have entered into a contract for pregnancy management in the MEDOC network of antenatal clinics undergo all necessary examinations and pass all tests required for pregnant women.
The contract for pregnancy management includes:
- issuing an exchange card and maternity leave disability (sick leave).
consultations with an obstetrician-gynecologist and laboratory diagnostics (tests) for the initial examination when registering for pregnancy,
consultations with doctors, instrumental and laboratory diagnostics by trimester,
additional tests and specialist consultations,
You can read more about the tests required for pregnant women in a separate article on our website.
What are the main advantages of concluding a contract for pregnancy management at MEDOK?
The main advantages of pregnancy management in MEDOC clinics:
- When planning a birth abroad, a individual programs management of pregnancy up to 30 weeks with translation of research and analysis results into English.
The pregnancy management program is compiled according to the standards of the Ministry of Health of the Russian Federation, supplemented by WHO recommendations.
Location of antenatal clinics. Network in Moscow and the Moscow region. Mostly residential complexes are located in new areas where young families live.
All analyzes and studies are performed at a time convenient for you without queues.
Minimum turnaround time for tests, the results of which are sent to you by email. The readiness of analyzes is notified via SMS.
All tests required by WHO are performed, and additional tests are included at no additional charge.
3D/4D ultrasound, which will introduce you to your baby, and a disc with a video and the first photos of your baby will remain as a keepsake.
The MEDOC antenatal clinic network provides all the necessary documents (exchange card, pregnancy sick leave, current sick leave).
The opportunity to personally choose a doctor after preliminary communication. The first consultation is free.
Experienced specialists.
Modern equipment.
24-hour communication with your doctor in all emergency situations.
Unlimited number of emergency appointments.
Day hospital.
The pregnancy management contract provides various options payment: one-time payment, installments for two payments, payment options according to an individual schedule are possible.
The MEDOK network of antenatal clinics provides contacts of the best leading maternity hospitals in Moscow.
It is possible to manage pregnancy with various pathologies.
Discount on contract 7%.
10% contract discount on all services for one relative.
When concluding a contract, the pregnant woman gets a 10% discount on services not included in the contract and 20% on tests.
The contract price provides a discount of up to 40% on all services compared to prices without a contract.
There is a 5% discount for re-signing a contract.
Pregnancy management has been our leading area since 2011 (since the opening of the first MEDOC clinic in the city of Krasnogorsk in the Pavshinskaya Poyma microdistrict)
During the existence of the network of clinics, we have accumulated vast experience. As one of the leading rapidly growing antenatal clinics in Moscow and the Moscow region, we are constantly introducing new technologies and improving examination systems.
Our specialists constantly improve their skills, exchange experience with leading specialists in the field of obstetrics and gynecology, and conduct research work.
Doctors and employees of the MEDOC antenatal clinic network create all the conditions to ensure that pregnancy brings only joy to expectant mothers.
We want you to turn to us after childbirth.
Reading time: 5 minutes
The news that a woman will become a mother implies the need to decide who will manage the pregnancy in order to receive the necessary medications, vitamins, do tests, and be examined by a good specialist. Pregnancy care takes place in antenatal clinics in Moscow and the region, but there are clinics where paid pregnancy monitoring is carried out, and there are courses in preparation for childbirth. The choice is up to the future parents, depending on their capabilities.
What is pregnancy management
A pregnant woman is required to register; specialists from a medical institution will observe her until birth, monitor the development of the fetus, promptly identify pathologies, and prevent dangerous diseases. A vaginal examination is carried out at least three times during pregnancy, blood pressure, weight, abdominal circumference, height of the uterine fundus are measured, the fetal heartbeat is listened to, and tests are taken. You also need to visit:
- otolaryngologist;
- dentist;
- surgeon;
- venereologist;
- ophthalmologist;
- endocrinologist.
Pregnancy management in the maternity hospital
An important condition for bearing a healthy child is a systematic visit to an obstetrician-gynecologist, who determines how the pregnancy is progressing and records this in the exchange card. Reception is carried out by the antenatal clinic at the clinic or maternity hospital. Such free pregnancy support is convenient: close to your place of residence, you can easily get all the documents, referrals to specialists and to the maternity hospital. But there are disadvantages:
- you can’t do without queues;
- for additional consultations, you should contact specialists from other medical institutions;
- antenatal clinics are not always provided by highly qualified doctors;
- often inattentive attitude towards the patient;
- choosing a doctor is difficult;
- lack of modern equipment, good conditions, so wealthy women choose comprehensive management at a certain price.
Pregnancy management plan
Registration occurs no later than 12 weeks. The pregnancy management plan in the antenatal clinic involves a clear system of examinations and recommendations. The pregnant woman’s chart will record the results of tests and examinations, doctor’s appointments, and consultation schedule; the decision on their number is made depending on the progress of fetal development and the condition of the woman. The plan includes screenings, there are two of them, they determine the risk level of congenital defects. So, the main points of the plan:
- On early stages– examination by a gynecologist, referral for tests, filling out an individual card, ultrasound – to avoid the threat of miscarriage, to determine an ectopic or complicated pregnancy, problems of the uterus, placenta, multiple births.
- Weeks 14-16 - study of test results, referral to a second ultrasound of the fetus, to other specialists - according to indications.
- 18-20 weeks - ultrasound examination to determine the size, age, position, and possible pathology of the fetus.
- Week 22 – study of the examination results.
- Week 26 – examination.
- Week 30 – blood and urine tests, sick leave (if necessary).
- 32 - 36 weeks - ultrasound to monitor fetal development and clarify the date of birth.
- Visits to the gynecologist in recent weeks.
Necessary tests
Laboratory tests are required:
- Clinical blood test – 3 times;
- urine test - at each visit;
- microscopic examination of a vaginal smear – 2 times (first visit and at 30 weeks);
- examination for pathogens of the TORCH complex and hepatitis B and C (repeat the hepatitis test in the third trimester);
- analysis for blood group and Rh factor;
- blood test for RW - 3 times (first visit, 30 weeks, 2-3 weeks before birth);
- screening for HIV infection (first appointment, 30 weeks);
- Ultrasound – 3 times (10-14 weeks, 20-24 weeks, 32-34 weeks);
- biochemical screening (for a period of 10-14 weeks); at 16-20 weeks - a triple test to determine AFP and hCG to determine the risk of developing a child’s heart defect, the presence of Down syndrome, and chromosomal problems.
- blood test for antibodies - every month.
Additional examinations
Sometimes the doctor prescribes additional types of examination for the patient. May refer for tests if there is a history of herpes, chlamydia, toxoplasmosis, chronic inflammation of the appendages, miscarriages, ectopic or frozen pregnancies, placental insufficiency, polyhydramnios. According to indications, a hemostasiogram is performed to study blood coagulation processes and tests for sexually transmitted diseases. At negative rhesus the mother's blood is examined by the child's father.
Pregnancy management in a paid clinic
Doctors at private clinics in Moscow competently, according to established standards, but taking into account the characteristics of the condition of expectant mothers, conduct comprehensive monitoring of pregnancy. A big plus is the lack of queues; examinations are carried out at the appointed time, in one place, even on weekends. But often the price of services becomes a disadvantage when choosing, as well as the fact that getting sick leave if necessary is more difficult than in an antenatal clinic, and an emergency situation prohibits consulting a pregnant woman.
Contract for pregnancy management
This document must be concluded with an institution that employs proven specialists - obstetricians and gynecologists, who will promptly detect changes in the health of the fetus and the expectant mother, where there is a good laboratory. The contract regulates the system of examinations of pregnant women; round-the-clock telephone contact with a doctor is possible. You can also conclude a contract for childbirth: “your” doctor will attend the birth and provide postpartum care. The document must specify all required services and the possibility of issuing an exchange card.
Today, on almost every corner you can find a service paid pregnancy management. Often, this service is actively advertised by paid clinics, which offer to immediately pay a certain amount in exchange for a full examination of you in connection with pregnancy and subsequent monitoring of you for all nine months. What the concept of “full-fledged” includes and what the mandatory pregnancy management service includes - we will consider in our article today. At the end of the article, we will dwell on the alternative to paid pregnancy management - free pregnancy management.
Mandatory examinations during pregnancy
In the most early pregnancy Every pregnant woman must register with the antenatal clinic. This can be done in paid clinics that offer pregnancy management services. Already at the first visit, a pregnant woman should undergo a vaginal examination. This examination is carried out at least three times during pregnancy:
- at the first visit to a pregnant woman;
- at the 28th week of pregnancy,
- at the 36th week of pregnancy.
During vaginal examination A smear is taken and the cervix and birth canal are assessed. If there are any problems, for example, cervical insufficiency and partial dilatation, treatment is offered. In such cases, the frequency of vaginal examination will exceed three times.
Also at every doctor visiting a pregnant woman An obstetrician-gynecologist must:
- measuring the pregnant woman’s blood pressure, counting the heart rate and assessing the pulse,
- measuring the weight of a pregnant woman,
- assessment of the abdominal circumference of a pregnant woman,
- starting from the 8th week of pregnancy, the height of the uterine fundus (UFH) is measured,
- from the 20th week of pregnancy, the fetal heartbeat is heard - auscultation,
- from the 20th week of pregnancy, the fetal position is assessed using Leopold maneuvers.
On your first visit obstetrician-gynecologist It is mandatory to assess the external dimensions of the pelvis for early detection of an anatomically narrow pelvis.
Knowledge of measurement techniques blood pressure, assessment of abdominal circumference, height of the uterine fundus, Leopold's maneuvers are mandatory for any obstetrician-gynecologist. Many doctors do not comment on anything during the examination, but if you first study these procedures using ours from the “Medical Video” section, you will be able to understand when the height of the uterine fundus is assessed, and when the doctor uses Leopold’s techniques.
Mandatory tests during pregnancy
Ultrasound examination of the fetus allows early detection of its pathology. But a lot depends on the quality of the ultrasound machine and the specialist who performs the examination. Agree, an ultrasound doctor with 20 years of experience using a 3D ultrasound machine will be able to give a more objective conclusion than a doctor with less experience working with a regular 2D machine. The clinical value of fetal ultrasound in terms of early diagnosis of malformations is described in our article "".
Except Ultrasound Mandatory instrumental examinations of a pregnant woman include an electrocardiogram (ECG). Pregnant women do not have to undergo fluorography - only when indicated and after the 20th week of pregnancy. At the same time, in many regions of the country, all residents living with a pregnant woman are required to have a certificate of fluorography to exclude the source of tuberculosis in the family.
Mandatory consultations with doctors during pregnancy
During pregnancy, a pregnant woman must undergo consultations with the following doctors:
- consultation with a dentist 1 time. Additional consultations are scheduled based on identified diseases of the oral cavity and teeth.
- consultations with a general practitioner - twice during pregnancy.
- consultations with an ophthalmologist at least twice in the absence of complaints and 3 times in the presence of pathology, for example, high myopia.
- consultation with an ENT doctor - 2 times.
These are all the examinations and analyzes that the concept "" includes. Pregnancy management is carried out for a fee at every “corner”. Moreover, you can go through all this absolutely free through your own antenatal clinic. But, unfortunately, in many regions we only have free medicine, and for examinations you have to pay extra, travel to take tests in remote corners of the city at other clinics, which discourages many pregnant women from “free pregnancy management” at the local antenatal clinic. Of course, a lot still depends on the obstetrician-gynecologist at the site, who also often expect “thanks.” Thanks to the development of the Internet, you can learn about the peculiarities of pregnancy management both at the local antenatal clinic and at a paid clinic that you take a closer look at. Having assessed all the pros and cons, each pregnant woman decides for herself whether she will pay for pregnancy or take advantage of the free services offered by the state as part of compulsory health insurance (CHI).
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