I. Early pregnancy period.
1.In the early pregnancy period, in order to determine the pregnancy, or there is bleeding from the vagina in order to determine whether the pregnancy is normal, pregnancy test of blood or urine is required: urine HCG qualitative and quantitative, blood HCG, ultrasound.
2.After the pregnancy is confirmed, a systematic prenatal check-up is performed at the local hospital to establish a card, and detailed inquiries about this pregnancy, previous physical condition, pregnancy, family history, etc. Record the basal weight, blood pressure, pelvic external measurement, etc.
3.Laboratory tests should be done: hematogram, urinalysis, blood type, blood sugar, renal function, liver function, A function, hepatitis B triplet, hepatitis C, viral tests such as cytomegalovirus, toxoplasmosis, herpes virus, rubella virus, syphilis serology, AIDS test, etc.
4. Health care guidance.
Second, mid- to late-term pregnancy.
1. Regular prenatal checkups: every 4 weeks from 12 to 28 weeks, every 2 weeks from 28 to 36 weeks, and weekly thereafter.
2. Checkups include: weight, blood pressure, uterine height, abdominal circumference, and listening to fetal heartbeat.
Weight monitoring: the weight of pregnant women can also indirectly reflect the growth and development of the fetus. Generally, it can be measured once a week. In the second trimester (after 28 weeks), the fetus grows faster and the weight of the pregnant woman increases by about 500 grams per week. If the weight does not increase for several weeks, it means that the fetus is growing slowly; if the weight increases too fast, the pregnant woman may have edema, or her body is rapidly obese due to excessive food intake. If you find that the weight does not increase or increases too quickly, you should look for and determine the cause and take appropriate measures.
Blood pressure monitoring: prevent hypertensive syndrome in pregnancy
Fetal size monitoring: slow fetal growth, overgrowth, abnormal uterine growth
Fetal heartbeat: 120~160 times/min
3. About ultrasound examination: at least 5-6 times throughout pregnancy.
The first early pregnancy (7-10 weeks): to understand the development of embryo, the gestational age can be estimated according to the size of the germ (especially suitable for those who are not allowed to menstruate or the time of menopause is unknown)
Second 11-14 weeks of gestation: measurement of NT value to predict the occurrence of fetal malformation
Third mid-term 16-20 weeks to understand fetal development and provide accurate gestational age for mid-term Down screening
Fourth systematic ultrasound for malformation screening: 22-26 weeks , if you want to do fetal heart ultrasound can be done at 28-30 weeks
The fifth 30-34 weeks, close screening for malformations (especially brain, digestive tract, kidney and other organs), understanding fetal size, timely detection and treatment of fetal intrauterine growth retardation (FGR).
Sixth 37-40 weeks to understand fetal size, placental maturity, amniotic fluid, etc.
The number of times needs to be increased in special cases: pre-eclampsia in early pregnancy, placenta praevia bleeding, placenta abruptio tendency, ultrasound once a month in twin pregnancy, abnormal umbilical blood flow, single umbilical artery, etc.
4. Special tests.
1.Glucose tolerance test: 24-30 weeks (fasting)
2.Blood group antibody test (for couples with blood group incompatibility: the female partner is type O), at least 2 times during pregnancy
3, Down’s syndrome screening: China currently has 13%-20% of babies born with congenital defects, the prevailing screening program is mainly for screening and diagnosis of congenital stupidity (pediatric dementia, trisomy 21), neural tube abnormalities, trisomy 18 and other diseases.
4.Including: early Down screening (11-13 weeks + 6 days), mid-term Down screening (14-21 weeks)
5.Amniotic fluid test or non-invasive genetic test: those with poor maternal history, people with high risk of Down’s syndrome, senior pregnant women, those with family hereditary diseases; amniocentesis at 16-20 weeks, non-invasive genetic test can be performed after 15 weeks.
6.Cervical cytology smear screening during pregnancy: recurrent vaginal bleeding and exclusion of placenta praevia can be examined.
5.Self-monitoring.
Fetal heart monitoring: remote fetal heart monitoring can be done after 28 weeks of pregnancy, and fetal heart monitoring can be done every time you do a maternity check after 34 weeks.
Fetal movement monitoring: the fetus “curled up” in the uterus, often stretching and stirring, which is called fetal movement. Normal fetal movement is 4-5 times per hour. Measure 3 times a day (once in the morning, once in the afternoon and once in the evening) for 1 hour each time. If the number of fetal movements in 3 hours multiplied by 4 (equal to the number of fetal movements in 12 hours) is less than 30, or reduced by half than before, or the fetal movements are frequent, it means that the fetus has abnormal possibility, and fetal heart monitoring can be performed immediately or go to the hospital for medical treatment.
Fetal position monitoring: The abdominal examination is mainly to check the position of the fetal head. In normal fetal position, the fetal head should be in the middle of the lower abdomen, i.e. above the pubic symphysis. If the fetal head is felt in the upper abdomen, it is breech position; if the fetal head is felt in the side abdomen, it is transverse position, both of which are abnormal and can cause difficulties in delivery and should be corrected. Pregnant women need to make chest and knee position, so that the fetal position will correct itself.
6.Special attention.
In the middle and late pregnancy, attention should also be paid to the correction of anemia and thrombocytopenia, regular rechecking of the hemogram, and if the anemia cannot be corrected after iron supplementation, screening for thalassemia should be performed.
If itchy skin/diarrhea/jaundice occurs, liver function should be checked promptly to prevent biliary stasis in pregnancy ;
If edema is present, urine protein should be checked regularly to prevent low protein edema.
If placenta praevia is found, be careful to reduce activity and once there is vaginal bleeding, be absolutely bed rest or go to hospital;
In twin pregnancies, attention should be paid to rest and nutrition to avoid preterm delivery;
If you have uterine contractions in the middle and late stages of pregnancy, you should go to the hospital in time to avoid preterm delivery.