Pregnancy care knowledge

Pregnancy care is an important measure to reduce maternal mortality and birth defects. As the famous obstetrician Eastman once pointed out, “In this day and age, maternal health care can save more lives than any other means”. There is a wide variation in prenatal checkup protocols in different regions and hospitals in China, and even different obstetricians in the same hospital provide different prenatal checkup protocols, which is one of the major reasons for the high maternal mortality and birth defect rates in China today. Knowledge of pregnancy care is introduced as follows: The main feature of today’s pregnancy care is the requirement to systematically provide evidence-based prenatal care programs at a specific time, abolish the traditional pattern of regular interval visits, and the schedule of pregnancy care should be determined by the purpose of prenatal checkups. 1, the number of prenatal checkups and pregnancy week: a reasonable number of prenatal checkups and pregnancy week can not only ensure the quality of health care during pregnancy, but also save health care resources. According to the needs of prenatal checkup programs, the gestational weeks recommended by the guidelines for prenatal checkups are: 6-8 weeks of gestation; 10-14 weeks; 15-19 weeks; 20-24 weeks; 24-28 weeks; 30-32 weeks; 32-36 weeks; 38-41 weeks. A total of 8-11 visits. For those with high-risk factors, increase the number of times as appropriate. 2. Contents of prenatal checkups: ① First prenatal checkup (6-8 weeks of gestation): including health education and guidance and routine health care content such as screening for high-risk factors during pregnancy; physical examination; auxiliary examination items: routine blood count; routine urine count; blood type (ABO and RH); liver and kidney function; fasting blood sugar; five items of hepatitis B; syphilis, HIV, ultrasound; electrocardiogram and possible preparation items. ② Prenatal checkups at 10-14 weeks of gestation: including health education and guidance and routine health care contents (for all pregnant women) such as establishing a pregnancy health care handbook, analyzing the results of the first prenatal checkup, focusing on vaginal bleeding and diet; physical examination; auxiliary examinations: ultrasound to measure the thickness of the posterior nuchal translucency (NT) and possible preparatory tests. ③Prenatal checkups at 15-19 weeks of gestation: including health education and guidance and routine health care (for all pregnant women) such as questions about vaginal bleeding, diet and exercise; physical examination; ancillary tests: midtrimester aneuploidy serological screening (AFP/HCG/uE3) and possible preparatory tests. ④20-24 weeks of gestation antenatal checkup: including health education and instruction and routine health care contents (for all pregnant women) such as asking about fetal movement, vaginal bleeding, diet and exercise; physical examination; ancillary examinations: 4-dimensional or 3-dimensional ultrasound for fetal system ultrasound screening; routine blood count; urine protein and possible preparatory tests. ⑤ Prenatal checkups at 24-28 weeks of gestation: including health education and guidance and routine health care (for all pregnant women) such as asking about fetal movement, vaginal bleeding, contractions, diet and exercise; physical examination; ancillary examinations: 50g glucose screening (50g GCT ≥7.8mmol/l, ≤11.1mmol/l, then 75g OGTT; ≥11.1mmol/l and then fasting glucose); urine protein and possible docketing. (6) Antenatal checkup at 30-32 weeks of gestation: including health education and guidance and routine health care contents (for all pregnant women) such as asking about fetal movement, vaginal bleeding, contractions, diet and exercise; physical examination; auxiliary examinations: routine blood, urine protein, ultrasonography and possible preparatory tests. (7) Antenatal checkups at 32-36 weeks of gestation: including health education and guidance and routine health care contents such as asking about fetal movement, contractions, skin pruritus, diet, exercise, and preparation for delivery; physical examination; auxiliary examinations: urine protein, liver function, no stress test (NST) to predict intrauterine reserve capacity of the fetus, and possible preparatory tests. (8) Prenatal checkups at 38-41 weeks of gestation (8th-11th): including health education and guidance and routine health care contents (for all pregnant women) such as asking about fetal movement, contractions, redness, delivery plan, etc.; physical examination; auxiliary examinations: ultrasound, NST and possible preparatory tests. 3. Elements of routine screening not recommended during pregnancy: extra-pelvic measurements; serological screening for toxoplasma, cytomegalovirus, herpes simplex virus; screening for bacterial vaginosis; FFN testing of cervicovaginal secretions and ultrasound cervical assessment; edema screening; urine protein and blood tests at each maternity visit; thyroid function screening; tuberculosis screening. In fact, for the purpose of ensuring maternal safety and eugenics, women should undergo preconception care 3 months before preparing for childbirth, including health education and guidance, following a combination of universal guidance and individualized guidance for each woman; screening for preconception high-risk factors through questioning; physical examination; and necessary ancillary tests.