(a) Early Pregnancy Health Care The 12 weeks of gestation is called early pregnancy, which is an important period for the development and formation of fetal organs. The focus of health care in early pregnancy is: early detection of pregnant women, identification and management of medical complications, and prevention of fetal malformations. 1. Early detection, early examination and early diagnosis of pregnancy Early detection, early examination, early diagnosis and early health care for pregnant women should be achieved. About 85% of women of childbearing age who have normal sexual life will become pregnant within the first year of marriage if they do not take contraceptive measures. Early detection of pregnancy, timely examination and diagnosis of early pregnancy and early protection of embryo through marriage examination, regular visit, establishment of menstrual card and consultation of pregnant women. 2.Early first prenatal examination The first prenatal examination should be conducted early after the pregnancy is confirmed and the pregnancy card (register) should be established. To understand the overall health condition of the pregnant woman, find out early whether there are any diseases affecting pregnancy and delivery, whether pregnancy can be continued, and give appropriate guidance and treatment. (1) Take medical history (2) Calculate the expected date of delivery Calculate the expected date of delivery according to the first day of the last menstrual period in the solar calendar, subtract 3 for the month and add 7 for the number of days, add 9 for the month less than 3 and still add 7 for the number of days. (3) Comprehensive physical examination (4) Obstetrical examination Gynecological examination is performed to find out whether there are any diseases affecting pregnancy and delivery in the internal and external reproductive organs, and to deal with any abnormalities appropriately. (5) Laboratory examination Routine laboratory tests include serum progesterone, B-HCG, routine blood count, clotting time, platelet count, blood type, urine routine, urine sugar, liver function, hepatitis B surface antigen, trichomonas and mycobacteria in the white belt. STD and TORCH screening can be performed in areas with conditions. (6) Ultrasound examination 3. Maternal screening for high risk High risk pregnancy score based on prenatal Down’s syndrome screening results. Early screening 9-13 weeks, intermediate screening 14-16 weeks. When prenatal diagnosis is needed, chorionic villus karyotype analysis, or amniotic fluid karyotype analysis or even cord blood karyotype analysis can be performed at 18-24 weeks of gestation. 4.Guidance on health care in early pregnancy (1) Health education (2) Protection of embryo Pay attention to the safety of the general and small environment in which the pregnant woman lives, and avoid exposure to various toxic and harmful factors. It is necessary to avoid exposure to harmful physical and chemical factors as well as harmful biological factors, psychological factors and bad lifestyles, especially to prevent infections and use drugs carefully. (3) Pay attention to the symptoms of vaginal bleeding For vaginal bleeding or abdominal pain after early pregnancy and amenorrhea, you should be alert to the possibility of ectopic pregnancy and gravidity, and you must go to the hospital in time to avoid delaying the condition. (4) Psychological guidance and facilitation Early pregnancy can easily lead to miscarriage due to external stimuli, so sexual life should be abstained, and pregnant women with a history of habitual miscarriage should abstain from sex. (2) Mid-pregnancy health care 13 weeks to 27 weeks of gestation is called the mid-pregnancy, the fetus grows rapidly during this period, the focus of health care is: regular prenatal checkups, monitoring the health of pregnant women and fetal growth and development in utero, strengthening the nutritional guidance of pregnant women, fetal education and maternal gymnastics. 1, regular prenatal checkups Normal pregnant women have a prenatal checkup every 4 weeks. High-risk pregnant women should increase the number of re-examinations according to their condition, generally once every 1-2 weeks, and those who have not been re-examined at the specified time should be followed up to avoid the risk of development of the disease. The prenatal examination includes: (1) general examination (2) fetal movement inquiry (3) obstetric examination including four-step palpation method to check uterine size (including measurement of uterine height and abdominal circumference), fetal delivery pattern, fetal previa and fetal orientation, monitoring fetal heart rate, and drawing gestation chart to monitor fetal development after 6 weeks. (4) Laboratory tests Necessary laboratory tests, such as routine blood, urine (including urine sugar), liver function, etc., should be performed as needed. Pregnant women who have reached 16 weeks of gestation need to measure blood alpha-fetoprotein (AFP) to screen for fetal neural tube abnormalities. An ultrasound will be done at a level II or higher hospital from 18 to 24 weeks of pregnancy to understand the development of the fetus and the presence of malformations. If necessary, perform amniocentesis for prenatal diagnosis. 2.Further screening for high risk Comprehensive prenatal examination results for high risk score and high risk management for pregnant women found to be at high risk. Pregnant women found to have combined medical and other diseases should be monitored jointly with staff from internal medicine or other related departments, in addition to strengthening prenatal monitoring in the high-risk pregnancy health clinic. 3.Monitoring the intrauterine development of the fetus 4.Mid-pregnancy health care guidance (1)Strengthening nutritional guidance for pregnant women Pregnant women’s appetite increases in mid-pregnancy, and the fetus grows and develops rapidly at this stage, so nutritional guidance for pregnant women should be strengthened, paying attention to a reasonable diet and adequate intake of protein, carbohydrates, fat, vitamins and minerals, etc. Pregnancy health exercise is a set of whole body exercise for pregnant women. Doing gymnastics for pregnant women every day during pregnancy can move joints, exercise muscles, feel relaxed and energetic, and at the same time can relieve the discomfort in some parts of the body caused by the loss of balance in posture during pregnancy, as well as loosen ligaments and muscles, so that the body enters the late pregnancy and delivery in a supple and robust state. (2) Psychological guidance Encourage husbands to attend various types of lectures with pregnant women, such as maternity schools, where they can learn more about pregnancy, childbirth and general knowledge of child rearing. Help pregnant women to establish a wide range of social interactions, increase the opportunity to get in touch with other mothers and gain more knowledge about motherhood. For pregnant women who are worried about fetal abnormalities, they can learn about the intrauterine growth and development of the fetus through prenatal checkups to reduce their psychological pressure. (3) Late Pregnancy Health Care After 28 weeks of gestation is called late pregnancy. In addition to continuing to guide pregnant women to ensure adequate nutrition and appropriate activities, the focus of health care in this period is: timely prenatal checkups, good family self-monitoring, prevention and management of pregnancy complications, and preparation for delivery. After 28 weeks of gestation, antenatal checkups should be conducted once every 2 weeks; after 36 weeks of gestation, checkups should be conducted once a week. The number of antenatal checkups should be increased according to the condition of high-risk pregnant women, and if necessary, they should be hospitalized. (1) General examination Ask the pregnant woman if she has any abnormalities such as headache, ophthalmia, edema, vaginal bleeding, check for edema, measure weight and blood pressure, and understand fetal movement. (2) Obstetric examination Measure fundal height and abdominal circumference, draw pregnancy chart, actively prevent intrauterine growth retardation; listen to fetal heartbeat, check fetal position, and correct fetal position abnormalities in time. During 28~32 weeks of gestation, pelvic measurements are performed to predict the mode of delivery based on the pelvis, fetal size, fetal orientation and the health status of the pregnant mother and fetus. (3) Laboratory tests Check urine protein every time and recheck hemoglobin every month to actively correct anemia. If necessary, ultrasound examination to understand the condition of the fetus, placenta, umbilical cord and amniotic fluid. 2. Strengthen the management of high-risk pregnancy Comprehensive prenatal examination results for high-risk scoring, and high-risk pregnant women found should be promptly included in the management of high-risk pregnancy. Strengthen the monitoring and treatment of high-risk pregnant women, and actively mobilize pregnant women with pregnancy complications or complications to plan delivery at the right time. 3.Late pregnancy health care guidance Health education, guidance on family self-monitoring, childbirth preparation education, breastfeeding education.