The antenatal checklist

Becoming pregnant is exciting as well as scary. There's a lot of planning involved, tests to be done and precautions to be taken. All this information can be overwhelming if you are a new mom-to-be. We hope these tips on antenatal care will reduce some of the confusion you are facing.

Calculating your due date

An exact due date helps monitor progress, baby's growth, and plan tests and procedures at the right time. Due date is calculated from the date of the last period. An early ultrasound may be needed if the date is not known or your periods are irregular. It is usually 9 months and 9 days from the last menstrual period. (Consider the first day of last menstrual period.)

See a doctor

Take an appointment and register for antenatal care with a good gynecologist. First prenatal visit will be usually at fourth week. It will include recording a detailed personal and family medical history, physical examination, checking the medication you are on, history of menstrual cycle, along with a pelvic examination by the doctor.

Inform the doctor of any changes you feel and feel free to ask any queries. The doctor should be informed of any abdominal pain, nausea, vomiting, backache, and weight loss or gain. The doctor should also be informed of the first flutter or kick. This usually happens by about the 20th week. It might happen earlier in women who have been pregnant before.

Tests and examination

The first routine blood test is to detect blood group and hemoglobin level to rule out anemia. Urine test is done at routine screening to rule out any urinary tract infection and other conditions.

Mother is tested for syphilis, hepatitis B, and rubella. Test for chicken pox is done depending on status of earlier immunization. Pap smear, culture to test Chlamydia and gonorrhea are also done. A blood test for HIV is offered. Be sure to ask for it if it is not requested by the doctor.

Such diseases, if treated during the pregnancy, can reduce the risk of passing it to the baby. Vaccines like measles, mumps, Rubella (MMR), chicken pox, BCG (tuberculosis) and flu vaccine are not recommended during pregnancy.

A blood test and first ultrasound is done during the second month. It measures the fluid at back of baby's neck (nuchal translucency). These evaluate the baby's risk for developing Down syndrome and other chromosomal abnormalities.

If the mothers has Rh negative blood group, and the father has Rh positive blood then a test needs to be done to test for Rh antibodies. These develop if baby is Rh positive. Antibodies can cross placenta and harm the baby if not treated, especially in the 2nd pregnancy.

Amniocentesis is advised in case of abnormality in the blood test or ultrasound or any other risk factor.

A glucose screening test to check for gestational diabetes is done between the 24th and 28th week, and possibly another blood test to check for anemia.

When the due date is near

Keep a track of how often fetal movements are felt. The doctor should be informed immediately if fetal movement is felt less than usual.

When the due date is near, antenatal visits are scheduled every two weeks and weekly from the beginning of the 36th week.

Make sure to ask for a second dose of tetanus vaccine to be given approximately four weeks prior to the expected date of delivery.