Your first checkup would usually be for the confirmation of a pregnancy. This can occur in two ways. One is a test with a pregnancy kit. The second is with an ultrasound scan. Usually the ultrasound scan is done after confirmation with a positive result from the pregnancy kit and is in turn used to confirm the presence of a beating heart.
Below 8 weeks (sometimes 10 wks) you may need a full bladder for the ultrasound scan. This is to pinpoint the location of the uterus so that the doctor will know where to point the transducer (that’s the thing that they ‘scroll’ all over your abdomen to ‘see’ or scan for the embryo).
If you are too early, the embryo may not turn up on the scan. Then, the doctor or sonographer will suggest one of two things: to have a transvaginal scan or to wait for a few weeks more until the embryo is big enough to see.
Note that at 8 weeks a typical embryo is only about half an inch to three-quarters of an inch big.
During my own scans, my pregnancy was confirmed at 6 weeks with a kit at the doctors. I went for a scan but my doctor couldn’t see the baby yet and so she asked me to wait for a couple of weeks as according to her the transvaginal scan is ‘not very comfortable’. So I waited about two weeks for the embryo to reach 8 weeks and went back. Another doctor was working at the time and she immediately arranged for me to get a transvaginal scan… which was really not comfortable, believe me.
But I did get to see my baby for the first time. So it was worth it.
Periodical checkups: Charting the development of the baby
In the first trimester (first three months) the baby is known as an embryo, From the fourth month onwards, it is known as the foetus until birth. The development of the baby is charted against the statistics of other babies.
Some of the measurements taken during the monthly checkups are:
• the crown-rump length of the baby*
• the circumference of the head
• the circumference of the abdomen (tummy)
• the length of the femur (in the second trimester when bones are more pronounced)
*The crown-rump length is the length of from the baby’s head toits bum bum (bottom), as this is the position readily assumed
by the baby inside the confined space of the womb.
Source: fetal.com
During checkups the doctor may also monitor the heartbeat (sometimes with a Doppler scanner to ensure that there are no irregularities in the heartbeat), check on the gut, heart, brain, the development of the backbone and how active your baby is.
During the scan, the doctor will also check on the availability of the amniotic fluid inside the womb. Too much or too little of the amnion fluid may be of concern but always check with your doctor if anything worries you.
The doctor will also need to chart your blood pressure, check your urine for the presence of protein or glucose and take measurements of your weight. The height taken is only a one-time thing.
Tests and perpetuating the fear of needles
Amniocentesis and Down Syndrome check.
Around week 15 to week 20, you doctor may ask you if you want to screen for Down syndrome. You doctor will show you statistics that show the probability that your baby has it depending on your age and other indications during the scans or based on the results of your urine tests. This is currently done through amniocentesis: the fluid inside the womb is taken out with a syringe for testing. The results will only be available in a week or two.
I did not opt for mine as I was not in the high-risk group (mother being 35 years old or older) and I do not like the idea of having a syringe poked into my womb.
Checking for diabetes
Around Week 24 you will be submitted to a glucose tolerance test. You will need to fast from 10 pm or midnight the day before, go to the clinic and have your blood taken, then drink an extremely sweet drink, wait for two hours then have your blood taken again. This test is really important to ensure that you are not diabetic during or due to the pregnancy.
I was diagnosed to have gestational diabetes when I ‘failed’ this test. The glucose levels in my blood were in the ‘impaired’ zone, which means that I am diabetic but it can still be controlled through my diet. A more serious case would need control through medication and is not healthy for the pregnant mother or for the baby.
Since I was diagnosed with GD, I have to take glucose tests every month in which I have my arm jabbed four times a day, three times before meals and once before bedtime. For most this would perpetuate a lifelong fear of needles. For me, I’ve grown accustomed to it. The matter was worsened by the fact that most of the poking were done on my left arm, as my right arm does not have veins pronounced enough for them to draw blood from.
Imagine having been poked by 28 needles through the whole pregnancy, four of which was caused by a botched test. I don’t want to talk about that.
I've had enough of you to last a lifetime!Other things to look out for
By the time your foetus reaches 7 months, he or she will be around 1.5 kg. In the last three months, you will experience, have or see more weight gain, stretch marks, cravings, cramps, fatigue, difficulty in breathing, constant toilet trips (including in the middle of nights) and more checkups. The checkups will go from once every four weeks to once every two weeks to once every week.
The foetus is sometimes more vulnerable during the last trimester as many things may go wrong. It is extremely important that you watch your diet during this time as some research show that what you eat during the final months of the pregnancy will lead to having a hypersensitive baby with allergies.
Weight gain and size development of the baby is also crucial at this juncture. In almost all the cases of pregnancies around me, the foetuses were found to have stop growing near the 8th month. I have a friend who has to deliver one month early because the baby has stopped growing since the 7th month. The baby’s weight during birth barely reached 2.5 kg.
Weight gain in the baby does not rely solely on the mother’s food intake during the last trimester. You can keep eating and eating but it may not go into your baby for reasons that even doctors do not understand. However, if weight gain in the baby seems to balloon out of control, this is also reason for worry as cases of stillbirth are linked to foetuses being overweight. I have another friend whose sister in law lost her baby due to this. The heart stopped at the 7-month mark. This will be very traumatic for the mother so take heed and be cautious about your eating habits during the last trimester.
Conclusion and disclaimer (as usual):
Exercise, eat healthily, be safe, go slow, listen to advice from other mothers, communicate with your doctor, be watchful, savour the nine months and wait eagerly for the arrival of our baby because believe me, it will come to an end eventually (even though you feel like this will go on forever =)) and you will have a new beginning!
As usual, here comes the disclaimer. I am not a doctor, a practitioner, a nurse, a medical lecturer, a gynaecologist not even a medic student. I am a woman, a mother, a wife, once-pregnant-now-free and a blogger who just loves to dissipate information. The things I write here, I will tell my sister, my daughter or my female friends who are pregnant. Hence, I find them fit to put here to share.
However, do understand that everything is different for everyone and you should not take the information here word-for-word. Talk to your doctor or do your own research. Make educated choices and informed decisions for yourself and for your baby.
Lastly, congrats on your pregnancy and I pray that all will go well for you and your baby.
No comments:
Post a Comment