Taking Care of Pregnancy Part II

 

By Dr Noah O. Olaomo

This is another insightful article on our teachings about how to take care of your pregnancy. If you missed the first part, please click here to read.

ANTENATAL (PRENATAL) CARE.
This refers to the care given to a woman during pregnancy to keep the mother and baby in good health, ensure safe delivery and an uneventful postdelivery state. Its main aim is to ensure the delivery of healthy babies to healthy and satisfied mothers without any untoward complication.

Antenatal care is to be provided by a medical team comprising of doctors, nurses and midwives.
Pregnancy has three phases referred to as trimesters. Each trimester has roughly 3months (13weeks). There are some important points to note in order to have a satisfying antenatal experience.

FIRST TRIMESTER. (0-13week)
The medical team is there to serve and help you have a fulfilling experience. Feel free with them.
Register early for your antenatal care. Ideally you should register for your antenatal care after your second missed period. Your pregnancy will be about 8weeks around this period. This early registration is also important to allow you to do an early ultrasound scan to determine the location of your pregnancy. If a pregnancy is located outside the uterus, it is referred to as an ectopic pregnancy. Such a pregnancy needs an urgent intervention.

At registration, you will be requested to carry out essential investigations to assess your health status. These usually include, Packed Cell Volume (PCV), Hepatitis B and C screening, blood group and genotype, syphilis screening (VDRL), urinalysis and HIV screening.

The first trimester is a very sensitive period. This is the time when the “foundation” of all the baby’s organs is being laid. Any irrational drug use can cause irreversible damage to the baby and even death. Therefore, avoid drugs, herbal mixtures, concoctions and any other medicament. Use drugs only as prescribed by your doctor. Always let any doctor attending to you know that you are pregnant.

Continue to use folic acid 0.4mg daily and any other drug prescribed by your attending doctor. Iron supplement is usually added later.
Maintain a good health habit and eat a balanced diet. Pregnancy is not a reason to starve yourself.

Note that you may have some common complaints like nausea, vomiting (especially early morning), bloating, heartburn, constipation and backpain. Make sure you visit your doctor for any complaint you have. These complaints can be readily managed.

Your antenatal visit will be once a month; every four weeks throughout the first trimester. It may be more frequent if there is a need. However, you should visit your doctor any time you have a complaint.

At every visit, your blood pressure (BP), urinalysis and general wellbeing will be checked. Your PCV (level of blood) and other tests will be checked as necessary.
An ultrasound scan may be requested from you to confirm your date or as part of screening for some genetic anomalies.

SECOND TRIMESTER(14-27weeks)
Your antenatal visit schedule will still be four weekly, that is once a month. It may however be more frequent if the doctor thinks so.
At every visit, your blood pressure (BP), urinalysis and general wellbeing will be checked. Your PCV (level of blood) and other tests will be checked as necessary.

As a first timer, you should feel your first fetal kick (baby movement) around 18-20weeks while those who have delivered before should feel it earlier about 16-18weeks.

Use your daily routine drugs which should include iron (ferrous) tablets and folic acid. Vitamin C, calcium tablets and multivitamin tablets may be added. Some drugs like Pronatal, Pregnacare etc contain most of these in one capsule and may therefore be easier to use but may need additional iron tablets.
You should take your first dose of tetanus toxoid (TT) at this time. Four weeks after, the second dose should be taken. You need two doses of TT during any pregnancy unless you have completed your 5dose TT schedule. If you have completed this, a booster dose may also be taken in pregnancy. This vaccination is mainly to protect your baby from neonatal (newborn) tetanus.
You should also take the first dose of malarial prophylaxis (prevention) around 22weeks. The second dose will be taken at least four weeks after. A minimum of 2 doses is recommended. Fansidar is the most commonly used drug for malarial prevention. However, you should not use Fansidar if you react to Fansidar and or Septrin. There are other alternatives to Fansidar.

You may be requested to have an anomaly scan done between 18-20 weeks. This is to discover any structural abnormality in the baby some of which may be amenable to treatment.
Always consult your doctor if you have any doubt.

THIRD TRIMESTER (28-40weeks)
Your antenatal visit will be fortnightly (two weekly) from 32-36weeks and weekly from 36 weeks till you deliver.
Ultrasound may be requested at 32weeks to definitively confirm the placenta location if it was previously low lying and at 36-37 weeks to confirm your baby’s position and other important parameters.

You must continue taking your routine daily drugs. If you have done only one caesarean section (CS) before and you are considering having a normal delivery, your doctor will assess you at 36-37weeks to advise you on the best mode of delivery. If you have had 2 or more CSs previously, you should have another CS. Your doctor will plan you for a repeat caesarean section.

At every visit, your blood pressure (BP), urinalysis and general wellbeing will be checked. Your PCV (level of blood) and other tests will be checked as necessary.
Note that any baby that is more than 37weeks is term, that is, it is old enough to be born without fear of prematurity.
Therefore, watch out for signs of normal labour from 37weeks of pregnancy.

Watch out for Part Three.

Dr Olaomo Noah Oluwafemi is a Consultant Obstetrician and Gynecologist with a love for writing. His desire is to enhance people’s lifestyle and effect positive change in their health through his writings

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