Prenatal: Essential Preparation For The Arrival Of The Baby

Know what are the main examinations throughout gestation and clarify your doubts on the subject.

Not many people are aware of it, but, unfortunately, not all pregnant women carry out prenatal care. As much as the subject is quite commented, some people don’t understand the importance of closely monitoring the evolution of pregnancy and only seek a doctor when the pregnancy is well advanced or when delivery is near.

In this way, it is always valid to highlight the importance of prenatal care, remembering that it is he who will ensure a healthy pregnancy and childbirth without risks for both the mother and the baby.

According to Isaac Yadid, gynecologist and obstetrician, specialist in human reproduction and Medical Director of the Primordia reproductive medicine, in Rio de Janeiro, several studies point to the relationship between prenatal care and the health of the baby. “Maternal complications such as urinary tract infection, high blood pressure, premature separation of placenta, diabetes, thyroid changes, congenital infections (toxoplasmosis, Cytomegalovirus, syphilis, HIV), use of alcohol and illicit drugs and poor diet are crucial for prematurity and other serious complications in the newborn,” he explains.

“Recent statistics from the Ministry of health, for example, shows that between 2011 and 2013, 419 babies under a year died as a result of congenital syphilis, which is transmitted by the mother. In 2011 this number was 211. The examination of syphilis is one of the included in the prenatal routine and the transmission of the disease from mother to baby is given by diagnosis or lack of appropriate treatment during pregnancy, “adds the gynecologist.

What Is Prenatal Care?

But, after all, what exactly is prenatal care?

Isaac Yadid explains that the prenatal monitoring encompasses a number of tests and medical consultations to which pregnant women must undergo during the entire period preceding the birth of the baby.

Ideally, start it early in the first quarter, so the wife finds out about the pregnancy. Or, if possible, before pregnancy, during planning.

“It is important for the monitoring and assessment of the State of health of mother and child. It is during the prenatal period we were able to identify and reduce various health problems in both, as illnesses, infections or disorders can be detected early and treated quickly, “the gynecologist.

Essential Prenatal Examinations

Below you know what are the main tests that are/should be made in prenatal care:

  1. Cbc

When will it be done?

According to Yadid, the CBC is one of the first tests will be required for pregnant women, usually in the first query. He still may be required at other times throughout the pregnancy.

Goal

“It’s how we were able to identify several changes, such as infections and anemia. During pregnancy your doctor may request it more times according to the clinical conditions of the mother, “the gynecologist.

Exam preparation

The most appropriate is that the pregnant woman is in 3 hour fasting, according to Yadid.

  1. Blood Sugar

When will it be done?

According to Yadid, normally this review is requested in the first query. “And, if everything is within the standards, should be repeated between the 24th and 28th week of pregnancy, when the body has more difficulty to assimilate the sugar,” he says.

Goal

The gynaecologist explains that the blood test indicates the amount of glucose present in the blood, and detect glucose intolerance and diabetes.

Exam preparation

To do this test, according to Yadid, 8-hour fasting is required.

  1. ABO And Rh Factor

When will it be done?

This review is required on first appointment, early in the pregnancy, as highlights Yadid.

Goal

“The ABO system identifies the mother’s blood type; and the Rh factor, whether it is positive or negative. If the mother is negative and the baby factor positive factor, can develop a framework called Erythroblastosis fetalis. When the blood of mother and son come into contact at birth, is formed a RH in the body of the mother, which can destroy the red blood cells of the Rh + next baby that she has.Knowing this difference of factors, is given a medicine after birth which prevents these antibodies to form “, explains gynecologist.

Exam preparation

The examination does not require prior preparation.

  1. Serology For HIV And VDRL

When will it be done?

Yadid points out that these scans are also required in the first query.

Goal

“The HIV detects the presence of the AIDS virus in the body of the mother; the VDRL, the presence of syphilis “, explains gynecologist.

Exam preparation

There is no need for prior preparation for the exam.

  1. Reaction To Toxoplasmosis And Rubella

When will it be done?

According to Yadid, these tests are requested in the first query, and repeated in the third quarter.

Goal

“Also part of the prenatal routine and indicate whether the woman had contact with the causative agent of toxoplasmosis (Protozoan Toxoplasma gondii) or the German measles (Rubella virus)”, explains gynecologist.

Exam preparation

There is no need for prior preparation for the exam.

  1. Urine Test

When will it be done?

“The review is requested in the first query, and according to the evaluation of the obstetrician, can be repeated in other quarters” Yadid.

Goal

“It is an exam that is part of the routine, especially to identify urinary infections, which can be related to premature birth,” explains gynecologist.

Exam preparation

According to Yadid, no need to prepare prior to this test, “but it is recommended to be done with the first urine of the day, or after an interval of more than 4 hours between a pee and the other”.

  1. Examination Of Feces

When will it be done?

It is normally prompted in the first query, and can be repeated in case of diarrhea or other clinical symptoms, “explains Yadid.

Goal

According to the gynecologist, this is an exam that is part of the routine, as it identifies the presence of worms.

Exam preparation

“For the parasitological examination of feces, there is no need to prepare, but it is recommended to be done in the morning,” explains gynecologist.

  1. Serology For Hepatitis B And C

When Will It Be Done?

According to Yadid, this is more a type of requested examination in the first query.

Goal

“It identifies the presence of the two types of viruses (hepatitis B and C)”.

Exam preparation

There is no need to prepare for the exam.

  1. Pap Smear

When will it be done?

“The Pap smear is performed on first appointment if the pregnant woman is not on the test,” explains Yadid.

Goal

“With this review makes the screening of cervical cancer,” the gynecologist.

Exam preparation

It is recommended that the woman keep sexual abstinence in the 24 hours preceding the exam. She still should be avoided, in the 48 hours before, the use of Douches, vaginal creams or ointments.

  1. Ultrasound

When will it be done?

At the beginning of the prenatal care will be conducted an ultrasound, that should/can be repeated as many times as the doctor responsible sees fit. There are professionals that perform, for example, in all prenatal consultations.

Goal

“Is indicated to confirm the chronology of pregnancy and prognosis of chromosomal disease or malformations” Yadid.

Exam preparation

Usually there is no need of any special preparation, but if it is, it will be informed by the doctor.

  1. Ultrasound Morphology

When will it be done?

According to Yadid, morphological ultrasound is performed in the second quarter.

Goal

“The examination is intended to analyze the formation of fetal organs and malformations,” the gynecologist.

Exam preparation

Usually there is no need of any special preparation.

Vitamins And Supplements In Prenatal Care

Sundays Mantelli, gynecologist and obstetrician from Faculdade de Medicina da Universidade de Santo Amaro (UNISA) and post-graduate Residency in the area of gynaecology and obstetrics, talks about vaccines and suplements which may (or may not) be necessary in prenatal care.

  1. Vaccines

MANTELLI explains that ideally, the expectant mother update vaccine calendar before pregnancy, and not during pregnancy. “During pregnancy will be given only those vaccines the doctor deems necessary, there is no rule,” he says.

He cites that, basically, the pregnant woman can take:

Flu vaccine: at any time;

TDAP: that is for Diphtheria, Tetanus and pertussis, and which is given from 27 weeks.

“Apart from these two vaccines, the obstetrician will assess to see whether there is need for other vaccines,” Mantelli.

  1. Folic Acid

The obstetrician explains that the ideal is that the pregnant woman take folic acid at least three months before becoming pregnant and during the first trimester of pregnancy, at the dosage of 5 mg per day.

“That folic acid is extremely important to avoid premature closure of the neural tube, which is the part of the formation of the central nervous system of children,” explains Mantelli.

  1. Iron

The obstetrician explains that not always the pregnant need iron supplementation, “unless those pregnant women who already had a iron deficiency anemia before getting pregnant.

“If she has adequate iron levels, there is no need to iron supplementation. Who’s going to have to evaluate and see the need for supplementation will be her obstetrician gynecologist “Mantelli.

  1. Multivitamins

“Supplementation during pregnancy is indicated throughout the gestational period. There are multivitamins that pregnant women purchase at the pharmacy – she can use during all the pregnancy-and will meet the need of the basic elements that the baby will need for training “, says the obstetrician.

  1. Vitamin D

Once again: it is not a rule. “If there is an organic vitamin D deficiency, then worth supplementation because it does well during this period of formation of the baby. If the expectant mother already has adequate levels, there will be no need for supplementation, “says Mantelli.

  1. Omega 3

“Only if there is a dysfunction of Omega-3 supplementation is worth it, because he also does well in this period of formation of the baby. If the expectant mother already has adequate levels, there will be no need for supplementation, “Mantelli.

“Once again it is worth saying that is the obstetrician who has to evaluate and indicate those substances. The indiscriminate use of them with self-medication, can also bring problems. So, only the obstetrician can release, “adds the doctor.

Care Of The Pregnant Woman Must Have

Pregnancy is a magic stage in a woman’s life, but it is also a period that inspires care and usually generate many questions. It is worth noting, however, that although the period requires attention, it is often possible that the expectant mother keep a routine without many restrictions.

Some of the things that pregnant women can not do are:

Laser hair removal;

Take alcoholic beverages in excess;

Eating raw food or of dubious quality;

Drinking coffee in excess;

Exaggerate in the consumption of sweets and pasta;

Skip antenatal consultations.

On the other hand, there are no restrictions for many things. The pregnant woman can, in General:

Shave (with wax);

Exercise (provided with permission from the doctor);

Having sex;

Go to the beach (remembering to use sunscreen suitable);

Air travel (providing you have a low-risk pregnancy).

MANTELLI points out that the care in pregnancy are very concerning and will vary too much from one pregnancy to another. “It will depend on her physical state, the State of health before pregnancy, i.e. the obstetrician will have to evaluate and, for each pregnant, the recommendation is different. There is no rule to be followed by care in pregnancy. Obviously, general recommendations, as a balanced diet, physical activities are for all, however, each will have a different degree, a different nutritional level, a type of physical activity that you can do. So, there is no general rule, “he says.

Prenatal In SUS: Meet The Rights Of Pregnant Women

Pregnancy represents nine months to prepare for the birth of the baby. The Ministry of health emphasizes the importance of prenatal care and encourages mothers to seek free care in the unified health system (SUS).

Ideally, the woman start prenatal care in the first trimester, as soon as you know of the pregnancy. With the exams and medical monitoring, it is possible to identify and reduce many health problems that can affect the mother and the baby. In addition, this is the time of mother-to-be take all your questions about pregnancy, childbirth and the postpartum.

Performs basic tests free SUS during pregnancy, such as blood and urine to check for diseases such as hepatitis B, toxoplasmosis, syphilis, HIV and other problems, in addition to giving vaccinations and provide medications, if necessary.

“Very difficult to say how the prenatal care in the SUS, the rights of women, because women’s rights are numerous. They are entitled to date during prenatal care, childbirth, postpartum, anyway, a plethora of rights, “Mantelli.

“Generally, queries are Protocol, where she will take the exams required for each term. Are monthly queries usually until 36 weeks. Fortnightly thereafter (up to 39, 40 weeks). And weekly until birth, no passing of 41 weeks. Typically this is the rule, but talk of the pregnant woman is complicated. She should and is entitled to perform all the tests and must make at least three ultrasound during the prenatal period, one every quarter, but also has many other, “adds the obstetrician.

Prenatal Health Plan

Women who have health insurance must inform about antenatal examinations cover, consultation, delivery, hospitals and emergency calls with the carrier early in the pregnancy or, preferably, as they begin to plan for pregnancy.

It is worth noting that the same carrier offers different types of plans, which means varied toppings.

In General, the health plans cover basic examinations requested in prenatal care, however, the biggest difference is that some plans have full coverage of various examinations and hospitalizations, while others give right only to consultations and basic tests.

The health care provider can still restrict the numbers of inquiries and examinations performed per month or during the entire period of gestation. It is important to know all that and also check if there is any grace period for delivery coverage (if the plan has been recently acquired).

As the health care coverage is quite varied and can generate many questions, the ideal is to carefully read the contract operator to know about their rights. It is important to also inform the doctor about the conditions of the plan, up to so that he can advise you on how best to proceed with prenatal care and childbirth.

9 Questions About Prenatal Care Clarified

Below, Sharafu Franchi Rizzo, a gynecologist from the Family Doctor Clinic, explains the main questions that many pregnant women on prenatal care.

  1. What should I ask on the first visit to the obstetrician?

Sharafu Rizzo: Typically, in the first consultation, the patient is eager for novelty and, often, why is knowing the gynecologist at that moment.

It is worth asking about what foods may or may not eat; use of sweeteners and or sugar; about physical exercises (whether or not start physical activity during pregnancy, when begin and what kind of exercise can do); cosmetic procedures and other questions you may have.

Obviously, the questions arise with the course of gestation; Thus, it is valid to note the doubts that arise between a query and one not to forget.

Very important and you can even set monitoring maintenance with this doctor or not, is in relation to childbirth. Currently, many colleagues accompany the patient during prenatal care, but they don’t deliver.Given this, know if your doctor makes delivery by agreement or not, and if it performs or not vaginal birth, is paramount today.

  1. How many times do I have to go to the appointment with the obstetrician during pregnancy?And what is the time interval between queries?

Sharafu Rizzo: According to the Ministry of health, the expectant mother must have a minimum of 5 queries, ideal 4 weeks interval between them, and of 15 days from 36 weeks, since the beginning of the prenatal care in the first trimester of pregnancy is.

However, in clinical practice, it is customary to follow the patient every 15 days from 32 weeks, and every 7 days from 37 weeks.

  1. Can skip any prenatal examination?

Sharafu Rizzo: No. The tests performed during the prenatal period serve to track morbid States that may be specific to pregnancy or even background which may lead to changes to the pregnant woman and the fetus and are treatable or, at least, possible. Some tests make diagnosis of pathologies with grave consequences to the binomial mother-foetus, how gestational Diabetes; In addition to the diagnosis of diseases such as syphilis and HIV.

  1. When can I start to feel the baby’s movements?

Sharafu Rizzo: The most experienced mother can feel the first movements with 16 weeks, during which the fetus has between 14 and 17 cm and about 100 g. With 20 weeks, the movements such as kicks are noticeable even by primigestas (pregnant women for the first time).

  1. When can I find out if I’m going to have a boy or a girl?

Sharafu Rizzo: With advances in diagnostic medicine, it is possible the knowledge of the sex of the baby from eight weeks, for an exam known as fetal sexing-in which the presence of the Y chromosome in the peripheral blood of the mother. In the presence of this finding, the diagnosis of the male.

The genitalia becomes clear by ultrasound from 16 weeks, so on second-trimester ultrasound morphology, it is possible to determine with certainty what the sex of the baby.

Some more experienced in ultrasonography can, from 12 weeks, identification of sex through the embryonic shoot.

  1. In my prenatal physician should guide me about my power supply?Or need tracking a nutritionist?

Sharafu Rizzo: In General, the doctor can guide the patient as to food, emphasizing the need for a fractional and balanced diet. However, any excessive weight gain or loss, especially in the first trimester of pregnancy, requires more specialized attention, due to the consequences which can lead both to the mom, and the fetus, and may lead to preterm labor, fetal growth, anemia and even fetal malformations. Therefore, if the doctor identify any change in pregnancy weight (gain or loss) should consider the additional service of the nutritionist for the well-being of the maternal-fetal dyad.

  1. What is the ideal weight gain for pregnant women throughout pregnancy.

Sharafu Rizzo: The first prenatal consultation the expectant mother must be weighed and measured and evaluated your BMI (body mass index). Acceptable weight gain during pregnancy varies according to the BMI: the higher it is, the smaller should be the weight gain.

Thinking of a eutrófica patient, i.e. BMI between 19-26, acceptable weight gain is 11.5 to 16 kg.

  1. will I receive prenatal guidance In how to prepare for breastfeeding?

Sharafu Rizzo: Part of prenatal consultations breast examination to evaluate the type of nipple that pregnant women and the possible difficulties that it may have to breastfeed. You don’t generally stimulate the nipple preparation with abrasive utensils as Loofah, for example, or even manual stimulation by the risk of premature labor. Can expose them to the Sun to minimize the chance of cracks.

In relation to take correct for breastfeeding, the obstetrician guide the patient at the end of pregnancy, as well as at birth, after birth, so that the patient can breastfeed the baby by minimising the risk of cracks, pain and bleeding.

  1. When should I tell my healthcare provider the type of delivery that wish to have?

Sharafu Rizzo: In the first query. The route of delivery should be discussed from the beginning of pregnancy to the patient feel safe of choice made both in relation to the delivery route, as the professional chosen to share this time. And thus reach the quiet birth as to progress and, consequently, can only enjoy that moment so special and waited.

The more informed and clarified the patient as to the risks and benefits of each route of delivery, the safer you will be on your choice and the birth itself.

Natural Childbirth: Why Choose It?

Childbirth is a moment of woman and, therefore, she has the right to plan, to expose what you want for your baby’s birth. In the pre-natal, she must talk openly with your obstetrician about the subject, making clear what you expect.

However, it is worth remembering that Brazil is considered the leader in Cesarean section: the recommendation of the World Health Organization (who) is that 15% of births are via c-section, but, in the country, on the private network, the fees amount to 82% and on the public network, 52%.

In this sense, it is extremely important to stress the benefits of betting on natural childbirth, so that the woman has fewer questions on the subject and can feel safer if you choose for this type of delivery.

Sharafu points out that the regular features, among other advantages:

An extremely rapid recovery for the patient even when there is the performance of episiotomy.”The patient is able to undertake the care of the baby and his very easily and in a manner that is painless,” says gynaecologist.

Due to the hormonal release that occurs on labor, the bond between mother and son is more natural and precocious, “taking the mother to breastfeed the baby possibility still in the delivery room, immediately at birth,” recalls Sharafu.

For the baby, “passage through the birth canal causes a chest compression which provides the output of amniotic fluid in the Airways and minimizes the risk of respiratory distress,” adds the gynecologist.

Some women say they don’t want the regular way by deciding he “suffered”. But Sharafu points out that, in your opinion, the natural childbirth begins first in the patient’s head. “She has to be prepared for it to occur in a natural way and not sustained. The most important thing is the information. The patient should remove all doubt in relation to childbirth with your obstetrician, because if it remains any ‘ mark ‘ about childbirth, she may not feel safe and hinder the evolution of childbirth, making it suffered “guides.

“In relation to procedures during labour, there is the possibility to ease the pain by means of analgesia with epidural can be performed at any time the patient desired, as long as there is supervision of the vitality and even fetal spinal anesthesia at the end of childbirth”, adds the gynecologist.

“Other procedures such as acupuncture, hydrotherapy, use of balls and massage relieve and the pain of the contractions and bring physical and psychological comfort to the mother,” says Sharafu.

The gynecologist remember the importance of the presence of a chaperone. “Can be a relative, a friend or even a doula (professional accompanying the labor to comfort the mother) … This makes the woman feel safe and calm for the period of labor, “he says.

“The best way of delivery is one for which that patient is prepared, since she is aware of all the risks and benefits of each procedure,” says Sharafu.

Book Of Pregnancy: How It Can Help You

Have you ever heard of the book of the pregnant woman? She can be a good ally of the woman in this phase.

Drawn up by the Ministry of health in conjunction with the State departments, municipal and Federal District, the book discusses various subjects maternal, as, for example:

Rights of pregnant women before and after childbirth;

Consultation and examination card, with space for pregnant women note their doubts;

Tips for a healthy pregnancy and warning signs;

Information and guidance about the pregnancy and the baby’s development, some health care, childbirth and the postpartum;

Information and guidance on breastfeeding;

Guidelines on how to get the birth certificate of the child.

The health professional can annotate on the still all prenatal data, writing the result of the consultations, examinations, vaccinations and what is important to a good prenatal monitoring.

To download/view the book of pregnant women simply access this link.

So, remember: prenatal care is essential to ensure the health of the baby and the pregnant woman.Now is the time to prepare for the birth of (a) your child (a) and clarify any doubts you may have about the subject.

 

Leave a Reply