Table of contents
Pregnancy Follow-ups
First Follow-up in Pregnancy:
It is the first meeting of the health team that will follow up with the mother-to-be. It is the recommended first follow-up examination at the first detection of pregnancy or within the first 14 weeks.
A detailed pregnancy history of the pregnant woman is taken and examined. Examinations are requested according to the gestational week.
In the pregnancy history, information about the pregnancy is recorded:
- Age of the pregnant,
- Contact information of himself and his relatives,
- Education information,
- Information about the living space (house of residence, heating status, toilet, bathroom facilities, etc.),
- Social security,
- Profession, working conditions,
- Distance of home and workplace to health facility (for emergencies),
- The presence of a hereditary disease in the family,
- blood diseases,
- blood group incompatibility,
- Smoking, alcohol or substance abuse,
- Psychiatric diseases,
- Chronic disease history (high blood pressure, diabetes mellitus, epilepsy, cardiovascular diseases, liver diseases, kidney diseases, etc.),
- allergy history,
- Past diseases (parasitic, viral, tuberculosis etc.),
- Past gynecological diseases, operations, biopsies,
- Sexually transmitted diseases,
- Drugs used,
- Vaccination status (tetanus, hepatitis B, measles, rubella vaccines etc.),
- Organ transplantation, blood transfusion history,
- Information on cancer screening tests.
In addition, information about previous pregnancies is searched:
- Consanguineous marriage,
- Previous pregnancies and births,
- Multiple pregnancy history
- Last pregnancy information (date, type of birth, etc.),
- Stillbirth story,
- Premature birth history
- Use of assisted reproductive techniques
- Previously applied methods of protection,
- Troubles experienced during pregnancy and childbirth,
- History of breastfeeding in previous babies,
- Last menstrual period,
- Menstrual order,
- Pregnancy-related complaints (nausea, vomiting, heartburn, frequent urination, etc.),
- Diseases in the last pregnancy, drugs used,
- Travels during the last pregnancy.
During the examination, the patient’s blood pressure, height and weight findings are recorded. Anemia findings are investigated. Examination findings related to liver, kidney, cardiovascular diseases are evaluated. Examination findings are examined in terms of bleeding disorders, coagulation problems, and chronic diseases.
Laboratory tests to be performed in the first follow-up of pregnancy are as follows:
- Complete blood count (anemia, platelet problems, etc.),
- Complete urinalysis (infection, kidney disease, etc.),
- Blood group determination (Coombs test for Rh incompatibility),
- Sexually transmitted disease tests (syphilis etc.),
- HBsAg (Hepatitis B),
- HIV/AIDS testing,
- Thyroid tests (TSH),
- Blood glucose test (fasting blood glucose, postprandial blood glucose, sugar loading test, HbA1C),
- Liver function tests,
- Kidney function tests,
- Down syndrome screening tests.
Imaging tests are done:
- Ultrasonography (nape transparency is checked)
History, examination and laboratory tests are evaluated together. It is recommended to allocate at least 30 minutes to each pregnant woman for the first follow-up. According to the result, if there is a suspicion of risky pregnancy, specialist physician control is recommended.
The pregnant woman is informed about pregnancy, possible problems, methods of combating them, and nutrition. If necessary, detailed information can be given by taking them to pregnancy classes. In addition, psychological support and couple therapies can be applied.
Vitamin D supplementation is started if needed. Tetanus vaccination is evaluated, if not, the vaccination program is started.
Second Follow-up in Pregnancy:
18-24th of pregnancy. between weeks is recommended.
The information obtained at the first follow-up is reviewed. Missing or missing points are re-evaluated. In particular, information on past pregnancies and births is examined in detail. It is important to re-examine the use of cigarettes, alcohol, drugs and drugs.
The current pregnancy is evaluated. Complaints of the pregnant are investigated. Coping methods are explained. In particular, symptoms that may put the pregnancy at risk are examined. The nutritional habits of the expectant mother are evaluated.
In the examination, findings related to blood pressure level, weight gain, and complaints, if any, are evaluated. In addition, the size of the uterus is calculated according to the gestational week. Further research may be needed for values that are not at the desired level.
Laboratory tests to be performed in the second follow-up of pregnancy are as follows:
- Complete blood count (anemia, platelet problems, etc.),
- Complete urinalysis (infection, kidney disease, etc.),
- Blood glucose test (fasting blood glucose, postprandial blood glucose, sugar loading test, HbA1C),
- Alpha fetoprotein (neural tube defect),
- Liver function tests,
- kidney function tests,
- Down syndrome screening tests (if not done).
Imaging tests are done:
- Ultrasonography (the amount of amniotic fluid, number of fetuses, heartbeat of the baby, location of the placenta, etc.),
If needed and not started at the first follow-up, vitamin D supplementation is started. Tetanus vaccination is evaluated, if not, the vaccination program is started.
Third Follow-up in Pregnancy:
28-32 weeks of pregnancy. weeks is recommended.
The pregnancy history taken in the first two follow-ups is evaluated. Especially cigarette, alcohol, substance and drug use are questioned again. Complaints of the pregnant are investigated. Coping methods are recommended. Bleeding etc. symptoms that will put the pregnancy at risk are questioned.
In the examination, findings related to blood pressure level, weight gain, and complaints, if any, are evaluated. In addition, the size of the uterus is calculated according to the gestational week. Further research may be needed for values that are not at the desired level.
Payment check is done. Swelling, especially in the legs, is evaluated.
Laboratory tests to be performed in the third follow-up of pregnancy are as follows:
- Complete blood count (anemia, platelet problems, etc.),
- Complete urinalysis (infection, kidney disease, etc.),
- Blood glucose test (fasting blood glucose, postprandial blood glucose, sugar loading test, HbA1C),
- Liver function tests,
- Kidney function tests.
Imaging tests are done:
- Ultrasonography (the amount of amniotic fluid, number of fetuses, heartbeat of the baby, location of the placenta, etc.),
Fourth Follow-up in Pregnancy:
36-38 weeks of pregnancy. weeks is recommended.
Pregnancy history taken in previous follow-ups is evaluated. Especially cigarette, alcohol, substance and drug use are questioned again. Complaints of the pregnant are investigated. Coping methods are recommended. Bleeding etc. symptoms that will put the pregnancy at risk are questioned.
In the examination, findings related to blood pressure level, weight gain, and complaints, if any, are evaluated. In addition, the size of the uterus is calculated according to the gestational week. Further research may be needed for values that are not at the desired level.
Payment check is done. Swelling, especially in the legs, is evaluated. Breast control is performed in terms of breastfeeding.
Laboratory tests to be performed in the fourth follow-up of pregnancy are as follows:
- Complete blood count (anemia, platelet problems, etc.),
- Complete urinalysis (infection, kidney disease, etc.),
- Blood glucose test (fasting blood glucose, postprandial blood glucose, sugar loading test, HbA1C),
- Liver function tests,
- Kidney function tests.
Imaging tests are done:
- Ultrasonography (the amount of amniotic fluid, number of fetuses, heartbeat of the baby, location of the placenta, etc.),