Pregnancy check up, tests & baby ultrasound scan schedule

Your relations with the doctor plays an important role during your pregnancy. Let it be sharing your experiences, asking for advice or knowing more about how your baby is doing, she is the one who has answers to all your questions. This relation will grow as your baby grows in your tummy. Your visits to the clinic will also grow along. For the healthy pregnancy, you will visit the clinic for a regular pregnancy check up. Following is the pregnancy check up schedule and timeline :

This is the typical pregnancy check up schedule to be followed. You may need to do more visits based on how you and your baby is doing. Be sure to stick to the check up schedule that has been suggested to you. Prenatal care is important for both your and your baby's health. In fact, when a mother doesn't get prenatal care, her baby is three times more likely to have a low birth weight.

Sometimes, life may feel hectic, but remember that your baby's health depends on this. You will forget all the hard work and will feel proud when you will hold your healthy baby in your arms. So be positive and motivated, follow the schedule and timeline suggested to you.

Following is the week-by-week schedule for the prenatal check up and required ultrasound scans during pregnancy.

Your first prenatal check up visit should be immediately when you got to know about your pregnancy. During your first prenatal or antenatal visit, your medical history will be recorded, and a general health check up will be done. Your blood pressure, weight, and height will be recorded to calculate your body mass index (BMI). The systemic examination will be done to rule out any preexisting heart or respiratory related problems. For a healthy baby, you will be advised on early pregnancy tips, diet, and lifestyle you need to follow during your pregnancy.

There are few medications to be taken during this period. Folic acid is an important vitamin supplement and it is highly recommended to take folic acid supplements during your first trimester (3 months) to prevent neural tube defects in the baby. You may experience some early pregnancy symptoms like nausea or vomiting during this period. If required, an appropriate medication will be prescribed.

It is recommended to have your first pregnancy ultrasound scan between 6 to 9 weeks. Although you don't need a scan to confirm your pregnancy, the dating, and viability ultrasound scan help in many other aspects. It checks if your baby is at the right place or not, it finds the accurate due date, determines the reason for any spotting or bleeding, and show how many babies you are carrying. Hearing your baby's heartbeat for the first time is the most exciting part of this pregnancy ultrasound scan.

You will go through many blood and urine test during this period. The blood tests will identify your blood group, Rhesus status, Hemoglobin, thyroid function. You'll also get blood tests for infections, such as hepatitis B, HIV, syphilis and possibly the blood disorder thalassaemia. Blood sugar testing (either random sugar level or fasting and postprandial or OGCT) will be done to check for your diabetic status. A urine test will be for traces of protein, which can be a sign of pre-eclampsia, and for a urine infection called asymptomatic bacteriuria (ASB), which can increase your risk of giving birth too early.

Overall, your first prenatal visit is an important milestone for having a happy and healthy pregnancy. Give a special attention to you and your baby during this period.

During 11 to 13 weeks of pregnancy, a regular blood pressure check up and weight are measured. During pregnancy, a weight gain of around 11 to 16 kg is considered good for person with normal BMI (pregnancy BMI - 18.5 to 24.9). The amount of weight gain will help to understand the growth of the baby. Generally, iron and calcium supplements will be also started between 11 to 13 weeks.

Pregnancy ultrasound scan called Nuchal Translucency (NT) scan is the most important part during 11 to 13 weeks check up timeline. The nuchal translucency scan measures the thickness of this fluid to assess the risk of Down's syndrome. The scan looks at and measures the thickness of your baby's nuchal fold, a fold of skin on the back of your baby's neck. Increased thickness might indicate a chromosomal abnormality, but it doesn't tell you that your baby has, or doesn't have an abnormality. The results will tell you if your baby is at high risk or low risk of chromosomal abnormality in comparison to the general population. The main purpose of the NT scan is to check chromosomal abnormalities like Down's syndrome. In case if dating scan is not done during your first visit, this pregnancy ultrasound scan can be used to accurately calculate due date and to tell you if you are carrying more than one baby.

During 16^th weeks visit, your blood pressure and weight are checked. Abdominal examination is done to check the growth of the baby. From this week onwards, you can listen to your baby's heartbeat during your prenatal visit and experience the most amazing moment of your pregnancy period.

It is recommended to continue your iron and calcium supplements. During the pregnancy, iron is important than ever. Iron helps to make haemoglobin which helps the red blood cells store and carry oxygen around the body. Not getting enough iron from your diet can lead to anaemia. This is called iron-deficiency anaemia. During the pregnancy, your body needs more iron than usual to produce the added blood required for your growing baby. You also have more fluid in your body so the haemoglobin gets diluted. So, getting enough iron during pregnancy is important to help keep yourself and your baby healthy.

After 16 weeks of pregnancy, you might have understood and adapted to the body changes. If you still have some questions, as that of any other antenatal appointments, you can ask questions and raise any issue that might be worrying you.

18 to 20 weeks pregnancy check up visits are not different for regular check up. As that of other visits, it includes checking your blood pressure and weight to understand the growth of the baby.

18 to 20 weeks is halfway through your pregnancy. By now, most of your baby's vital organs have already developed and can be clearly seen in the scan. So, during this period, an important pregnancy ultrasound scan called anomaly or ultrasound level II scan is done. This scan helps you to understand how your baby is growing, check the fetal movement, see the growth of baby's internal organs and detect birth defects in your baby. Many aspects of baby's internal organs are checked including the shape and structure of the head, face, length and cross-section of spine, abdominal wall, heart, stomach, kidney, arms, legs, hands and feet. In addition to this detailed look at how your baby is growing, the doctor will check the placenta, the umbilical cord, and the amniotic fluid.

The anomaly scan is important because if a problem is detected, the necessary precautions can be discussed and taken. This scan can cause a great deal of anxiety among the parents. It's important to remember that many normal babies also have markers. Try not to panic in case if something unusual is found. Discuss it with the doctor, confirm the problem first, do the re-scan if necessary and try to find the solution in case if the problem is confirmed.

As usual, 24 to 26 weeks visit will include blood pressure, weight and abdominal examination to make sure that your baby is growing well. You will again get an experience to hear your baby's heartbeat. You will get another blood test done at this stage to check your haemoglobin levels. Based on the results, change in your regular dose of the iron supplement will be decided. If needed, another iron supplement might be advised.

You will also be asked to do a glucose challenge test to screen for gestational diabetes. Gestational diabetes happens when you have too much sugar (glucose) in your blood during pregnancy. Your blood sugar levels can go up when your body isn't producing enough of a hormone called insulin. Insulin helps the muscles and tissues in your body to use blood sugar for energy and helps your body to store any blood sugar that isn't needed. Having too much sugar in your blood can cause problems for you and your baby, so you need to take extra care during your pregnancy. The glucose challenge test helps to identify the sugar problem and take necessary actions to prevent any problem for you and your baby.

The Federation of Obstetric and Gynaecological Societies of India (FOGSI) recommends the flu vaccination for all the pregnant women from 26 weeks of pregnancy. Having the flu vaccine will help to protect you and your baby from swine flu and other strains of flu. If there is an outbreak, you may be advised to have the vaccine earlier.

Pregnancy results in many immunity changes in a woman's body, becoming more susceptible to infectious diseases. Read this pregnancy vaccinations article, to know more about vaccination schedule and protection it offers.

Your pregnancy check up visit during this week will involve routine check up like blood pressure, weight, and abdominal examination. You may be requested to go for a blood test to check the haemoglobin level. Based on the haemoglobin level in the blood, the appropriate iron supplement will be suggested. If your blood group is negative (Rh negative), you would be offered an anti-D injection to deal with any antibodies in your blood after checking your immune status (ICT test).

There is a chance of contracting tetanus during pregnancy. The infection can be transmitted to the fetus and can be life-threatening for both mother and baby. Neonatal tetanus is a severely fatal condition that affects newborns. Babies are affected because they have no immunity that passes from the mother who has not been immunized. It is therefore of high importance that pregnant women should take the Tetanus Toxoid vaccine.

Tetanus is preventable by vaccination. Antibodies that are formed in your body after vaccination, passes to your little one and protects the baby for some months after birth. To protect you and your baby from tetanus, two doses of Tetanus Toxoid (TT) injections are given. These does are given in 6 weeks interval and the first dose is given mostly between 26 to 28 weeks of pregnancy.

It is recommended to have a pregnancy ultrasound scan name growth and fetal wellbeing scan between 28 to 32 weeks. This scan helps to check how well your baby is growing. During this scan, the size of the baby is understood by measuring the circumference of baby's head (HC) and baby's tummy (AC), the length of baby's thigh bone (FL) and depth of the amniotic fluid around the baby. If the measurements are well within normal limits, your baby is likely to be doing just fine. In case, if your baby is either larger or small than expected, you will be advised to have a second scan two weeks later. These serial scans help to accurately track the baby's growth and take appropriate actions if required.

As your baby is growing well and you are very close to the baby's arrival, the frequency of your prenatal visits will increase now. You will visit the clinic once every two weeks.

These visits will involve routine check up like recording the blood pressure, weight and measure your bump to understand how the baby is growing. Baby's heartbeat and position will be checked to see if the baby is doing good and resting in a good position. These visits will also include your breast examination and advice will be given on how to prepare for breastfeeding. You will be due for your growth and fetal wellbeing scan if it hasn't been done yet. During 36th week's visit to the clinic, the second dose of tetanus toxoid vaccine will be given.

After 36 weeks of your pregnancy, you will visit the clinic once every week. These visits include routine check up like blood pressure, weight, and size of the bump. Baby's heartbeat and position will be examined. It is recommended to have a scan and colour Doppler studies if you haven't had these recently.

As you are close to giving birth to your baby, it is important to know the baby's position. A thorough bump examination will be done to check if the baby is in the breech position. The breech position means that your baby is in a bottom-down and head up position inside your womb. Throughout your pregnancy, your baby will be moving around in your womb. But around eight months of pregnancy, baby will settle in one position. The head down position is the good and normal position of the baby and observed in about 96% of the babies. But few babies will settle into bottom-first or a breech position.

Completion of 38 weeks of pregnancy is the good time for caesarean section (LSCS) delivery. In case if your baby is in the breech position or there are any other conditions which demand caesarean section (LSCS). In such conditions your caesarean section will be planned during this week.

Your baby will arrive soon now, so you will be requested to report the clinic immediately if you experience some symptoms. These symptoms include pain in the abdomen, watery discharge per vagina, decreased fetal movements, bleeding per vagina. During these weeks, you will be also oriented towards the process of labour and guidance about epidural analgesia/painless labour.

You are almost at the final stage of your pregnancy journey. Your baby will be in your arms any time. Your 39^th week pregnancy check up visit will involve routine check up like blood pressure, weight to monitor baby's growth. Your baby's heartbeat and position will also be checked. If anything unusual is noticed, an appropriate actions will be taken.

If by now you have not delivered your baby, along with routine examination, a vaginal examination will be carried out to check favorability of your cervix for vaginal delivery. You may be asked for post-dates testing such as nonstress tests, ultrasound, and biophysical profiles to check for the baby's wellbeing. Few checks will be carried out to see if all is well and options of inducing a labour will be discussed. Most of the labour starts naturally, but sometimes the birth process may need a little help. Certain medications are used to start the artificial labour pains.