Expert answer:
The examinations that should be done during prenatal care, ideally, in pregnant women without risk factors, are the following:
1st month:
- Blood typing (ABO and Rh): It is important to identify the blood type, which is essential, especially when the pregnant woman is Rh negative and the father is Rh positive. When this happens, it is necessary to perform checkups during pregnancy to check if isoimmunization has occurred - passage of Rh positive fetal blood to the mother and consequent production of antibodies, especially after the second child of the couple. Currently the Rh negative poses no risk if there is adequate control through the Coombs indirect blood test. It is important to remember that a "vaccine" should be applied at the 28th week of gestation and another soon after delivery, to inhibit the creation of the anti-Rh factor);
- Complete blood count: It reveals if the pregnant woman has anemia, or shows signs of bacterial or viral infection; may be repeated during the course of prenatal care, if necessary. During pregnancy it is normal for the pregnant woman to be somewhat anemic compared to normal patterns. However, attention must be paid to marked decreases in hemoglobin in peripheral blood);
- Fasting glycemia In specific cases, it should be repeated during pregnancy and accompanied by postprandial glycemia or glycemic curve.
- Serologies for Syphilis, Toxoplasmosis, Rubella, Cytomegalovirus, Hepatitis B and C and HIV (search for congenital infections capable of causing fetal damage);
- Urine I: Research of urinary tract infection, which is quite frequent during pregnancy, because hormonal changes and uterus growth occur. Whenever infection is suspected, the examination should be repeated;
- Protoparasitológico of feces: Research of verminoses that can cause anemia or other problems in pregnant women. Although they do not cause problems in the fetuses, problems must be identified and treated at the right time of pregnancy so as not to harm the mother.
2nd month (7-8 weeks):
- Transvaginal ultrasound (assessment of the correct location of gestation, more precise calculation of gestational age, diagnosis of multiple gestation and its viability).
4th month (11-14 weeks):
- Nuchal translucency (TN) (also called 1st trimester gestational ultrasound - screening for changes that may suggest chromosomal abnormalities);
- Amniocentesis and / or corial villus biopsy It is performed on the basis of parental solicitation, advanced maternal age, altered TN in the USG, or women who have had a child with congenital problems, who have a history of genetic diseases in the family, and want to know as soon as possible the baby was affected);
- Doppler of the venous duct (Doppler is a sophisticated ultrasound that looks at the venous duct, a blood vessel in the fetus, and cardiac abnormalities there may signal birth defects).
5th month (20-24 weeks):
- Morphological ultrasound of 2nd trimester (evaluation of fetal growth, fetal anatomical malformations);
- Fetal echocardiography (research on fetal heart diseases, especially in diabetic mothers with heart diseases or family history of these diseases);
- Triple test (when indicated and / or amniocentesis for assessment of fetal abnormalities);
- Fetal Fibronectin (early identification of pregnant women at risk of preterm birth).
6th month:
- Gestational diabetes research; besides some serologies performed that should be repeated as, HIV, syphilis, toxoplasmosis; research on anemia and urinary tract infection;
7th and 8th month
- Ultrasound (only if there is any specific need);
- Streptococcal Research (although vaginal, odorless and light-colored vaginal discharge is normal, the investigation of beta-hemolytic streptococci in the vaginal "secretion" at 37 weeks of gestation is very important. The presence of this bacterium can lead to complications for mother and postpartum baby).
9th month
- Ultrasound of third trimester (evaluation of fetal growth and development, fetal position, estimated birth weight, quantity of amniotic fluid, placental maturation).
On many occasions, it is not necessary to perform absolutely all the aforementioned examinations. In case of pregnancy or suspected, a gynecologist should be consulted to see if she is pregnant or not and to start her correct follow-up.
