Antenatal - Lady Care Women's Hospital & Child Care : Best Women Hospital in Ahmedabad

Antenatal (During Pregnancy)

MONTHS	WHAT PATIENT HAVE TO WATCH FOR	WHAT WE R GOING TO DO
MONTH 1 (4WK TO 8WKS)	When you miss your period THEN do pregnancy test at home and if it is positive visit your doctor immediately Inform your correct LMP to your doctor Inform about your past history related to your health	• First of all proper history taking • Ultrasonography to decide presence of intrauterine or extrauterine pregnancy Dating and viability of baby. • counceling regarding importance of pregnancy. • Give the list of blood and urine reports which are needed during antenatal care. • Complete general examination of patient.
MONTH 2(8WKS TO 11WKS)	Get all the blood and urine reports suggested by us. all your symptoms which you started to feel like nausea, vomiting, fatigue, tender swollen breast, food aversions or cravings, heartburn etc. Understand all the things to be done and not done during first 3 to 4 months of pregnancy You must avoid intercourse and travelling during first 3 months of pregnancy	• Dating scan to match both EDD (counted and AUA EDD). • Counsel the patient about diet which is required during pregnancy. • About dental health. • Educate her about dos & don’ts of pregnancy. • Educate her about natural symptoms of pregnancy like morning sickness, nausea, vomiting, fatigue, and advice about its management. • Give the date for nuchal translucency scan and explain about its importance.
MONTH 3 (11WKS TO 14 WKS)	Must visit the doctor on the given date, because this is very important scan to see for abnormal foetus Show all blood and urine reports to your doctor If any health issue discuss with your doctor	• nuchal translucency scan during this visit,(to screen out probable chromosomal trisomy). • Now start with iron , calcium and protein and vitamin D supplements. • Prescribe other medicines according to blood and urine reports of the patient. • Note the blood group of the patient(if Rh -ve, ask for the husband’s blood group and explain its importance). • 1st dose of Titanus Toxoid / Td/TdaP injection.

MONTHS

WHAT PATIENT HAVE TO WATCH FOR

WHAT WE R GOING TO DO

MONTH 1 (4WK TO 8WKS)

When you miss your period THEN do pregnancy test at home and if it is positive visit your doctor immediately
Inform your correct LMP to your doctor
Inform about your past history related to your health

• First of all proper history taking
• Ultrasonography to decide presence of intrauterine or extrauterine pregnancy
Dating and viability of baby.
• counceling regarding importance of pregnancy.
• Give the list of blood and urine reports which are needed during antenatal care.
• Complete general examination of patient.

MONTH 2(8WKS TO 11WKS)

Get all the blood and urine reports suggested by us.

all your symptoms which you started to feel like nausea, vomiting, fatigue, tender swollen breast, food aversions or cravings, heartburn etc.
Understand all the things to be done and not done during first 3 to 4 months of pregnancy
You must avoid intercourse and travelling during first 3 months of pregnancy

• Dating scan to match both EDD (counted and AUA EDD).
• Counsel the patient about diet which is required during pregnancy.
• About dental health.
• Educate her about dos & don’ts of pregnancy.
• Educate her about natural symptoms of pregnancy like morning sickness, nausea, vomiting, fatigue, and advice about its management.
• Give the date for nuchal translucency scan and explain about its importance.

MONTH 3 (11WKS TO 14 WKS)

Must visit the doctor on the given date, because this is very important scan to see for abnormal foetus

Show all blood and urine reports to your doctor

If any health issue discuss with your doctor

• nuchal translucency scan during this visit,(to screen out probable chromosomal trisomy).
• Now start with iron , calcium and protein and vitamin D supplements.
• Prescribe other medicines according to blood and urine reports of the patient.
• Note the blood group of the patient(if Rh -ve, ask for the husband’s blood group and explain its importance).
• 1st dose of Titanus Toxoid / Td/TdaP injection.

Dangerous signs in 1st trimester

Bleeding or spotting per vagina
High grade fever
Any viral infection
Accidental fall
Severe vomiting
Pain in lower abdomen.

MONTHS	WHAT PATIENT HAVE TO WATCH FOR	WHAT WE R GOING TO DO
MONTH 4 (15WKS TO 18WKS)	Now you start with your 2nd trimester pregnancy, it often brings a renewed sense of well being Visit in given date Now you can see your baby’s all the body parts perfectly in USG Scan You might notice pink, red or purple streaks along your abdomen , breast or thighs	• To decide about the requirement of the Biomarker (Qudruple /Tripple marker), women with 30 plus age has high risk for congenital anomaly, • Watch for foetal well being on USG, to see cervical length if it is • Any patient with history of pre term labour during last pregnancy ask her to go for cervical encirclage
MONTH 5 (19WKS TO 22WKS)	22 Wks Anomaly scan is very important. don’t miss the date given. we will show you all the external as well internal organs of your baby in USG Discus about antenatal exercise, yoga and ante natal physiotherapy with us. Now your belly will start to expand You will feel heaviness of breast.	• To do anomaly scan of 22 Wks. • In this scan we have to watch for any cardiac anomaly, uterine artery flow, foetal bladder, stomach bubble, spine, foetal brain, kidney, both extremities, diaphragm, placental location, 3 vessel cord, umbilical artery etc. • Advice the patient about flu vaccination • Educate her about dos & don’ts of pregnancy. • Advice the patient to come with repeat CBC and urine report on follow up • Give the 2nd dose of TT / Td / Tdap vaccine.
MONTH 6 (23 WKS TO 27 WKS)	Visit us with reports adviced Now you can feel your baby’s movement in your tommy Sometimes you feel weak contraction in your abdomen. It’s very weak and generally comes and go unpredictably. You might notice dark patches on your face. you may also see a dark faint line down your abdomen (linea nigra).This skin changes are usual and fade after delivery You may feel leg cramps. If it is severe discuss with us You might notice a thin, white vaginal discharge.	• This is the routine visit if everything is ok in anomaly scan, just watch for foetal well being and growth. • Educate the patient regarding Stem-cell banking and neonatal screening(NBS). • Educate her about dangerous signs like painful contractions of abdomen, diarrhoea , sever vomiting, excessive vaginal discharge and swelling.

MONTHS

WHAT PATIENT HAVE TO WATCH FOR

WHAT WE R GOING TO DO

MONTH 4 (15WKS TO 18WKS)

Now you start with your 2nd trimester pregnancy, it often brings a renewed sense of well being Visit in given date

Now you can see your baby’s all the body parts perfectly in USG Scan

You might notice pink, red or purple streaks along your abdomen , breast or thighs

• To decide about the requirement of the Biomarker (Qudruple /Tripple marker), women with 30 plus age has high risk for congenital anomaly,

• Watch for foetal well being on USG, to see cervical length if it is

• Any patient with history of pre term labour during last pregnancy ask her to go for cervical encirclage

MONTH 5 (19WKS TO 22WKS)

22 Wks Anomaly scan is very important. don’t miss the date given.

we will show you all the external as well internal organs of your baby in USG
Discus about antenatal exercise, yoga and ante natal physiotherapy with us.

Now your belly will start to expand
You will feel heaviness of breast.

• To do anomaly scan of 22 Wks.
• In this scan we have to watch for any cardiac anomaly, uterine artery flow, foetal bladder, stomach bubble, spine, foetal brain, kidney, both extremities, diaphragm, placental location, 3 vessel cord, umbilical artery etc.
• Advice the patient about flu vaccination
• Educate her about dos & don’ts of pregnancy.
• Advice the patient to come with repeat CBC and urine report on follow up
• Give the 2nd dose of TT / Td / Tdap vaccine.

MONTH 6 (23 WKS TO 27 WKS)

Visit us with reports adviced

Now you can feel your baby’s movement in your tommy

Sometimes you feel weak contraction in your abdomen. It’s very weak and generally comes and go unpredictably.

You might notice dark patches on your face. you may also see a dark faint line down your abdomen (linea nigra).This skin changes are usual and fade after delivery

You may feel leg cramps. If it is severe discuss with us
You might notice a thin, white vaginal discharge.

• This is the routine visit if everything is ok in anomaly scan, just watch for foetal well being and growth.
• Educate the patient regarding Stem-cell banking and neonatal screening(NBS).
• Educate her about dangerous signs like painful contractions of abdomen, diarrhoea , sever vomiting, excessive vaginal discharge and swelling.

Dangerous signs in 2nd trimester

Painful abdominal contractions
Bleeding / leaking per vagina
Excessive nausea and vomiting
High grade fever
Vaginal discharge and itching
Raised blood pressure
Lower limb swelling

MONTHS	WHAT PATIENT HAVE TO WATCH FOR	WHAT WE R GOING TO DO
MONTH 7 (28 Wks TO 32 Wks)	Now you have started with your 3rd trimester. Now you are feeling your baby movements very well in your tummy. As your baby continue to gain weight , you may start feel heartburn again and again Your ankles and feet may got swollen, you may develop varicose veins.	• Do careful foetal echo / growth / fluid assessment/ color doppler • Watch for IUGR and placental calcification and perfusion • Watch for pedal oedema and close monitoring of blood pressure, as PIH may develop between 28 to 32 Wks • Counsel the patient about backache ask her to take small frequent meals to get rid of heartburn. • Educate her about early labour pains
MONTH 8 (33 Wks TO 36 Wks)	Now you will have weekly check up. This time is physically and emotionally challenging Your baby’s size and position might make you uncomfortable As your baby grows, it’s movements will become more obvious till date you might gain 11 to 13 Kg weight You might get winded easily as your uterus expands beneath your diaphragm. You will feel frequency of urination. As your baby move deeper in you pelvis this extra pressure may cause leaking of urine while you are laughing or coughing Pay attention to your baby’s movement and let us know right away if you notice decreased movements	• Now we have to watch for color Doppler, watch for amniotic fluid • We have to do pelvic assessment by doing P/V. • Educate patient to recognize labour pains. • Educate the patient regarding alarming signs like leaking or bleeding per vagina
MONTH 9 (37 wks to 40 wks)	This is the final stage of pregnancy. You may feel more comfortable during this last month as your baby moves down ready to be borne, but you may feel pressure in your lower abdomen. Most women go into labour between 37 to 40 Wks. Keep your bag ready for hospital admission put the all things which your nurse or doctor asked and which you feel necessary. You must collect all the information regarding recognition of labour pain and signs of labour .Contact your doctor when you start with your labour pain and get admitted in hospital	• Ask the patient to come every week for check up. • Educate her about labour pains and signs of labour. • Watch for the presenting part of the foetus (VERTEX OR BREECH OR TRANSEVERSE Lie). • Watch for the cord around neck and baby weight.

MONTHS

WHAT PATIENT HAVE TO WATCH FOR

WHAT WE R GOING TO DO

MONTH 7 (28 Wks TO 32 Wks)

Now you have started with your 3rd trimester.

Now you are feeling your baby movements very well in your tummy.

As your baby continue to gain weight , you may start feel heartburn again and again

Your ankles and feet may got swollen, you may develop varicose veins.

• Do careful foetal echo / growth / fluid assessment/ color doppler

• Watch for IUGR and placental calcification and perfusion

• Watch for pedal oedema and close monitoring of blood pressure, as PIH may develop between 28 to 32 Wks

• Counsel the patient about backache ask her to take small frequent meals to get rid of heartburn.

• Educate her about early labour pains

MONTH 8 (33 Wks TO 36 Wks)

Now you will have weekly check up. This time is physically and emotionally challenging

Your baby’s size and position might make you uncomfortable
As your baby grows, it’s movements will become more obvious
till date you might gain 11 to 13 Kg weight
You might get winded easily as your uterus expands beneath your diaphragm.

You will feel frequency of urination. As your baby move deeper in you pelvis this extra pressure may cause leaking of urine while you are laughing or coughing

Pay attention to your baby’s movement and let us know right away if you notice decreased movements

• Now we have to watch for color Doppler, watch for amniotic fluid
• We have to do pelvic assessment by doing P/V.
• Educate patient to recognize labour pains.
• Educate the patient regarding alarming signs like leaking or bleeding per vagina

MONTH 9
(37 wks to 40 wks)

This is the final stage of pregnancy.
You may feel more comfortable during this last month as your baby moves down ready to be borne, but you may feel pressure in your lower abdomen.

Most women go into labour between 37 to 40 Wks.
Keep your bag ready for hospital admission put the all things which your nurse or doctor asked and which you feel necessary.

You must collect all the information regarding recognition of labour pain and signs of labour .Contact your doctor when you start with your labour pain and get admitted in hospital

• Ask the patient to come every week for check up.
• Educate her about labour pains and signs of labour.
• Watch for the presenting part of the foetus (VERTEX OR BREECH OR TRANSEVERSE Lie).
• Watch for the cord around neck and baby weight.

Dangerous signs in 3rd Trimester

Swelling over lower limb or all over the body
Loss of foetal movement
Bleeding per vagina.
Increased blood pressure
High grade fever and convulsion
Accidental fall