Pregnancy consultation is an examination procedure that is carried out routinely during pregnancy to check the condition and development of the fetus in the womb.
Pregnancy is a time when an embryo forms, grows, and develops in a woman's uterus as a result of fertilization between an egg and a sperm. The embryo will continue to develop to form a fetus within 36-40 weeks. To ensure that the mother and fetus in the womb are in good health, regular consultations and prenatal checkups are necessary.
In addition, pregnancy consultation is very important because it has several purposes, including:
- Check the condition and monitor the development of the fetus in the womb.
- Reducing the risk of complications that may occur in pregnant women and the fetus in the womb.
- Detect abnormalities or disorders that may occur in the fetus early on.
- Make it easier for pregnant women in undergoing pregnancy.
- Streamlining the labor process and reducing the risks that endanger the mother and fetus during delivery
Doctors who specifically handle pregnancy tests are called obstetrics and gynecology specialists (Sp.OG), or in general, obstetricians.
Indications for Pregnancy Consultation
Pregnancy consultation is highly recommended for every pregnant woman from the beginning to the end of pregnancy. The consultation schedule is generally carried out according to the gestational age of the pregnant woman, namely:
- 1 time a month for 4-28 weeks of pregnancy.
- 2 times in 1 month for 28-36 weeks of pregnancy.
- 4 times in 1 month (every week) for 36 weeks of pregnancy until delivery.
In addition, there are several conditions that require pregnant women to undergo pregnancy consultations more often than the recommended schedule. Among others are:
- >35 years old.
- High risk pregnancy. If a woman is considered prone to certain complications during pregnancy, for example, people with diabetes or high blood pressure.
- Twin pregnancy
- History of premature birth. If the pregnant woman has experienced premature birth or appears premature birthmarks during pregnancy.
Before Pregnancy Consultation
There are several things that need to be prepared by pregnant women before conducting a pregnancy consultation, including:
- Overall medical history. The first pregnancy consultation will usually review the overall medical history of the pregnant woman, including the partner's medical history and also the family. Pregnant women should bring all the results of previous examinations, such as X-rays, laboratory test results, and the results of other supporting examinations (CT scan or MRI).
- Types of drugs or herbal products that are currently or have been consumed. Pregnant women should bring a list of medications, including vitamins and supplements, that are being taken. This is because some types of drugs are not safe to take during pregnancy.
- A list of questions. Before undergoing a pregnancy consultation, pregnant women should make a list of questions about things they want to know about pregnancy. Sort the questions starting with the most important.
Pregnancy Consultation Procedure
The types of pregnancy consultations and examinations performed during pregnancy may differ, depending on the gestational age.
- 1st trimester (0-12 weeks) pregnancy consultation.In the first trimester of pregnancy, the types of examinations carried out include:
- Medical history check. The doctor will ask some questions and determine the expected day of birth (HPL). Determination of HPL allows doctors to monitor the growth and development of the patient's pregnancy, as well as determine the schedule of consultations and examination procedures that will be carried out in the future. Meanwhile, the types of questions that will be asked include:
- Menstrual cycle.
- Previous pregnancy history.
- Patient and family medical history.
- The type of medicine you are currently taking, including prescription drugs and supplements.
- The patient's lifestyle, including smoking or drinking alcohol.
- Physical examination. This examination is carried out to check and ensure the patient's body condition is healthy during the early stages of pregnancy. The types of inspections carried out include:
- Measurement of the patient's height and weight, so that the doctor can determine the ideal body mass index according to the development of pregnancy.
- Examination of vital signs, including blood pressure, heart rate, and respiratory rate.
- Pelvic examination. The doctor will perform a pelvic exam by inserting two fingers into the vagina and one hand on the abdomen to determine the size of the patient's uterus and pelvis.
- Laboratory examination. The obstetrician will also instruct the patient to undergo blood and urine tests with the aim of:
- Check blood group, including ABO and Rh (Rh).
- Measure the amount of hemoglobin. A low hemoglobin count is a sign of anemia and if left unchecked can harm the developing condition of the fetus in the womb.
- Checks the immune system for certain infections, such as rubella and chickenpox.
- Detecting possible exposure to infections in pregnant women, such as hepatitis B, syphilis, and HIV.
- Imaging. The type of imaging test that is performed during the first trimester pregnancy consultation is ultrasound. The type of ultrasound that can be done can be a pelvic ultrasound or a transvaginal ultrasound, with the aim of:
- Helps confirm gestational age.
- Detecting disorders that may be experienced by pregnant women.
- Detect abnormalities in the fetus.
- Hear the heartbeat of the fetus in the womb (when the gestational age of 10-12 weeks).
- Medical history check. The doctor will ask some questions and determine the expected day of birth (HPL). Determination of HPL allows doctors to monitor the growth and development of the patient's pregnancy, as well as determine the schedule of consultations and examination procedures that will be carried out in the future. Meanwhile, the types of questions that will be asked include:
- 2nd trimester pregnancy consultation (13-28 weeks). The purpose of the pregnancy consultation in the second trimester is to ensure that the pregnant mother and fetus are in good health. The types of examinations carried out during the 2nd trimester pregnancy consultation include:
- Basic check. The obstetrician will measure the blood pressure and weight of the pregnant woman. The doctor will also ask for complaints that may be experienced during pregnancy.
- Examination of the condition of the fetus. This examination generally includes several things, including:
- Check fetal development. The examination is done by measuring the distance from the pubic bone to the top of the uterus.
- Hear the heartbeat of the fetus. Examination of the fetal heart rate is carried out using a Doppler instrument.
- Observe fetal movement. When entering the 20th week of pregnancy, pregnant women usually begin to feel a movement in the form of a small push or kick. The obstetrician will check the movement of the fetus.
- Prenatal test. During the second trimester, the obstetrician will recommend pregnant women to undergo several tests, such as:
- Blood test. Another blood test is done to count blood cell counts and iron levels, detect symptoms of diabetes that may develop during pregnancy, and detect possible infections.
- Urine test. A urine sample is used to detect the presence of protein or signs of infection.
- Genetic testing. This test is done using a blood sample to detect genetic disorders that may occur in the fetus, such as Down syndrome and spina bifida.
- Fetal ultrasound. This type of ultrasound is done to help doctors evaluate the anatomy of the fetus and find out the sex of the fetus.
- Diagnostic test. If the results of a blood test or ultrasound show signs of a high-risk pregnancy, your doctor may recommend that you undergo diagnostic tests, such as amniocentesis. Aminocentesis procedure is done by taking a sample of amniotic fluid from inside the uterus for further investigation in the laboratory.
- 3rd trimester pregnancy consultation (28-40 weeks). The types of examinations carried out during the 3rd trimester pregnancy consultation include:
- Basic check again. The obstetrician will re-measure the blood pressure and weight of the pregnant woman, and monitor the movement and heartbeat of the fetus in the womb. Urine tests are also done again to detect protein or infection.
- Fetal position check. At the end of the pregnancy, the obstetrician will estimate the weight of the fetus and observe the position of the fetus. Is the fetal head already at the door of the uterus. If the position of the buttocks of the fetus is near the door of the uterus (breech), the obstetrician will try to change the position of the fetus by pressing the abdomen of the pregnant woman so that normal delivery can still be carried out.
- Bacterial infection check Streptococcus Group B (GBS). This type of bacteria is often found in the intestines and lower genital tract, and is usually harmless to adults. However, if the baby is infected with this bacteria during the delivery process, it can experience serious health problems. The doctor will take a sample by wiping the lower part of the vagina with a cotton swab for analysis in the laboratory. If the test result is positive for GBS, the pregnant woman will be given antibiotics through an IV during delivery.
- Cervical examination. As pregnant women get closer to delivery, the obstetrician will perform a pelvic exam to detect cervical changes. At this stage, the condition of the cervix will begin to soften, enlarge, and thin. On the eve of delivery, the cervix will open, and its dilation is expressed in cm.
After Pregnancy Consultation
After the pregnant woman undergoes a pregnancy consultation and examination, the obstetrician will review the results of the physical examination, laboratory test results, and the results of the supporting examinations that have been carried out. From these results, obstetricians can find out several things:
- Conditions of pregnant women and fetuses in the womb. Through consultations and examinations, obstetricians can determine the health of pregnant women and fetuses, detect abnormalities that may be experienced, and preventative measures that can be taken if pregnant women undergo a high-risk pregnancy.
- Early screening or screening tests. If the fetus is at risk for abnormalities, the obstetrician may perform several diagnostic tests to confirm the condition of the fetus in the womb. Among others are:
- Amniocentesis or examination of the baby's chromosomes.
- Fetal blood sampling (FBS) or fetal blood sampling from the umbilical cord.
- Chorionic villus sampling (CVS) or cell sampling chorionic villus from the placenta using a special needle.
In addition to regular consultations and prenatal checkups, there are several things that pregnant women can do to maintain the health of the body and the fetus in the womb, including:
- Take folic acid vitamins regularly every day.
- Do not smoke or consume alcoholic beverages.
- Regular exercise or physical activity that is
- Eat nutritious foods, such as fruit, vegetables, whole grains, and foods high in calcium.
- Increase fluid consumption.
- Get enough rest.
- Avoid soaking in hot tubs (hot tub) or sauna.
- Find out information about pregnancy and childbirth, from books, videos and online (on line).
- Avoid exposure to chemicals, such as insecticides, solvents (paints or cleaners), lead, and mercury.
