Women with pregnancy tests must be checked
physical examination
As a must-check item in hospitals, physical examination is often ignored. Many people think that measuring height, weighing weight, measuring blood pressure, counting pulse, so simple, what is the need?
In fact, just like the importance of physical examination in marriage examination, although simple, it must not be ignored! For example, if the BMI is high, it often means that you may be at high risk for gestational diabetes and gestational hypertension; there are also many young, never checked-up women with chronic hypertension who first find out that they have slow heights during pregnancy tests.
Blood is drawn
Some of the items we care about most in the blood routine are white blood cells, hemoglobin, and platelets.
white blood cell
If the white blood cells are high before pregnancy, and accompanied by fever and pain in some parts of the body, it means that there is a high probability of infection in the body, and the source of infection needs to be identified in time and treated accordingly.
Tips:
After pregnancy, white blood cells tend to be higher than before pregnancy, which is physiological, so if there is no discomfort, even if there is a small arrow behind the white blood cells throughout pregnancy, there is no need to always grab the doctor and ask why.
haemoglobin
Hemoglobin <110 g/L is anaemia, which may increase the risk of fetal hypoweight, preterm birth and perinatal mortality. If the hemoglobin is too low, it may cause serious risks such as insufficient placental oxygen, hypertension during pregnancy, the onset of heart disease, and even the vasodilation of the fetal brain and intrauterine fetal death.
1. During pregnancy, because of the growth and development of the fetus and the increase in maternal blood volume, the demand for iron in pregnant women increases, so it is recommended to start from 16 weeks of pregnancy, even if the blood routine is normal, a certain dose of iron can be used to prevent anemia; 2. If the pregnancy continues to be anemia, eating liver, red meat, iron are ineffective, and the anemia is getting worse, it is recommended to go to the hematology department to check it out, because some anemia is not caused by iron deficiency.
platelet
Comrades who have platelets before pregnancy are lower than normal values must pay attention to whether they have combined idiopathic thrombocytopenic purpura and other diseases, and believe that if thrombocytopenia is found during pregnancy tests, the doctor who receives the treatment will directly recommend that the patient go to the internal medicine department.
If the monitoring of platelets during pregnancy shows a downward trend, it may be that there is a pregnancy (idiopathic) thrombocytopenia, pregnancy hypertension (preeclampsia, HELLP syndrome), pregnancy complicated by liver disease, etc., in addition to regular follow-up monitoring, it may also require corresponding treatment.
Note: HELLP is a serious complication of hypertensive disorders of pregnancy characterized by hemolysis, impaired liver function, and thrombocytopenia.
blood type
The reason for the blood type is that in addition to considering that there will be a rare situation that requires blood transfusion, I believe you have guessed that I am going to talk about the problem of neonatal hemolysis.
A、B、O、O、
A, B, and O blood group incompatibilities between couples are very common, but in fact, neonatal hemolytic diseases caused by incompatibilities in the A, B, and O blood groups of couples are usually relatively mild, and mainly occur in mothers with type O and newborns with type A or B.
Rh-negative blood
Rh-negative blood type is also commonly known as "panda blood", this blood type of mother's first pregnancy, if the baby is Rh-positive blood type, it may lead to the mother's body to produce Rh antibodies. In each subsequent pregnancy, the mother's Rh antibodies reach the fetus through the placenta, causing the fetus to develop Rh hemolytic disease.
Mainland pregestception and pregnancy care guidelines recommend A, B, O, and Rh blood types as mandatory, and recommend that Rh-negative people check their anti-D titers as early as possible. If necessary, Rh immunoglobulin injections are needed to prevent Rh haemolytic disease.
Hepatitis B, hepatitis C, AIDS, syphilis
These diseases are all infectious diseases that can be transmitted by mother-to-child transmission, so the importance of testing them during pregnancy does not need me to emphasize it!
Still have to be wordy - one! decide! want! examine! In this way, we can guide doctors to make timely and correct treatment and treatment for mothers and babies before, during pregnancy, before and after childbirth, so that babies can stay away from the disaster of congenital infectious diseases, after all, cute babies are quite innocent.
Thyroid function
This is also a must-check item, because hyperthyroidism may lead to miscarriage, premature birth, and may also lead to hypothyroidism and goiter. Hypothyroidism may impair the neurointelligence of offspring, increasing the risk of preterm birth, miscarriage, low-weight infants, stillbirths, and hypertensive disease during pregnancy.
Therefore, before pregnancy, you must find out whether you have any diseases in this regard, and if you have, you need to actively cooperate with the doctor for standardized treatment.
Conditional can directly check the eight items of nail gong (including thyroid antibodies), so that the guiding value of treatment is higher. If the thyroid gland has a place, it is recommended to go to the relevant department before pregnancy to find out the treatment plan.
Biochemical routines
Biochemical routine mainly reflects the body electrolyte ions, fasting blood glucose, liver and kidney function, blood lipids and other conditions.
If the fasting blood glucose is high, it means that you may be a diabetic patient, once diagnosed, after pregnancy belongs to diabetes and pregnancy, the control of blood glucose needs to start from the early pregnancy; if there is a problem with liver and kidney function, blood lipids, etc., you need to go to the relevant department for treatment, find out the cause, and treat it in time.
Coagulation function
Xiaobian also listed the coagulation function as one of the mandatory items of pregnancy testing, although the possibility of abnormal clotting function in young women is very small, but I still hope that you will also check the coagulation function, anyway, it will draw more than one tube of blood... If you really find a problem, it is better to start treatment as soon as possible.
Adjunctive testing
B-ultrasound
This doesn't have to be long-winded – the first of the essential obstetric and gynaecological tests for pregnancy tests can help us determine whether there are any mass lesions in the uterus and double appendages.
If there is an endometrial polyp, it may affect the implantation of the fertilized egg, so it is best to solve them through surgery before pregnancy; if there is a large ovarian cyst, it may be twisted during pregnancy, causing acute abdomen, so Xiaobian believes that it is also necessary to solve them before pregnancy; if there is a large uterine keratomyoma, it may compress the fallopian tubes to cause infertility, larger inter-myometrial fibroids may cause deformation of the uterine cavity or insufficient blood supply to the uterine lining leading to miscarriage, and submucosal fibroids may affect the implantation of the embryo, Moreover, uterine fibroids may undergo red degeneration during pregnancy, resulting in severe abdominal pain with fever.
If the uterine fibroid removal is done before pregnancy, a scar may be formed on the uterus, and there may be a risk of uterine rupture as the uterus enlarges during pregnancy, so whether the uterine fibroids before pregnancy are follow-up observation or surgical treatment also needs to be analyzed according to the specific situation.
TCT、HPV
This is not only a mandatory item for pregnancy testing, but also one of the mandatory items for women's health!!!
TCT is a means of detecting lesions in the cervix through cervical cytology, while HPV is used to detect HPV infection.
If both are negative, then you can safely prepare for pregnancy; if TCT (ASC-US), HPV negative, not in a hurry to prepare for pregnancy, 6 to 12 months to retest; if HPV positive, it is recommended to do HPV typing test - HPV16, 18 positive recommended direct colposcopic biopsy, HPV low-risk type positive recommended treatment of negative pregnancy (because pediatric laryngeal papilloma is related to HPV6, 11 low-risk subtype infection); if TCT (LSIL, HSIL) positive, Colposcopic biopsy is recommended regardless of HPV outcome.
leukorrhea
If there is severe vaginitis before pregnancy, it may affect the conception and lead to miscarriage, so it must be checked and formal treatment should be adhered to.
electrocardiogram
There are some heart diseases that may not be noticeably uncomfortable in everyday life, but the preconception ELECTROCARD can detect some potential problems. For abnormal ECGs, it is recommended to go to the cardiology department to improve further examination.
TORCH
The clinical symptoms of TORK infection in adults are mild and have no specific clinical manifestations, so the current expert consensus recommends "no objection to screening for TORCH antibodies for women preparing for pregnancy" to determine the natural immunity status of the subject to TORCH and screen out possible potential infections.
If possible, TORCH can be checked before pregnancy, and rubella virus and varicella virus vaccine can be given before pregnancy, but contraception is required for 1 to 3 months after vaccination.
A history of pet exposure before pregnancy, exposure to a person with rubella, and a history of genital, lip, or other skin rashes or herpes in couples or unilaterally are all high risk factors for TORCH infection.
Echocardiography
That is, cardiac ultrasound, generally not as a mandatory item for pregnancy testing, but conditional can be checked, because there are some minor heart malformations or lesions that do not necessarily affect daily life or exercise, but the blood volume increases during pregnancy, and the heart load is aggravated, which may have certain performance during pregnancy.
Chromosomes, genes
Chromosome and genetic tests are generally expensive and are not recommended as a mandatory item. However, if there is a clear genetic disease in the family, and you do not have clear symptoms (may only be a carrier of the disease-causing gene), then it is recommended that you go to professional hospitals and institutions to do tests on chromosomes and genes, so that you can guide eugenics and give birth to a healthy and cute baby.
Male test for pregnancy tests
For now, there are still a few mainland men who can consciously take the pregnancy test or take the initiative to take the pregnancy test, and their words are often "what is easy to check, and what problems can not be found", and in the face of infertility, they all blame the daughter-in-law.
As a doctor, I am very angry when I hear and see these cases. In fact, male pregnancy test is not simply to check the semen on the end, Xiaobian believes that in addition to the semen test, men's hepatitis B, AIDS, syphilis test is also very important, because these sexually transmitted diseases will be transmitted to women through men, and then it is possible to spread to children, causing greater tragedy.
Moreover, if there is a genetic disease in the male family, whether it is an autosomal genetic disease or a sex chromosomal genetic disease, it should be checked before pregnancy, which is of great value for guiding fertility!
Source: Eleventh Consultation Room
Edited by: Yeah Reviewer: Xiao Ran