▼Author of this article▼
I often hear some women complaining: Why do you want a maternity check-up?
There are so many obstetric examinations, and many times of blood, my elderly generation can not understand, saying that the current mother is squeamish, giving birth to a child to do so many obstetric examinations? How simple it is like they were in their time! Seven or eight children don't go out, let alone do obstetric examinations, aren't they all good now?
They now pay so little attention to obstetric examinations, pregnant with a child is just against the will of God to bless, they do not want to think, once the child and the mother have a problem, it will be a hundred percent disaster, adults and children will be affected.
We also encountered some critical situations in our work, such as the vaginal bleeding of pregnant women who did not do obstetrics, I could not judge the cause of the bleeding at the first time, whether it was caused by placenta previa, or caused by placental abruption or other reasons, blindly going to surgery or waiting for examination is very dangerous.
Another example is that pregnant women did not do obstetric examinations, suddenly there were labor signs to the hospital, the mother was in a hurry to give birth, the doctors and nurses were in a hurry to check and improve the blood test, the family was busy with the hospital payment signature, the whole scene was chaotic, and it was bound to cause a dispute when encountering the family members who did not handle things in an orderly manner.
This shows that obstetric examination is very important.
What is a maternity check-up?
Obstetric examination is the basic examination that pregnant women perform during the birth of a woman. From pregnancy to delivery, 9-12 obstetric examinations are generally done, and there are various test requirements according to the time period of pregnancy.
Women of suitable gestational age need to go to the hospital for examination once they have stopped menstruating for 1-2 weeks to determine whether they are pregnant, and women who need to continue pregnancy should supplement folic acid or start supplementation in the first trimester of pregnancy. Special pregnant women should increase the number of obstetric examinations.
Initial obstetric examination
It is carried out 1 to 4 weeks after menopause, mainly to check the physical condition of the pregnant woman and whether it is a normal pregnancy state.
If ultrasound B prompts the fetal heart of the embryo to be seen in the womb, it is given a register (obstetric examination book). Blood draws are required, including blood routine, urine routine, alpha function, liver function, kidney function, infectious disease, blood type, winning ten items, screening for ground poverty, screening of folic acid metabolic capacity, electrocardiogram, systematic physical examination, and detailed family genetic history and whether there is any abnormal pregnancy history.
Check whether you are a high-risk pregnant woman, whether you need to add other tests or whether to consult with the relevant department. If ultrasound B suggests that there is no gestational sac in the cervix or sees a gestational sac without germ tube pulsation, it is recommended to re-examine after 1-2 weeks and establish a register according to the situation, and some of the women have miscarriages without the need to establish a record.
Every four weeks after the initial check-up
11-13 weeks + 6 days of pregnancy is the timing of NT examination, mainly to check the thickness of the transparent layer of the skin of the fetal neck to detect fetal malformations early.
At 16-18 weeks, Down's screening is checked, along with genetic testing for deafness and secondary hematuria routine. A four-dimensional ultrasound examination at 22-26 weeks is done during the period of large-scale fetal system dysplasia, accompanied by a third routine hematuria examination.
Obstetric check-ups are done every two weeks after 28 weeks until 37 weeks
Glucose tolerance tests are done at 28-32 weeks to guide pregnant women's diet, how to control weight, pay attention to fetal growth and development, and conduct a fourth routine hematuria examination and secondary infectious disease screening. Group B streptococcus tests and routine tests for vaginal discharge are required at 35 to 37 weeks.
Once a weekly check-up after 37 weeks until delivery
At this stage, the fifth hematuria routine examination, liver and kidney function electrolysis value, blood type, three infectious disease screenings, electrocardiogram, etc., should be carried out to assess the timing of hospitalization of pregnant women.
The importance of obstetric screening!
Obstetric examination is very important for pregnant women with fertility requirements, its purpose is to check the physical health of pregnant women, but also to detect the growth and development of the fetus, but also to screen the fetus for malformations.
Once NT thickening is found, Down's high risk or pregnant women of advanced age need to undergo amniocentesis or chorionic puncture to exclude the risk of Down's children, if the four-dimensional examination finds that the fetus has a serious deformity of the parenchymal organs, intrauterine can not be corrected, can not survive after birth or has a lifelong fatal disability of the deformity. Induction of labour is required to terminate pregnancy.
Pregnant women in the middle and third trimester of pregnancy increase too quickly, the fetus is too heavy, and it is necessary to guide diet and control weight to avoid difficulties in childbirth caused by too large fetus. The number of times B ultrasound is done during pregnancy is the most, and the first B ultrasound is mainly to find out whether there is intrauterine pregnancy, check whether there is a fetal heartbeat, and exclude ectopic pregnancy.
The middle and late B ultrasound mainly looks at the growth and development of the fetus, whether there is malformation, the shape and position of the placenta, whether there is an umbilical cord around the neck, the amount of amniotic fluid, and the biophysical score of the fetus in the womb.
Every woman has the right to be a mother and should enjoy the right to regulate obstetric examinations, but the situation of people is very different, the rich people will not worry about money, they are willing to check anything, and the compliance with standardized obstetric examinations is relatively high. But the poor are eager to divide a penny into two cents, and their pockets are shy, and the compliance with obstetric examinations is poor.
Doctors should express informed understanding and do a good job of signing and communicating, never let her miss the NT, Down's and four-dimensional examinations, and patiently guide dietary conditioning to monitor fetal movements.
About the author
Yu Yinghua
The Second People's Hospital of Baoshan City
Deputy Chief Physician, Department of Obstetrics
Introduction: Graduated from Kunming Medical College in 1994, majoring in clinical medicine, engaged in clinical work for 27 years. He has studied professional knowledge in and out of the province for many times.
Specialty: Management of obstetric high-risk outpatient clinics and prenatal consultation, rescue of acute and critical diseases, published several medical papers. Have a certain understanding of obstetric difficult and critical care management.