Prenatal care

• Prenatal care is the care you get while you’re pregnant.
• Regular prenatal care helps keep you and baby healthy.
• A doctor, midwife or other health provider gives this care.

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Throughout your pregnancy, you will receive routine medical tests as part of prenatal care. These tests help your health care provider know how you and your baby are doing.

Your first prenatal visit
During your first prenatal visit, your health care provider will check your blood and urine for the following:

• Conditions that could harm your baby (for example, hepatitis B, syphilis and possibly other sexually transmitted infections). You will be offered a test to see if you carry HIV, the virus that causes AIDS.
• Antibodies that show whether or not you are immune to rubella (German measles) and chickenpox , both of which can cause birth defects if the mother is infected for the first time during pregnancy.
• Anemia (low red blood cell count), which could cause you to feel especially tired and possibly increase your risk of preterm delivery.
• Your blood type, including whether you carry a protein called the Rh factor on your red blood cells. Women who lack the Rh factor are said to be Rh negative and usually need treatment to protect their babies from a potentially dangerous blood problem.
• Bacteria in your urine. Up to 10 percent of pregnant women have bacteria in their urine, which indicates a urinary tract infection. Most have no symptoms, but even a symptomless urinary tract infection may spread upwards to the kidneys, where it can pose a serious risk to mother and baby. Urinary tract infections are treated with antibiotics that are safe for mother and baby.
• Sugar in your urine. This can be a sign of diabetes. Your health care provider may suggest additional tests if sugar shows up in your urine.
• Protein in your urine. This can indicate a urinary tract infection or, later in pregnancy, a pregnancy-related condition that includes high blood pressure. Your health care provider may suggest additional tests if your urine has protein in it.

All of these tests are routine, but they play an important role in protecting the health of you and your baby. Your provider may check your urine at each prenatal visit. The blood test for anemia will be performed at least once more during your pregnancy.

Your health care provider may also offer you a screening test for cystic fibrosis (CF), an inherited disease that can severely affect breathing and digestion. There is no cure for cystic fibrosis. A child who inherits an abnormal gene from each parent will have the disease. The American College of Obstetricians and Gynecologists (ACOG) recommends that a CF screening test be offered to all couples who are planning a pregnancy or are pregnant. Whether or not you take this test is a personal decision. Genetic counseling may help you to make your decision.

At every prenatal visit
At each prenatal visit, your health care provider will check your urine for protein and will measure your blood pressure. Protein in the urine and high blood pressure are symptoms of a pregnancy-related condition that includes high blood pressure called preeclampsia.

Preeclampsia affects about 5-8 percent of pregnant women. Left untreated, it can cause serious problems, including poor fetal growth. In rare instances, it can progress to a life-threatening condition called eclampsia. A patient with eclampsia has seizures and sometimes fall into a coma. Preeclampsia requires close observation and monitoring—another reason why it is important to keep all your prenatal appointments.

Also at every visit, your health care provider will listen to your baby's heartbeat with a hand-held device called a Doppler. After about 20 weeks, he or she also will measure your abdomen to follow your baby's growth. A normal heartbeat and growth rate are important signs that your baby's development is on track.

Ultrasound
Many providers offer an ultrasound examination to all pregnant women. Ultrasound uses sound waves to show a picture of the baby on a screen. The health care provider rubs a hand-held device (called a transducer) across the pregnant woman's belly or inserts a device into her vagina. The woman feels pressure as the provider moves the transducer, but usually no pain.

Special prenatal tests
Some women are offered special tests, such as amniocentesis, because they or their babies are at increased risk of certain problems.

September 2009