Prenatal care

Prenatal care refers to the medical care recommended for women before and during pregnancy. The aim of good prenatal care is to detect any potential problems early, to prevent them if possible (through recommendations on adequate nutrition, exercise, vitamin intake etc), and to direct the woman to appropriate specialists, hospitals, etc. if necessary. The availability of routine prenatal care has played a part in reducing maternal death rates and miscarriages as well as birth defects, low birth weight, and other preventable infant problems in the developed world.

While availability of prenatal care has considerable personal health and social benefits, socioeconomic problems prevent its universal adoption in many developed as well as developing nations.

Studies in Canada and the United States have shown that communities in rural areas as well as minorities are less likely to have available prenatal care and also have higher infant mortality rates as well as premature involuntary termination of pregnancy.

Prenatal care generally consists of:

• monthly visits during the first two trimesters (from week 1-28)
• biweekly from 28 to week 36 of pregnancy
• weekly after week 36 (delivery at week 38-40)

Contents

1 Prenatal Care Practitioners 2 Physical Examinations 3 Ultrasound 4 References

Prenatal Care Practitioners

In most developed countries, women have a choice between: obstetricians, family practitioners, and midwives. Each of these practitioners provide a different type of care. Obstetricians are surgeons specializing in pregnancy and childbirth. Family practitioners are general practice doctors whose training includes obstetrics. Midwifery has its basis in tradition, however, many modern midwives have medical training. Generally, midwives are used by women who prefer a less interventive or less expensive approach to childbirth. Most experts recommend careful research when choosing a practitioner. There are many factors to consider including: what practitioners are available, skills, services and preferences.

Physical Examinations

Physical Examinations generally consist of:

1. collection of (mother's) medical history
2. checking (mother's) blood pressure
3. (mother's) height and weight
4. pelvic exam
5. (mother's) blood and urine tests
6. discussion with caregiver

Ultrasound

Obstetric ultrasounds may be performed during the second trimester at week 20. The ultrasound determines, among the other things, the gender of the baby, number of fetuses, due date, health of the baby, and expected weight. Ultrasounds are considered relatively safe and have been used for over 35 years for monitoring pregnancy.

Ultrasounds are used to:

1. Diagnose pregnancy (uncommon)
2. Assess a likely miscarriage, blighted ovum, ectopic pregnancy, and molar pregnancy conditions. Each can be a threat to the mother if left untreated.
3. Determine if an intrauterine growth retardation condition exists
4. Determine due date
5. Check for fetal malformation
6. Check for multiple fetuses
7. Determine sex of infant

Generally an Ultrasound is ordered whenever an abnormality is suspected or along the schedule of:

1. 7 weeks - confirm pregnancy, ensure its neither molar or ectopic, determine due date.
2. 13-14 weeks (some areas) - evaluate Down Syndrome
3. 18-20 weeks - determine number of babies, diagnose any malformations, monitor growth, verify due date.
4. 34 weeks (some areas) - evaluate size, verify placental position

References

• Prenatal care (http://www.makewayforbaby.com/prenatalcare.htm)
• Pub Med abstract of paper showing importance of prenatal care (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12521796&dopt=Abstract)
• Pub Med abstract of paper showing risk of HSV (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12517830&dopt=Abstract)
• Prenatal Screening Curbs Infant Deaths (http://my.webmd.com/content/article/24/1840_50908.htm)
• Prenatal ultrasound (http://my.webmd.com/content/article/51/40825.htm)
• Obstetric Ultrasound (http://www.ob-ultrasound.net/)
• CDC US prenatal care statistics (http://www.cdc.gov/nchs/fastats/prenatal.htm)
• Prenatal care (http://www.4woman.gov/faq/prenatal.htm)