Pregnancy Care

Pregnancy Care includes

  • Routine Tests During Pregnancy
  • Normal Pregnancy
  • Diet & Eating During Pregnancy,
  • Exercise During Pregnancy.

Routine Tests During Pregnancy

A range of tests is recommended to make your pregnancy safe, check and assess the development and well-being of you and your baby, and screen for particular conditions.


Other Tests are done only at certain times during pregnancy or if you have certain indications or problems. Blood tests and urine tests are two routine tests conducted during pregnancy.


Screening tests help determine a pregnant woman's risk of having a baby with certain birth defects. These are done during the first and second trimesters of pregnancy.

First Trimester Tests (1 - 12 Weeks)

8-10 Weeks

  • Ultrasound on all our patients to help establish your baby's due date and check on the pregnancy's health.
  • Blood tests are done to know your blood type (A, B, AB, or O; Rh positive or Rh negative),
  • Immunity to German measles (rubella), haemoglobin levels, Iron and Vit D levels, Thyroid function and fasting sugar levels
  • Infectious disease conditions such as hepatitis B, syphilis, HIV and Syphilis

11-14 Weeks

  • Blood tests to measure papp-A and B Hcg (these are placental hormones ) and a Nuchal translucency scan can give the woman a risk ratio of having a baby with Trisomy 21, 18 and 13.
  • Recently there have been some advances in screening, and a new test is being used and available in Brisbane. It is called NIPT ( non-invasive prenatal testing ). It involves a simple blood test from you to determine the percentage of fetal cells circulating in your blood. They can then check these fetal cells for genetic abnormalities like trisomy 21, 18 and 13. They can also check the sex of your baby.

Second Trimester Tests (13 - 28 Weeks)

A morphology ultrasound scan is routinely done between 18 to 21 weeks. The baby would have formed all its organs by now, and a detailed ultrasound scan would study all organ structures.


The tests of the first and second-trimester screenings can be combined to confirm birth defects such as Down syndrome in a relatively larger number (90-95%) of the cases. Diagnostic tests for further information usually follow positive screening tests.

Genetic Tests

You will be asked to give Genetic Testing. Genetic testing is performed to identify changes or abnormalities in humans' genetic makeup (DNA, chromosomes, genes and proteins).


The tests can be performed at any stage of life but are recommended in certain cases before conception, during pregnancy or after birth.


Genetic Tests can help detect

  • Check for genetic abnormalities in the unborn (embryo or fetus) or newborn.
  • Chronic villus (ability to absorb nutrients from mother) Test for genetic conditions in adults before symptoms surface
  • Check for inheritance or transmission of a certain condition to your family members (carrier testing).


Prenatal genetic studies may be performed during pregnancy to check the offspring's genetic makeup. In cases of uterine abnormality, you may be recommended for surgery.


Samples for testing can be taken from blood, cheek swabs, and amniotic fluid (protective liquid in which the unborn child develops).

Genetic testing provides vital information for diagnosing, treating and preventing various diseases.

Types Of Genetic Tests

  • Molecular genetic testing is used to study short lengths of DNA to identify mutations. Chromosomal genetic testing to study changes in chromosomes like duplication or reduction in number; and
  • Biochemical, genetic testing is used to study the amount of protein activity. Although genetic testing may give you an insight into the diseases you may develop, it is not always that you will develop a certain condition if your genetic test is positive.

Prenatal Screening And Diagnosis

Prenatal screening tests are safe procedures to determine if an expectant mother is likely to have a baby with a particular birth defect. Prenatal tests can include

Cystic Fibrosis.

Cystic Fibrosis (CF) is a genetically inherited disorder affecting children and young adults. This disorder leads to problems with digestion and respiration and can shorten an individual's lifespan. Symptoms of CF include the build-up of thick mucus in the lungs, causing congestion and associated respiratory problems. Mucus build-up is also seen in the digestive tract leading to difficulty absorbing nutrients.

Chorionic Villus Sampling

Chorionic villus sampling (CVS): Prenatal test done in weeks 10 and 12 of pregnancy in which a sample of chorionic villus - wispy projections in the placenta (a structure that develops in the uterus during pregnancy to provide oxygen and nutrients to the growing baby) is removed and tested to confirm or rule out CF in the baby.

Amniocentesis

Is a Prenatal procedure in which a sample of amniotic fluid (the fluid that surrounds and protects a baby in the uterus) is removed and tested to check if the baby has CF.

Common Risks Associated With Prenatal Testing

Certain risks are common to both prenatal tests. They include

  • Miscarriage,
  • Rh sensitisation (occurs in women with Rh-negative blood), and
  • Uterine infection.


Amniocentesis carries additional risks, although rare, such as needle injury, which may occur if the baby moves in the path of the needle used during the procedure.


Also, the baby might develop orthopaedic problems if there is chronic leakage of the amniotic fluid after the procedure.

Fetal Monitoring

Fetal monitoring is the procedure used to assess the rate and rhythm of the fetal heart and determine the fetus’s health. It is generally recommended during late pregnancy and labour.


CTG is useful for detecting fetal distress during pregnancy and or during labour. Fetal distress can occur for many reasons:

  • during pregnancy, if there is evidence of growth restriction, if there is a history of trauma ( fall or car accident), or if placental abruption occurred.
  • during labour, fetal distress can occur if there is a cord around the neck, or if there is compression of the cord against the uterine wall, silent placental abruption, or in cases of long labour and poor placenta oxygenation.


The average heart rate of the fetus lies between 110 and 160 beats per minute, which can vary up to 5-25 beats per minute. The heart rate may vary as the fetus responds to uterine conditions, but an abnormal pattern may indicate problems such as the lack of oxygen supplied to the fetus.

Methods

Two methods can monitor the fetal heart and uterine activity (CTG ):


External monitoring: placing a device on the mother’s abdomen so the fetal heartbeat can be heard and recorded. External monitoring can be done to

  • Track the baby's heart rate during rest and movement
  • Measure the frequency and duration of contractions during labour and delivery
  • Detect premature labour
  • Monitor the baby's health if certain problems are suspected
  • Monitor the placenta (membrane lining the womb and enveloping the fetus) and ensure that the baby gets enough oxygen
  • Monitor for delayed fetal growth if you have hypertension, diabetes, or you have been pregnant for more than 41 weeks


Internal monitoring: placing an electronic device on the fetus's scalp monitors the fetal heart rate.

  • Once the doctor determines the head of the fetus with a gloved hand, a plastic electrode will be inserted into your vagina, which will guide a spiral wire, which will be placed on the fetal scalp.
  • The electrode wires will be held around your thigh with a band and connected to the monitor.
  • The electrode will be removed after the birth of the baby.

Normal Pregnancy

Normal or Low-Risk Pregnancy is exciting for women, but complications may sometimes develop even in healthy women.


Many health issues can create a risk to you and your baby. A pregnancy that has no maternal or foetal complications is considered to be a low-risk pregnancy.


Most pregnancy complications can easily be detected and prevented with routine prenatal care.

Management Of Low-Risk Pregnancy

Your doctor will assess your pregnancy progress and determine whether you fit into the category of a low-risk pregnancy. Low-risk pregnancy is a pregnancy that is not complicated by:

  • preeclampsia,
  • diabetes,
  • expecting twins or other complications during your pregnancy


Women with low-risk pregnancies have wider options and a better chance of achieving a natural birth. You can undergo labour and delivery during a natural birth without pain relievers or epidural anaesthesia. There will be minimal medical interventions such as foetal monitoring and intravenous therapy.

Natural childbirth is very safe if you follow Your doctor’s recommendations correctly.

Steps To Promote A Healthy Pregnancy

The following are some steps that can prevent risks during pregnancy:

  • Preconception appointments: It is good to consult Your doctor before planning to get pregnant. You can discuss your medical condition and understand your overall health and chances of pregnancy in detail during your consultation.
  • Regular prenatal care: A regular prenatal visit can help Your doctor monitor your and your baby’s health.
  • Healthy diet: You will be advised to follow a healthy diet and take essential nutrients like folic acid, calcium and iron.
  • Avoid risky substances: You are advised to quit smoking, alcohol and illegal drugs to prevent complications during pregnancy.
  • Weight gain: A weight gain of approximately 8 to 12 Kg is recommended if you have had a healthy weight before pregnancy.


Reference www.foodauthority.nsw.gov.au/consumers/life-events-and-food/pregnancy

Diet & Eating in Pregnancy

Nutrition During Pregnancy

Now that you are pregnant, it is important to maintain a healthy, well-balanced diet with various food so that you and your baby get all the important nutrients required for normal growth, development and healing.


A diet consisting of the right balance of carbohydrates, proteins, fats, minerals, vitamins, and water constitutes a healthy diet. A variety of food in recommended proportions is suggested for optimal health for you and your baby.


Some important nutrients to be included in your diet are:

  • Folic acid: Folic acid prevents neural tube defects in the early stages of a developing fetus. Getting the recommended amount of folic acid alone from food may be difficult; hence, it is necessary to include folic acid supplements before and during pregnancy.
  • Calcium and Vitamin D: A growing baby demands calcium and vitamin D as bones and teeth develop. You can take in calcium through food or as supplements during pregnancy. Foods with high sources of calcium, such as milk, milk products and broccoli, should be included in your regular diet. Vitamin D can be obtained from milk fortified with vitamin D and from exposure to sunlight.
  • Iron: During pregnancy, your body produces more blood to carry oxygen to the growing fetus; hence, the amount of iron required for this oxygen transfer needs to be increased. You should include iron-rich food such as fish, poultry, lean red meat, prunes and dried beans. Vitamin C-rich foods, such as tomatoes and citrus fruits, help faster iron absorption in the body.
  • Fish: Fish is a rich source of omega-3 fatty acids and an important nutrient for developing your baby’s brain before and after birth. Fatty fish like salmon is a good source of Vitamin D, and sardines are rich in calcium. However, fish with high mercury concentrations, such as shark and swordfish, should be limited or avoided during pregnancy, as mercury is responsible for causing birth defects and damaging the baby’s nervous system.


Consumption of alcohol and caffeine should be avoided during pregnancy.

Food To Avoid During Pregnancy

Other foods to be avoided include:

  • Unpasteurised milk, cheese and juices
  • Raw eggs and foods that have raw eggs, such as Caesar salad
  • Uncooked seafood and meat
  • Processed meat products

Being A Vegetarian During Pregnancy

Doctors generally do not suggest a vegetarian diet while pregnant, but you can continue with the same foods if you are a vegan or vegetarian.


Your doctor may suggest protein, vitamin B12 and vitamin D supplements if you do not consume meat, eggs, milk products and seafood.

Exercise During Pregnancy

Exercise during pregnancy is generally considered safe and beneficial for both the mother and the developing baby. However, it is essential to consult with your obstetrician before starting or continuing any exercise routine during pregnancy. They can provide personalized advice based on your specific circumstances and any potential risk factors.


Here are some general guidelines and considerations for exercising during pregnancy:

  • Walking, swimming, stationary cycling, prenatal yoga, and low-impact aerobics are usually safe options for most pregnant women.
  • Pay attention to how you feel during exercise. If you experience any pain, dizziness, shortness of breath, or other discomforts, stop exercising and consult your healthcare provider.
  • You may need to modify your exercise routine accordingly. For example, you might need to reduce the intensity, duration, or impact of your workouts. Focus on maintaining fitness and well-being rather than pushing yourself to new limits.
  • Drink plenty of water before, during, and after exercise to prevent dehydration.
  • Wear loose-fitting, breathable clothing and supportive footwear to stay comfortable during your workouts.
  • Pay attention to signs of overheating, such as dizziness, nausea, or excessive sweating.
  • Consult with a certified prenatal fitness instructor or physical therapist for appropriate exercises.
  • Avoid activities that involve lying flat on your back after the first trimester, as it can compress a major vein and reduce blood flow to the uterus.
  • Start each workout with a gentle warm-up to prepare your body for exercise, and finish with a cool-down and stretching routine to help prevent muscle soreness.
▲TOP