Patient's question:
Just got pregnant, my mother-in-law asked me to do the eight major tests as soon as possible.Doctor's answer:
Clinical examinations during pregnancy for the pregnant woman and fetus. Due to the growth and development of the fetus, a series of adaptive changes occur in the various systems of the pregnant woman's body. If these changes exceed the physiological range or if the pregnant woman suffers from a certain disease that cannot adapt to the changes of pregnancy, pathological conditions can arise in both the pregnant woman and the fetus. Through prenatal examinations, complications (such as pre-existing diseases in the pregnant woman, such as heart disease) and complications (such as pregnancy-induced hypertension syndrome that occurs during pregnancy) can be detected and prevented early, abnormal fetal positions can be corrected in time, and fetal abnormalities can be discovered, determining the mode of delivery. Prenatal examination time should begin after pregnancy is confirmed, generally once a month before the 28th week of pregnancy, every two weeks between the 28th and 36th weeks, and once a week in the final month. If there are abnormal conditions, the frequency of examinations may be increased as appropriate.First prenatal examination Mainly includes: ① Detailed medical history. This includes age, parity, occupation, menstrual history, menarche age, and menstrual cycle. If the patient is a multipara, her previous delivery history should be understood, including a history of difficult labor, stillbirth, delivery method, date of the last delivery or miscarriage, neonatal condition, and past medical history, such as hypertension or heart disease. The current pregnancy process, including the duration and severity of morning sickness, fever, viral infections, and other discomforts, as well as medication use. The health status of the husband and family history, paying attention to the presence of birth defects and genetic diseases.
② Calculation of estimated due date. Method: Start from the first day of the last menstrual period, subtract 3 months or add 9 months, and add 7 days (280 days, which is 40 weeks, equivalent to 9 months and 7 days). For example, if the last menstrual period was on March 5, the estimated due date would be December 12. The actual delivery date may differ by 1 to 2 weeks from the estimated due date. If the last menstrual period is unclear or irregular, the estimated due date can be estimated comprehensively based on the duration of morning sickness, the start date of fetal movement, the size of the uterus, and ultrasound measurement of the biparietal diameter of the fetus.
③ General examination. Observe development, nutritional status, gait, and height. Check if the heart, lungs, liver, spleen, thyroid, and breasts are normal. Check for any deformities or edema in the spine and limbs.
④ Obstetric examination. Abdominal examination: After urination, pay attention to the shape of the abdomen, measure the height of the fundus of the uterus, perform four-segment palpation to determine the fetal position, and listen to the fetal heart. Pelvic measurement: Divided into external and internal measurements. External measurement provides a rough estimate of the pelvic inlet, while internal measurement can assess the condition of the pelvic cavity.
⑤ Auxiliary examinations. Routine laboratory tests include blood, urine, liver function, etc. Ultrasound can assist in determining fetal position, fetal viability, and the presence of abnormalities. Special examinations: Amniotic fluid examination may be performed for patients with a history of stillbirth, fetal malformations, or genetic diseases.
Follow-up prenatal examination Inquire about any special conditions since the last prenatal examination, such as headaches, lower limb edema, vaginal bleeding, or changes in fetal movement. Measure weight and blood pressure, and perform a urine protein test. Re-examine the fetal position, listen to the fetal heart, and measure the fundal height. Provide guidance on prenatal hygiene.