Definition and Overview

A pregnancy follow-up is an appointment with an obstetrician-gynecologist or pre-natal care specialist to check on the condition of the pregnant woman and her growing fetus. This occurs and is usually prescribed by the doctor after a patient’s pregnancy is confirmed, and is performed on a monthly basis. The procedure involves a physical examination of the pregnant patient and monitoring of the fetus’ growth. These visits play an important role in ensuring that the patient and her baby are safe from risks and complications all throughout the pregnancy.

Who Should Undergo and Expected Results

A pregnancy follow-up is highly recommended for all pregnant women once their pregnancy is confirmed. This is typically initiated between the 6th and 8th weeks of pregnancy, the period during which most pregnancies are detected. Once the first examination is over, these check-ups must begin and should continue until the end of the pregnancy. Typically, the check-ups are scheduled every four weeks until the 28th week of pregnancy. After the 28th week, the pregnant woman must start seeing her doctor every two weeks until the 36th week, and then, once a week until the end of the pregnancy.

However, there are some women who are more at risk of developing complications during their pregnancy and are required to visit the doctor more frequently. These include those who are:

  • Overweight or underweight
  • Very young
  • Over 35 years old
  • Has a history of complicated or high-risk pregnancy
  • Has medical conditions such as high blood pressure, diabetes, autoimmune disorders, HIV, and cancer
  • Are pregnant with twins, triplets, or in rare cases, more babies
    The goal of this procedure is to make sure that both the mother and fetus are healthy. Each visit should confirm the patient’s health, including vital information such as weight and blood pressure level, as well as the fetus’ overall health and continuous growth based on its estimated size, position, and heartbeat.

Some examinations may also be performed during these check-ups, with the goal of identifying any concerns that may affect the pregnancy.

How is the Procedure Performed?

Each pregnancy follow-up visit typically lasts for about fifteen minutes. It usually follows a two-step process wherein the health of the mother and fetus are monitored.

Maternal Examination

The first part of the check-up involves taking the pregnant woman’s weight and blood pressure, which are then compared to data taken during her initial pregnancy visit.

At certain points during the pregnancy, some pre-natal examinations may also be performed. These include:

  • Amniocentesis
  • Biophysical profile
  • Glucose challenge screening
  • Glucose tolerance test
  • Chorionic villus
  • Maternal serum screening
  • Non-stress test
  • Urine test
    Fetal Examination

Once the mother has been checked, a physical examination of her abdomen is performed to monitor the fetus’ growth, based on the following factors:

  • Position - The fetus’ position can be determined using external examination techniques, such as the Leopold’s maneuver. This technique involves feeling the pregnant woman’s abdomen to locate the fetus, starting with its head. The doctor typically starts with the fundus or the top of the uterus and then goes to the opposite side and the pubic area of the pelvis. The fetus’ position inside the mother’s womb is an important factor to consider, as some fetal positions may cause difficulties during the delivery process.

  • Heartbeat - The baby’s heartbeat is detected between 10th and 11th week, and will be regularly checked during every visit thereafter. External and internal monitoring techniques are available. A normal fetal heart rate is between 120 and 160 beats per minute increasing to 170 at the 10th week and decreasing to 130 near the end of the pregnancy. This is a good indication of the fetus’ health, and can also determine if the fetus is in distress.

  • Ultrasound scans - Ultrasound scans are necessary at certain points of the pregnancy. It is typically suggested that a pregnant woman must undergo at least one ultrasonography session. This procedure is done by placing a device on the pregnant woman’s abdomen to produce sound waves that are processed into an image, which then appears on a monitor to be viewed by the doctor and the parents. The pregnant woman is sometimes required to undergo a pelvic ultrasound at the early stages of the pregnancy. Another ultrasound may be requested as the woman nears the end of her pregnancy. However, some doctors also perform monthly ultrasound scan if there is a special reason to do so, while some mothers also specifically request to follow the growth of their fetus with these scans. An ultrasound scan scheduled after the sixth month of pregnancy can typically confirm the fetus’ gender, although some ultrasound technicians use special techniques that can determine the gender through a scan performed as early as the 12th week.

  • Fetal activity level - Special monitoring equipment can be used to determine the baby’s movements and growth. This is another important part of a pre-natal visit as the rise and fall of a fetus’ activity levels are strong indicators of its health.

Possible Risks and Complications

A pregnancy follow-up visit does not pose any risks to the mother and fetus. In fact, it plays an important role in preventing and resolving any risks and complications that may arise during the nine months of pregnancy. These possible risks and complications, which doctors are trained to watch out for, may include:

  • Anemia
  • Urinary tract infections
  • Hypertension
  • Excessive weight gain
  • Infections
  • Severe morning sickness
  • Gestational diabetes mellitus
    If some complications are detected early, they can be safely resolved without posing any further risk to the mother and baby. For example, if the patient’s blood pressure seem to be rising at each visit or is unusually high at a particular visit, the doctor will be able to address the problem early. Likewise, if the patient seems to be gaining too much gestational weight, the doctor may give some nutritional advice to prevent the complications that may arise due to this. Also, if infections are detected, the doctor can prescribe medications that are safe for pregnant women.

Due to the sensitive state of a pregnant patient, all physical examinations that are performed during these check-ups are guaranteed safe and do not cause any difficulty or pain to the patient and her baby.

Reference:

  • The American Congress of Obstetricians and Gynecologists. https://www.acog.org/
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