Reasonable number of prenatal checkups and gestational age during pregnancy can not only ensure the quality of pregnancy care, but also save medical and health resources.
According to the current status of pregnancy health care in my country and the needs of prenatal examination items, the gestational weeks recommended by the "Preconception and Pregnancy Health Care Guide" for prenatal examination are: 6 to 13 weeks of pregnancy + 6, 14 to 19 weeks + 6, and 20 to 24 weeks weeks, 25~28 weeks, 29~32 weeks, 33~36 weeks, 37~41 weeks.
***7~11 times.
For those with high-risk factors, the frequency may be increased as appropriate.
Today I will introduce the contents of the first prenatal check-up. The first prenatal check-up (6~13 weeks of pregnancy +6) 1. Health education and guidance: (1) Awareness and prevention of miscarriage.
(2) Nutrition and lifestyle guidance (health, sexual life, exercise, travel, work).
Based on pre-pregnancy BMI, recommendations for weight gain during pregnancy are proposed, see Table 1.
(3) Continue to supplement folic acid at 0.4~0.8 mg/d until 3 months of pregnancy. Those with conditions can continue to take multivitamins containing folic acid.
(4) Avoid contact with toxic and harmful substances (such as radiation, high temperature, lead, mercury, benzene, arsenic, pesticides, etc.) and avoid close contact with pets.
(5) Use drugs with caution and avoid drugs that may affect the normal development of the fetus.
(6) Change bad living habits (such as smoking, alcoholism, drug abuse, etc.) and lifestyle; avoid high-intensity work, high-noise environment and domestic violence.
(7) Maintain mental health, relieve mental stress, and prevent psychological problems during pregnancy and postpartum.
2. Routine health care: (1) Establish a pregnancy health care manual.
(2) Carefully inquire about the menstrual status, determine the gestational age, and estimate the expected date of delivery.
(3) Assess high-risk factors during pregnancy.
Maternity and childbirth history (especially adverse pregnancy and childbirth history such as miscarriage, premature birth, stillbirth, stillbirth), reproductive tract surgery history, whether there are fetal malformations or mental retardation in young children, pre-pregnancy preparations, family history and genetic history of the pregnant woman and her spouse.
Pay attention to whether there are pregnancy complications, such as: chronic hypertension, heart disease, diabetes, liver and kidney disease, systemic lupus erythematosus, blood diseases, neurological and mental diseases, etc. Please seek consultation from relevant disciplines in a timely manner. Those who are not suitable for continuing the pregnancy should be informed and informed in time
Terminate pregnancy; for high-risk pregnancies that continue, evaluate whether to be referred.
Whether there is vaginal bleeding during this pregnancy and whether there are any possible teratogenic factors.
(4) Comprehensive physical examination, including cardiopulmonary auscultation, measurement of blood pressure, body weight, and calculation of BMI; routine gynecological examination (if not examined 3 months before pregnancy); fetal heart rate measurement (Doppler auscultation, about 12 weeks of pregnancy).
3. Required items: (1) Blood routine; (2) Urine routine; (3) Blood type (ABO and Rh blood type); (4) Liver function; (5) Kidney function; (6) Fasting blood glucose level; (7)
) HBsAg screening; (8) Syphilis serum antibody screening; (9) HIV screening; (10) Thalassemia screening (Guangdong, Guangxi, Hainan, Hunan, Hubei, Sichuan, Chongqing and other regions).
(11) Ultrasound examination.
Ultrasound examination is performed in the first trimester (6 to 8 weeks of pregnancy) to determine whether there is intrauterine pregnancy and gestational age, whether the fetus is viable, the number of fetuses, and the condition of uterine appendages.
4. Items to be checked: (1) Hepatitis C (HCV) screening.
(2) Anti-D titer test (for those with negative Rh blood type).
(3) 75 gOGTT (high-risk pregnant women).
(4) Thyroid function test.
(5) Serum ferritin (hemoglobin <110 g/L).
(6) Tuberculin (PPD) test (high-risk pregnant women).
(7) Cervical cytology examination (those who did not undergo examination 12 months before pregnancy).
(8) Test cervical secretions for Neisseria gonorrhoeae and Chlamydia trachomatis (high-risk pregnant women or those with symptoms).
(9) Detection of bacterial vaginosis (BV) (for those with symptoms or history of premature birth).
(10) Early pregnancy (gestation 10~13 weeks + 6) maternal serology screening [pregnancy-associated plasma protein A (PAPP-A) and free β-hCG] for fetal chromosomal aneuploidy abnormalities.
Notes: Fasting; Ultrasound examination to determine gestational age; Determine body weight on the day of blood draw.
(11) Ultrasound examination: 11 to 13 weeks of pregnancy + 6. Measure the thickness of the fetal nuchal translucency (NT); verify the gestational age; in twin pregnancy, the nature of the chorionic villi also needs to be determined.
The measurement of NT was performed in accordance with the British Foundation for Fetal Medicine standards (sonographers need to undergo strict training and undergo quality control).