There are many pregnancy appointments you need to lock in your diary. We take a look at the hospital appointments and what happens during it.
Congratulations, you fertile fox! Assuming you’ve already peed on a stick (the first test of many) to see a positive reading, your next step is to make an appointment with your family GP to confirm your pregnancy. Book a long appointment because your βhCG levels will be checked to indicate you are indeed expecting and this will be done via blood test (also some doctors will also insist on another urine sample while you’re there).
Fact: a test of βhCG levels in your blood can be accurate within one week or so after conception).
At this appointment, you will also be offered a full blood examination which will not only confirm your blood type, check your rubella and chicken pox immunity and also scan for various infections such as anaemia, HIV, hepatitis B or STIs such as syphilis. If you have any other health concerns, it’s a good idea to speak openly with your doctor so they know what to else they should be screening for.
9 – 10 weeks
Concerns about potential chromosomal problems can mar the first few weeks of pregnancy, and if it’s something that’s keeping you awake at night, it could be worth opting for a Non-Invasive Prenatal Test (NIPT). This relatively new screening test can scan for chromosomal abnormalities such as Down Syndrome, and all it takes is a simple blood test which is then send off-shore for analysis (although more and more Australian labs are now doing analysis so it’s becoming cheaper).
Although it’s said to far more accurate than the 12-week combined blood test and scan, it’s worth noting that NIPTs can’t detect major malformations such as spina bifida so you should still consider it essential to have an ultrasound at 12 weeks to make sure your baby is healthy.
NIPT has become readily available across Australia over the last couple of years, it does come at a high price, costing anywhere between $500 and $1400. An optional test, it is not covered by Medicare or private health insurance.
Whether you have it at 11 weeks or at 13 weeks, your end-of-first-trimester scan is referred to industry-wide as the 12-week scan and it’s a biggie. Where you have the ultrasound depends largely on whether you’re having your baby in the public or private system (public patients tend to have their scans at the hospital, while private will make an appointment at a private ultrasound clinic), but the methods are the same. Among the number of things your sonographer will check at the scan is the number of babies you’re having, the age and due date of your baby and they’ll also provide you with a snapshot of baby’s health at this point in time.
At this appointment, a blood test will also be carried out, as the findings of this test, combined with the information from the ultrasound can carry a wealth of information about your baby’s genetic makeup. Referred to as a Nuchal Translucency Test or Nuchal Translucency Scan, an ultrasound will focus on the aforementioned nuchal translucency which is the thickness of the fold at the back of the baby’s neck. Combined with your maternal age, weight, gestation and blood test results, this test will determine the probabilities of an abnormality.
12 – 15 weeks
If your Nuchal Translucency Scan shows baby to be at increased risk of a chromosomal abnormality, you will be offered a diagnostic test, either an amniocentesis or a Chorionic Villus Sampling (CVS) although whether you choose to go ahead and test further is completely up to you.
With an amniocentesis, a doctor will insert a fine needle in through your abdomen to withdraw a small sample of amniotic fluid surrounding the baby. This sample contains some of the baby’s cells and will able to accurately determine whether your baby has a genetic abnormality or not. Amniocentesis has a one in 200 risk of miscarriage with the rate increasing the further along in your pregnancy you are. It is often performed around the 15-week mark.
Chorionic Villus Sampling (CVS)
Usually performed earlier than an amniocentesis, a CVS will often be performed not long after the Nuchal Translucency Scan and it can be done one of two ways. Your doctor can either go in through your abdomen with a fine needle to take a small sample from the placenta, or your doctor can go in vaginally through the cervix and this often comes down to the position of your uterus, where the baby is lying and your doctor’s preference. The procedure has a miscarriage risk rate of one in one hundred.
15 – 18 weeks
As you zoom along towards the halfway mark, you will be offered Maternal Serum Screening, which is a blood test which determines the risk of your baby having a genetic abnormality such as Down syndrome, Edwards syndrome or Trisomy 18, or a neural tube defect such as spina bifida and anencephaly. The results are then combined with the results of your nuchal translucency scan to assess your risk.
Maternal Serum Screening is now offered within the first trimester as well as the second (in place of first trimester’s NIPT) and both have their pros and cons. NIPT is a more accurate screening test than maternal serum screening however it is also far more expensive option since maternal serum screening is not only more affordable but partially covered by Medicare.
18 – 20 weeks
Now that you’re growing nicely, it’s time to drop in on baby and see what he or she is up to at your 20-week scan (which can happen any time from the 18-week mark). At this scan, which will take place at the same clinic you had your 12-week scan, the sonographer will check baby’s development, monitor the size and location of the placenta and look for anything that could indicate a possible problem such as heart defect or limb defect. If a genetic abnormality was somehow missed at the 12-week scan and no further testing was undertaken, a genetic abnormality can also be picked up at this scan also.
Keen to learn the sex of your baby? By this stage, your sonographer will be able to see baby’s genitalia clearly so let them know beforehand if you’d like them to spill the beans or not.
24 – 28 weeks
Gestational diabetes can develop during the second trimester and if it isn’t managed carefully, it can cause a multitude of serious issues for both you and bub. For this reason, you will be asked to take a gestational diabetes blood test between 24 and 28 weeks (although if you’re at high risk of getting the condition or you’ve had it before in a previous pregnancy, you may be asked to have the test earlier). Having fasted overnight, your blood will be tested first thing in the morning, after which you will be given a glucose-filled sugary drink and then seated to wait. You will then have your blood tested twice more – once after a full hour is up, and again one hour after that. If your blood sugar levels read high, you will be diagnosed with gestational diabetes and put on a strict care management plan.
If you’ve enjoyed a relatively healthy pregnancy free of concerns, you’re unlikely to have any further testing, however some mums may be offered one last ultrasound within the last trimester to check baby’s growth and development, fluid levels around the baby, and the positioning of the placenta.
*If you’re having multiple babies, suffer a medical condition, or you’ve experienced issues in previous pregnancies, you may be subject to additional scans and testing which is not outlined here.
Culled from http://honey.nine.com.au/