First visit:
It takes place immediately after knowing the occurrence of pregnancy and before completion of 12 weeks of pregnancy, in which:
- Pregnant registration.
- Taking a medical history.
- Conducting a clinical examination.
- Classifying the pregnant woman according to the pregnancy care protocol, by determining the pregnant woman’s eligibility for follow-up in primary care centers or transferring her to hospital follow-up through questions that are answered and risk factors identified.
- The first ultrasound examination (sonar): It is carried out between the “11-14” week of pregnancy to ensure the duration of pregnancy and the absence of congenital and chromosomal abnormalities. The examination can also be done before this date in the event of bleeding to ensure that the pregnancy is inside the uterus and the presence of a pulse for the fetus.
Special medical analyzes and tests in the first visit:
- Blood type and Rh factor test.
- A complete blood test (CBC).
- Examination of urine using rapid test strips (urine dipstick).
- Urine culture test.
- Fasting diabetes test and cumulative sugar test.
- Thyroid test.
- Hepatitis B test.
- Hepatitis C test.
- Tests for sexually transmitted diseases (syphilis).
- Rubella test.
- Testing for acquired immunodeficiency virus (AIDS).
- Antiglobulin test (indirect Coombs test).
- Blood ferritin test.
Blood group and rhesus factor test:
Rhesus factor is a protein found on the surface of red blood cells. If the mother's blood cells contain this protein, they are positive, and if they are not present, they are negative.
The importance of this test: This test is done by taking a sample of the mother’s blood to determine the type of Rh factor present in her blood. No problems occur if there is a compatibility between the mother’s blood and the blood of the fetus, but problems occur when incompatibility occurs, for example when the blood of a fetus carrying a factor enters Rhesus positive into the bloodstream of the mother who carries a negative Rh factor, her body will recognize that the positive blood is not hers, and the mother’s body will respond by forming antibodies to destroy it, as these antibodies can cross the placenta and attack the Rh factor present on the blood cells of the fetus, which leads to the destruction of the blood cells of his blood.
A rhesus incompatibility can also cause jaundice (jaundice) in newborns. An incompatibility usually does not cause problems in the first pregnancy, as the body makes only a small number of antibodies, but it can cause serious problems starting from the second pregnancy. Especially when not taking treatment in the first pregnancy.
Procedures followed if the mother is Rh-negative in the first pregnancy:
Two appointments are set to take the first treatment injections at the 28th week of pregnancy and the second within 72 hours after delivery, as this treatment aims to prevent the mother’s body (rhesus-negative) from making antibodies.
If the mother is negative for the Rh factor, and this was not discovered until the second pregnancy, she is transferred to the hospital to determine whether there are already antibodies in her blood and to deal with them by conducting tests and monitoring throughout the pregnancy, and the child may also need treatment after birth.
Prevention of Rh-incompatibility problems: Prevention is done by finding out if the mother is Rh-negative early in pregnancy and dealing with it before delivery.
Comprehensive blood test:
This test determines the number of different types of cells that make up the blood, and from which various diseases are detected, as the number of red blood cells indicates whether the mother has any types of anemia, and the number of white blood cells indicates the presence of infection in the body, as well as the number of platelets blood clots, whether the mother has a problem with blood clotting.
Urine test (using rapid test strips):
A urine sample is taken and examined using strips of chemicals, which change color when certain substances are present, as it indicates the presence of certain diseases (such as: kidney disorder, urinary tract infection, diabetes, etc.).
Urine culture test:
This test looks for bacteria in the urine, which can be a sign of a urinary tract infection. The most common and most important in pregnancy is Streptococcus bacteria. Sometimes a UTI does not cause symptoms, so urine is tested early in pregnancy and later during pregnancy.
Fasting and cumulative glucose test:
It determines whether the mother had diabetes before pregnancy, as the fasting sugar test indicates the mother’s blood sugar level before eating, and the cumulative sugar test determines the blood sugar level in the three months preceding the test, and a diabetes test is performed at a later time during pregnancy to detect of gestational diabetes at 24 weeks of gestation.
Thyroid test:
Thyroid hormones are necessary for normal development of the fetal brain and nervous system. During the first three months of pregnancy, the baby depends on the thyroid hormone, which is transmitted to him from the mother through the placenta. Therefore, this test is performed to detect an imbalance in thyroid hormones and the absence of symptoms, or to evaluate the condition of the pregnant woman who suffers from a previous defect before pregnancy in the activity of the thyroid gland already.
Hepatitis B infection test:
Hepatitis B virus infection in a pregnant woman poses a serious threat to her infant at birth, as children born to mothers infected with hepatitis B are at risk of chronic liver disease and death for this reason, so all pregnant women are examined at the beginning of pregnancy for early detection.
Testing for hepatitis C infection:
This test determines whether the pregnant woman has hepatitis C infection or not. When the pregnant woman is confirmed to be infected, she is transferred to hospital to receive special care during pregnancy, and her baby will need continuous medical care.
Test to identify a sexually transmitted infection (STI)
Syphilis is a disease transmitted through sexual contact caused by bacteria that affects the genital area, lips or mouth for both sexes, and it can also be transmitted from mother to fetus during pregnancy.
STDs can cause complications (such as: miscarriage, stillbirth, death of the baby shortly after birth, severe anemia, enlargement of the liver and spleen, and jaundice) so all pregnant women are screened for syphilis at the first visit and treated early when infection is confirmed.
Rubella test:
German measles can cause birth defects in the fetus if a woman gets it during pregnancy, as the test can show whether the pregnant woman has German measles or has been vaccinated against this disease. If the pregnant woman is not immune, anyone infected with German measles should be avoided throughout pregnancy.
Human Immunodeficiency Virus (HIV) test:
The human immunodeficiency virus attacks the cells of the immune system in the body and causes acquired immunodeficiency syndrome (AIDS). If the mother is infected with it, there is a possibility that she will transmit it to the fetus. When the infection is confirmed, medications can be taken that can significantly reduce the risk of transmission to the fetus. It is also possible to obtain specialized care; To ensure that the health of the mother and child is maintained throughout pregnancy.
Antiglobulin test (indirect Coombs test):
It is a test conducted to detect the presence of antibodies in the blood against red blood cells, which, when present, lead to destruction of red blood cells and their dissolution. When these antibodies are present, they are transmitted to the fetus and attack the blood cells in his body and cause anemia, so this test is necessary to ensure the safety of the mother and fetus by identifying any need for intervention at an early stage.
Serum ferritin test:
Measuring the level of ferritin in the blood indicates the presence of iron deficiency anemia in the mother, which is one of the most common types of anemia during pregnancy. Iron deficiency anemia in the mother increases the risks of premature birth and the birth of a low-birth-weight baby. Therefore, it is important to detect and treat it at the beginning of pregnancy.
At the end of the examination, the pregnant woman is educated about normal symptoms in this period, good nutrition, and warning signs and symptoms that require emergency care. All her questions are listened to and answered, and a second visit is scheduled at 18 weeks of pregnancy. Folic acid and iron supplements are prescribed when needed.