Tests To Take Ultra sound should be done since it gives you information about your unborn baby. Dr Evita Fernandez of Fernandez Maternity Hospital, Hyderabad, says, “An expectant mother need not register with a doctor until her sixth week of pregnancy. If the pregnancy is an anticipated one, there’s no need to rush to the doctor, unless the expectant mother complains of excessive nausea, vomiting or she is spotting/bleeding.”
A scan should be done to help date the pregnancy accurately and also to confirm the viability of the pregnancy. Ideally, if the first scan is done between the 11th and 14th week, it would provide more information in terms of ruling out possible anomalies and confirming the possibility of multiple pregnancies. Women who have irregular periods or, who are on fertility drugs should see the doctor at the earliest.
Dr Fernandez adds, “In this country, pre-pregnancy counselling is needed and it would help reduce anxiety, unnecessary loss of pregnancies, reduce the risk of certain abnormalities in babies and also help advise those couples who have a family history of genetic disorders.'
Above everything else, I believe that the couple should undergo HIV testing. This would reduce the risk of the next generation carrying the virus as treatment options are given, should the couple still decide to have a child.”
Women who have a family history of genetic disorders, or face a higher risk of having an abnormal baby because of their age, can be offered chorion villus sampling, between the ninth to 11th weeks. This invasive test should be done by a doctor trained for the purpose. It’s expensive but it helps the couple make decisions about the pregnancy, should there be an abnormality.
Every year, 5,000 to 10,000 children are born with thalassaemia major in this country. It is the most common inherited disease in India. A haemogram (a complete blood picture with indices) done at the first visit, will alert the doctor to the possibility of the woman having the thalassaemia.
A further evaluation and a more expensive test, haemoglobin electrophoresis, would be needed to confirm the results. The husband should also be checked for the same. If both carry the trait, then in every pregnancy there is a 25 per cent chance that the child may have thalassaemia major. This couple can be counselled and early decisions can be made.
Blood grouping is important too. Dr Fernandez says, “If the expectant mother is rhesus negative, we need to check the husband. If he tests positive, we need to keep a close watch on her because the mother can start producing anti-bodies.
Every single patient should be checked for HIV. Strong words, but it’s a must. In fact, it should be made mandatory that the man is checked as well. Since there is a conversion period in HIV, this test should be done twice in the course of one’s pregnancy.”
A urine examination is also a must, especially in the case of newly-married girls, where, due to increased sexual activity, the chances of getting an infection are higher.
Dos And Don’ts In early pregnancy, the chances of spotting and urinary infection are higher, so, no stressful travel and no frequent and vigorous sex.
* “It is proven that the Vitamin A content in tablets and ointments that are used to treat pimples causes congenital abnormalities in babies. Please refrain from using these if you’re planning to conceive,” cautions Dr Savita.
* She adds, “You can party but do not expose yourself to crowded places and to passive smoking. You can dance, but do not strain yourself. Consider the waltz.’’
* According to her, working women can continue to work and to drive cars too. “But two-wheeler driving is a no-no in the first two months of pregnancy.”
* Any stressful situation can lead to a diabetic condition, and since pregnancy is a condition that could make a latent tendency manifest itself, mothers should be cautious.
Dr Alexander warns, “Age is also a risk factor. With women marrying later now, pregnancies after the age of 35 can be problematic. All the problems associated with ageing come in with late pregnancy.
Depending on the family history, lifestyle and stress-related jobs, we check out the lipid profile, BP, diabetic tendency and heart condition. Genetic problems like Down’s Syndrome or Mongolism could also arise when both partners are ageing. But this is under controversy because though the partners may be a pre-disposing factor, sometimes, it also happens in the first pregnancy, in much younger people too,” says Dr Alexander.
Your Diet Foetal requirements are minimal in the first trimester. If everything is normal, eat a healthier diet, which includes more calcium, protein and vitamins. Don’t stress yourself. It’s important to reduce fat, take folic acid, specially in cases, where the expectant mother is found to be deficient in supplements.
Second Trimester