Your week-to-week pregnancy guide

Your urine test shows you are pregnant. As excitement sets in, you will also start having lots of questions about pregnancy care. Let’s see what your doctor has in store for you at your scheduled antenatal visits besides routine measurement of blood pressure, weight and urine test for glucose and protein at every visit.

First 10-11 weeks
Your first antenatal visit
Preferably in the first 10-11 weeks to date your pregnancy and determine the type of twin pregnancy if you are carrying more than one. This will probably be your longest visit with your obstetrician, who would want to find out everything about your past medical history.

Routine tests are usually performed for blood group, Rhesus factor, screen for Thalassaemia and anemia, infection screen for syphilis, HIV, hepatitis B, Rubella immunity, as well as urine analysis for bacteria and white cells. In other circumstances, additional tests such as genetic screens and glucose tolerance test may be offered.

You will be able to see your baby’s heartbeat on the ultrasound scan as early as 6 weeks gestation. The doctor will measure the length of your baby (crown rump length) to have an accurate determination of your estimated date of delivery.

When can I sign up for maternity packages?
Maternity packages can commence from 12, 16 or 20 weeks onwards. The packages should cover all your scheduled consultations till your last appointment before your delivery.

Different clinics offer different types of maternity packages. Consult the clinic staff or doctor to find out more on which package suits you better.

When should I start to book my bed/ward for delivery?
Hospital beds cannot be reserved. However, depending on the hospital that you will be delivering at, your doctor will fax the maternity booking form to the delivery suite and a pre-admission form to the hospital administration to facilitate your registration upon admission. Beds cannot be reserved till your delivery, as delivery time and date cannot be specified. If you are undergoing an elective caesarean section, the hospital bed will be reserved for you on day of admission. However, your bed choice depends on hospital availability on admission.

11-13+6 weeks
First trimester screen (FTS) for Down syndrome
Through a combination of fetal neck fold thickness measurement by ultrasound and blood test, you can screen your baby’s risk of having Trisomy 21(Down syndrome), Trisomy 13 (Patau syndrome) and Trisomy 18 (Edward syndrome) with a 95% detection rate. Discuss options with your obstetrician and implications of a high –risk result.

15-20 weeks
Maternal serum screening (MSS) and fetal anomaly scan
If you had missed the FTS window, MSS is an alternative and gives you about 65% detection rate for Down syndrome.

A fetal anomaly scan is essential to screen your baby for major structural defects or subtle signs suggestive of possible increased risk of chromosomal disorders.

You may be able to find out the gender of your baby and start shopping for your newborn’s clothing.

21-28 weeks
Glucose tolerance test (OGTT) and growth assessment
OGTT at 28 weeks will exclude gestational diabetes if you had risk factors identified during your first antenatal checkup. Fetal growth is assessed by a growth scan at 28 weeks.

29 – 34 weeks
Besides routine checks, no other specialized test will be necessary

35 weeks
GBS screening
Group B strep (GBS) is a kind of bacteria that may inhabit your vagina, and it can be passed on to your baby during labor and birth. While GBS is generally harmless in healthy adults, it may cause stillbirth and serious infections in babies. A simple vaginal swab will detect this bacteria and precautions taken during labor.

36 – 40 weeks
Fetal position and birth plans
Your doctor will check on baby’s position by palpating your abdomen. It will be most appropriate to discuss with your obstetrician about your birth plans and concerns. You will see your doctor on a weekly basis till your delivery. Consider induction of labor if you go past 41 weeks.

Publication of this article by courtesy of Dr Ben Choey, Obstetrics and Gynaecology Specialist from SBCC Women’s Clinic located at Clementi Central.