Examinations during pregnancy are very important as they provide a way to monitor the unborn child in its growth and development. In the following you will find an overview and short explanation of the most important examinations during pregnancy. For further information, you will find a link to the main article on the respective disease under each section.
Initial examination
Regular check-ups during pregnancy are necessary to identify risks of pregnancy at an early stage and to treat them if necessary. During the initial examination, the maternity pass is issued to the pregnant woman. This documents all important examinations and events during pregnancy.
Up to two pregnancies can be entered in one maternity pass. The initial examination includes a detailed discussion between the pregnant woman and the responsible gynecologist. During this conversation, any illnesses of the pregnant woman and her family environment are discussed.
If there are any past pregnancies, the doctor will also ask about them and any complications. Afterwards, the social circumstances of the pregnant woman and her profession are discussed so that the doctor can assess whether these represent a risk for the pregnancy. In many cases, during the initial examination, the pregnant woman is also advised on topics such as nutrition, flu vaccination and HIV testing.
In addition, the date of birth is calculated with the help of the pregnant woman’s information and the ultrasound. A detailed gynaecological examination should also take place as part of the initial examination. An assessment of the internal genitals is carried out using the speculum.
In early stages the doctor may find a bluish discoloration of the vaginal mucosa, which is a sign of pregnancy. In addition, at the end of the speculum adjustment a smear is taken, which is processed in the laboratory. Among other things, the tissue material is examined for early detection of cancer and for infection with chlamydia.
Chlamydia are bacteria and can, if not treated beforehand, be transmitted to the newborn and cause various infections, such as pneumonia. This is followed by a palpation of the uterus, fallopian tubes and ovaries. During this examination, the size, position and consistency of the uterus are assessed.
From the 6th week of pregnancy onwards, the uterus can be palpated enlarged and appears more relaxed compared to a non-pregnant uterus. Next, the cervix is assessed by means of palpation. This is important to determine if the cervix has opened prematurely, which would require a quick intervention.
During the examination, attention is paid to the length of the cervix and its consistency, among other things. You can find detailed information on this topic at Gynaecological examinationDuring the initial examination, certain blood tests are carried out. The results or the performance of the tests are recorded in the mother’s passport.
First, the blood group and the Rhesus factor of the pregnant woman are determined. In the case of rhesus negative women, there may be a need for so-called rhesus prophylaxis, so it is important to determine the rhesus factor. Furthermore, a so-called antibody screening test is performed.
The antibody screening test is repeated between the 24th and 27th week of pregnancy. An antibody is a protein that binds to certain surface characteristics of blood cells, for example. The test is used to determine whether antibodies are present in the blood of pregnant women that could bind to blood cells of the unborn child.
The hemoglobin content of the blood is also determined at each screening appointment. Hemoglobin is the red blood pigment that transports oxygen in the blood. The hemoglobin content can provide information about whether anemia is present.
Low levels should be observed and the gynecologist should consider whether further diagnostic procedures are necessary to determine the cause of anemia. Using the blood sample taken at the initial examination, tests are performed in the laboratory to check for the presence of harmful pathogens. A screening test for the causative agent of syphilis is performed.In addition, it is determined whether there is sufficient immunity to rubella, since an infection during pregnancy carries risks for the unborn child.
If, at the 32nd week of pregnancy, there are doubts as to whether there is sufficient immunity to hepatitis B, a protein in the blood is determined which is located on the surface of the hepatitis B virus. If the test is positive, the newborn baby must be vaccinated against this virus immediately after birth. In addition to these prescribed tests, other tests can be carried out.
The gynaecologist should advise every pregnant woman regarding an HIV test and should also document this in the maternity record. The pregnant woman decides whether the test should be carried out. For pregnant women who have regular contact with cats, it is recommended to perform a test for toxoplasmosis, because the pathogen can be transmitted to humans via cat feces and also raw meat.
All articles in this series: