Personalized pregnancy control Monitoring the pregnancy at Procrear

The pregnancy control protocol at Procrear is specific to each pregnancy.

Monitoring the pregnancy at Procrear

The rhythm and the number of visits to the gynecologist depend on the initial evaluation of the obstetric risk. For women with high obstetric risks (multiple pregnancies, etc.), the frequency of visits will be higher (every 2-3 weeks).

In general, the visits will be based on a monthly basis until the last trimester, when it will be every two weeks. From week 36-37 onwards, we have to make a weekly control. We recommend making the first visit between the sixth and the eight week.

The purpose of this early control is to:

  • Confirm by means of an ultrasound the pregnancy.
  • Evaluate the number of embryos (early diagnosis of multiple pregnancy).
  • Remove any pathology (abortion, ectopic pregnancy, etc.).
  • Control the risk of abortion and the embryo vitality.
  • Pregnancy and DIU.
  • Calculate the probable delivery date and, if required, correct this date by ultrasound.
  • Blood analysis request for the first trimester.
  • Evaluation of additional treatment requirements.
  • Useful and general information about the pregnancy.
  • Information about the prenatal diagnosis techniques.

During each successive visit, we perform the following tests:

  •     Check the weight and the arterial tension.
  •     Evaluate the general state of the pregnant woman.
  •     Blood analysis (one per trimester).
  •     Routine ultrasound check-up.
  •     Evaluate the additional treatment requirements (iron, calcium, poly-vitamins, iodine, etc.).
  •     Information about pregnancy courses (Pregnant woman’s booklet).

During the last weeks, we include a fetal wellbeing check-up by Doppler ultrasound in color and fetal monitoring (cardiotocographic or “strap” record). Similarly, we perform a complete cardiologic test, controls with midwives, and a visit to the Anesthesiology Department.

Additional tests during the pregnancy

Blood analysis

  • Analysis of the first trimester: blood and urine analyses, coagulation, blood group and Rh factor, infectious diseases (aids, hepatitis B and C, toxoplasmosis, syphilis, Chicken pox Zoostera), gestational diabetes screening.
  • Blood analyses of the second and third trimester: urine and blood analyses, coagulation, infections disease control if required, indirect Coombs in Rh negative pregnant women and gestational diabetes screening.
  • Biochemical and chromosome screening (Down Syndrome) during the first and second trimester.

Vaginal and rectal culture

To detect the presence of the group B SGB streptococcus. In case of a positive result, antibiotics will be given to the mother during delivery.

Ultrasounds

  • Routine obstetric ultrasound (during each visit):
    it consists of ultrasounds of Level I (SESEGO), used to check the growth of the fetus (biometrics), its position, and the characteristics of the amniotic liquid and placenta.
  • Chromosome screening ultrasound during the 1st trimester:
    the main purpose is to screen chromosome ultrasound markers. We evaluate the nuchal ridge and the nasal bone of the fetus. If the nuchal ridge is increased, we recommend performing an amniocentesis for the genetic study of the fetus. (Refer to Pre-natal Diagnostic Unit).
  • Genetic amniocentesis:
    we practice it between 15th and 18th weeks (Refer to Pre-natal Diagnostic Unit)
  • High Definition Ultrasound (20 weeks or Morphologic):
    it is carried out in our Prenatal Diagnostic unit by a specialist (Level IV SESEGO). We study the anatomy (diagnostic of malformations), the growth and the sex of the baby, and the amniotic liquid and placenta characteristics. (Refer to Pre-natal Diagnostic Unit)
  • 4D Obstetric Ultrasound:
    with the help of this technique, we obtain images of the moving fetus (in real time) and in three dimensions. We perform it between the 26th and the 32nd week. It will not be used in the diagnosis, to help or monitor the pregnancy (except if specifically indicated by the gynecologist). In our Prenatal Diagnostic Unit, we perform a 4D Ultrasound and provide a DVD where we record it with color photos and an ultrasound report (Refer to Pre-natal Diagnostic Unit)
  • Doppler Ultrasound in color:
    we check the wellbeing of the fetus by evaluating the blood flow of the placenta towards the fetus (Refer to Pre-natal Diagnostic Unit)
  • Fetal echocardiogram (analysis of the heart of the fetus):
    congenital alterations of the heart are the most current fetal malformations. Most of them appear in pregnant women without any risk factor. At Procrear, our Prenatal Diagnostic and neonatal Cardiology specialists and pediatricians use all their experience to diagnose these alterations.

Cardiotocographic recording (“straps”)

The purpose of this test is to evaluate the wellbeing of the fetus by recording the beating of its heart and uterus contractions. The midwife does this, from the 36th week of the pregnancy onwards.

Last Update: 06/09/2014
References:
– F. GARY CUNNINGHAM. Obstetricia de Williams (23ª ED). MCGRAW-HILL, 2011
– Sociedad Española de Obstetricia y Ginecología. Protocolos: Control del bienestar fetal anteparto (2009) y Control pretanal del embarazo normal (2010)