Patient After Hours/Emergency: 404-487-2450

Your pregnancy journey

In women who are low risk, visits usually occur:

  • Weeks 4-28: every 4 weeks
  • Weeks 28-36: every 2 weeks
  • Weeks 36-40: every week until delivery

The frequency of visits may increase if pregnancy is determined to be high risk.

What to expect during your visits

First trimester (0-13 weeks)

After your pregnancy has been confirmed and an ultrasound shows a viable fetus, you can start your prenatal care.

The goal of prenatal care is to ensure the birth of a healthy baby with minimal risk for the mother.

Your first visit (the OB work-up) will include:

  • A thorough patient history (note these were below and should all go together
    This will include personal information and information about your past obstetrical, gynecological, medical, and surgical history. Family history will identify risks for genetic disease.

  • A thorough physical exam
    This will allow your doctor to evaluate the size of your uterus and the adequacy of your pelvis. Weight, blood pressure, and urine are checked and recorded. A body mass index is calculated to determine the proper amount of weight gain during pregnancy and to help identify at-risk populations.

  • A thorough laboratory evaluation that includes a blood type, testing for sexually transmitted diseases, a sickle cell test, and other indicated studies including genetic testing

Every visit will consist of:

  • Assessment of weight, blood pressure, and urine, uterine size, and fetal heart rate
  • Each assessment is to ensure the pregnancy is progressing well
  • Time to answer questions

Second trimester (14-28 weeks)

The second trimester is very similar to the first in terms of routine evaluation of weight, blood pressure, urine, and uterine size.

The other important tests that are performed during this trimester are:

  • Fetal Anatomy Ultrasound – looks at the development of vital organs, placental location, and amniotic fluid level
  • Neural Tube Defect testing (MSAFP)
  • Gestational Diabetes testing at 26-28 weeks

Third trimester (28-40 weeks)

Prenatal visits still include evaluation of weight, blood pressure, urine, uterine size, and fetal heart rate and position.

The important tests that are performed during this trimester are:

  • Gestational Diabetes testing (if not done in the second trimester)
  • Antibody Screening in women with Rh-negative blood type. This is done to ensure that she can receive the RhoGAM injection
  • CBC/blood count to check for anemia. Increased iron requirements in pregnancy often result in anemia. Checking for anemia in the early third trimester allows for proper supplementation and counseling
  • Group B Streptococcus Screening (GBS) is done at 35-37 weeks. This is a swab of the lower vaginal and rectal area to screen for colonization of the GBS bacteria organism. GBS colonization is not harmful to the pregnant woman but may be harmful to the baby if it passes through the birth canal. A baby’s immune system is immature at birth and may be unable to fight off the GBS bacteria. This, in turn, can cause life-threatening infections such as sepsis, pneumonia, and meningitis. Treatment of a GBS positive mother can prevent these complications
  • Ultrasound: May be done to follow up on placenta location, fetal growth, and fetal well- being in certain pregnancies

 

Other goals of Third Trimester screening are to diagnose fetal malposition and preeclampsia.

  • Detection of a baby presenting in the wrong direction after 36 weeks allows for the possibility to turn the baby to the “head down” position. This is known as an External Cephalic Version
  • Detection and treatment of preeclampsia was the reason prenatal care was established and will result in specific recommendations including possible hospitalization and/or early delivery. At-risk moms are often recommended to take low dose aspirin starting early in pregnancy to prevent this condition

Postdates/post-term pregnancy (41 weeks)

Approximately 6-8% of pregnancies will go past the assigned due date. The risks of going past the due date include:

  • Large or macrosomic baby and potential birth trauma
  • Increased risk of stillbirth, meconium aspiration, and low amniotic fluid
  • Maternal risks including: increase in labor abnormalities, 3rd, and 4th-degree lacerations, and increased risk of having a cesarean section


In order to prevent the problems with post term pregnancy, our practice recommends delivery by 41 weeks with induction if there is no spontaneous labor.

 

X