Routine Checks During Pregnancy

While you're pregnant, you'll have some routine checks to make sure both you and your baby are doing well. Some may be done at every visit, or at different times during your pregnancy. Other tests only need to be carried out once. If the tests show that there is, or may be, a problem, you'll be monitored closely and prompt action will be taken if necessary.

Height

Your height will be measured at your first visit. If you are petite, your midwife may suspect that you have a small pelvic inlet and outlet. The chances are, though, that your baby will match your particular physical build.

Weight

Women are weighed at every visit. If you lose weight in the first trimester, it's usually because of nausea and vomiting due to morning sickness and nothing to worry about. Maternal weight gain used to be taken as a reliable indicator of the growth of the baby. Recent research, however, shows that external examination, blood and urinary tests, and especially ultrasound scans are much more accurate in measuring fetal growth. A sudden weight gain could mean you have fluid retention, a sign of preeclampsia.

Legs and Hands

At every visit your legs will be checked for varicose veins, and your ankles and hands will be examined for signs of swelling and puffiness (edema). A little swelling in the final weeks of pregnancy is normal,   particularly in the evening, but excessive puffiness may give an early warning of preeclampsia.

Breasts

Your breasts will be checked for lumps and the condition of your nipples at your first visit. They won't usually be checked again, but if you're worried about anything, ask your midwife.

Urine

When you go for your first visit, you'll be asked for a sample of midstream urine to test for any underlying bladder or kidney infection. To collect a midstream sample, you'll be given a sterile pad to clean your few drops of urine into the toilet bowl and collect some midstream urine in the container. You then finish urinating into the toilet.

You'll be asked to bring a morning sample of urine with you on other visits. This will be tested for urinary infection; for sugar, to make sure you're not developing diabetes; and for ketones, which are the classic sign that diabetes is established and needs urgent treatment. A rare cause of ketonuria (raised levels of ketones) is very severe vomiting in pregnancy, called hyperemesis gravidarum, which means you have to go to the hospital right away. If you do have diabetes, it may disappear once your baby is born but come back in future pregnancies. A trace of protein in your urine in late pregnancy is a strong warning of preeclampsia. This will be looked into at once because of the risks of miscarriage, a small-for-dates baby, and premature delivery.

Blood Tests

Also at your first prenatal visit, you'll be asked for a blood sample, usually from a vein in your arm. This is used to check your basic blood group (A,B,O), and also your Rhesus (Rh) blood group (positive or negative), in case a blood transfusion becomes necessary. If you are Rh-negative, you'll be tested for Rhesus incompatibility with your baby.

your hemoglobin level will also be checked. This is a measure of the oxygen-carrying power of your red blood cells. The normal level is between 12 and 14 grams; if yours falls below 10 grams, you may be given treatment for anemia. Iron and folic acid raise the oxygen-carrying power of your blood, so it's essential to eat a healthy diet with plenty of vitamins and minerals.

The blood test will also show whether or not you've had German measles (rubella)-if you have, you're immune. Also, any sexually transmitted diseases, such as syphilis, will be revealed, and some genetic disorders, such as sickle cell anemia and thalassemia, are detectable in blood. You may also have a special screening blood test to help rule out certain types of fetal abnormalities.

You can also ask to have your blood tested for toxoplasmosis infection. Toxoplasma is a parasite that can be picked up from cat feces and also from eating poorly cooked lamb or pork. Toxoplasmosis is harmless to adults, but it can cross the placenta and cause blindness, epilepsy, and developmental delay in the baby.

Pregnant women aren't routinely screened for toxoplasmosis. The results can be hard to interpret, which means it's difficult to predict if the baby is affected, and this can cause extra stress for the mother. Ideally, you should be tested before getting pregnant. You won't necessarily be given this test unless you're thought to be at risk, so if you're worried-particularly if you have pets that hunt outside-ask for the test.

External Examination

At every visit your caregiver or obstetrician will gently feel your abdomen and the top of your uterus (fundus) to check the size of your growing baby. This gives a good idea of whether your baby is about the right size for your dates. After 26-28 weeks the doctor or midwife will also feel for your baby's "poles" (head and rump) so they can assess what position your baby is lying in. Your belly will be palpated to check your baby's size and growth.

Blood Pressure

You'll have this taken at every visit. As always, it measures the pressure at which your heart is pumping blood through your body. The reading is made up of two numbers: the upper one is the systolic pressure-when the heart contracts it pushes out blood and "beats." This is measured when the arm band is tight. As the pressure is released, the lower, or diastolic, reading is made. This is the resting pressure between beats.

The statistically average blood pressure reading in pregnancy is 120 over 70, although blood pressure differs with age, and there is a range of blood pressures that are considered normal. A higher reading than normal during pregnancy may be a sign of preeclampsia and you'll probably be advised to go into the hospital for evaluation. Constant checks are made so that changes are quickly noted.