Early Pregnancy Care

12 December 2020

Pregnancy is a beautiful and long-awaited phase for a woman to complete a family. Therefore, care throughout pregnancy is important to ensure during that phase, both mother and baby are healthy with no complications until birth.

The first trimester of pregnancy is important and should be well managed to avoid any possible risk of miscarriage. At this stage, the physical and mental health of the unborn baby is influenced by pre-pregnancy care and the first trimester of pregnancy.

Pregnant women should always seek medical advice, take care of their diet, adopt a healthy lifestyle, and follow pregnancy advice from a doctor and from authentic sources.

Sunway Medical Centre Consultant Obstetrician and Gynaecologist, and Maternal Fetal Medicine Physician, Dr Janani Sivanathan said pregnant women should be concerned about pregnancy care to avoid any complications.

She said some women experience various types of allergies, while some lose their appetite and some even lose so much weight that they have to be hospitalised besides experiencing bleeding during early pregnancy.

Once a woman has been confirmed pregnant, where the urine test came back positive, she needs to do an ultrasound scan to determine if the pregnancy is inside or outside the uterus.

“Various complications can endanger the mother’s life such as miscarriage, molar pregnancy and ectopic pregnancy that can be fatal. Bleeding and abdominal pain are among the symptoms of miscarriage, molar and ectopic pregnancy,” Dr Janani said.

“If the baby is healthy and is in the uterus in a normal position, an ultrasound scan should be done between 11 and 13 weeks (three months) to determine the expected delivery date, whether if you are carrying a single baby or twins, and if there are any structural or genetic problems in the baby. The scan can also detect growths in the ovaries or cysts and fibroids,” she added.

During this trimester, a screening test can be done to find out the risk of Down syndrome and other potentially fatal syndromes such as Edwards syndrome and Patau syndrome, which can cause the baby to die at birth.

“Blood tests can also be done to find out if the mother is at risk of pre-eclampsia (a condition where the mother has high blood pressure and there is protein detected in urine) as her pregnancy progresses,” Dr Janani said.

Women diagnosed with pre-eclampsia are at risk of seizures and even death. They are usually prescribed medicine to dilute the blood and calcium as a preventive measure.

Screening to asses fetal development can still be done between 20 and 24 weeks. Scans during this period will see the formation of the baby whether healthy or otherwise as well as determining the growth of the brain, face, heart, lungs, spine, kidneys, legs, hands and gender.

According to Dr Janani, screening tests are important to find out the risk of genetic problems in infants. If the results show a high risk for syndrome problems (such as Down syndrome), diagnostic tests during the first trimester can be made by taking tissue samples from the placenta which is called chorionic villus sampling.

“From the scan, we can see in detail the thickness of the back of the neck, nasal bones and other problems in the baby like if the brain is not formed normally or if the intestines are formed outside of the stomach. From there, we can expect the baby to have genetic problems.

“When this occurs, a diagnostic test is performed. If you miss this test in the initial stages, mothers still have time to do it after the 16th week and above by taking some amniotic fluid for an amniocentesis test,” Dr Janani said.

Older women, and women who are obese or have chronic diseases such as high blood pressure and diabetes are at risk of getting a more serious infection if they are infected with a virus such as COVID-19.

“Pregnant women are among the high risk groups who are prone to getting worse infections due to COVID-19, therefore they need to be more careful by washing their hands regularly, using hand sanitisers, avoiding crowded places, and always wearing a face mask.

“They also cannot ignore their appointments with their doctor, especially after they enter their third trimester, that means 28 weeks and above,” Dr Janani said.

Pregnant women are advised to maintain good health and eat a balanced diet including fruits, vegetables, proteins and calcium as well as doing appropriate exercises.

“Pregnancy should not prevent women from adopting an active lifestyle to prevent obesity, diabetes and other diseases. However, pregnant women need to know what types of exercise are suitable at each stage of pregnancy as well as to ensure there are no problems such as the low placenta and uterine problems among others,” Dr Janani advised.

Source: Berita Harian