What do we really know about pregnancy? What are the usual signs and which ones should generate alert? Àngels Martínez, comadrona del Clinic Barcelona Hospitalsummarizes it clearly: “The normality of pregnancy is between 37 and 42 weeks of gestation.” During that period, and whenever there are no risk factors – biological, psychological or social – or previous or developed pathologies during pregnancy, pregnancy usually evolves without complications. In that context, the woman only needs to adapt to a series of physical and emotional changes typical of this stage.
How is pregnancy classified according to the level of risk?
Pregnancy is classified at different levels of risk: low, medium, high or very high. Sandra Hernández, gynecologist at the Clinic Hospital, details that “most pregnancies are low risk, but approximately 10% catalog them as high -risk gestations.”
The risk assessment is updated on each visit, so it can vary throughout pregnancy. If a low or medium risk pregnancy is considered, the reference professional will be a midwife. On the other hand, if it is considered at high or very high risk, the follow-up is in charge of a Obstetrics-Ginecology professional and the team of specialists required. In the latter case, medical control is more strict and frequent.
Most pregnancies are low risk, but approximately 10% of gestations are classified as high -risk gestations
What tests are performed in each quarter?
The evidence that are made during pregnancy to verify that everything evolves normally vary according to the pregnancy quarter. In general, the controls are programmed with a monthly periodicity, but in risk pregnancies the frequency is usually higher and specific studies can be indicated.
In the first quarter, a blood analytical is performed to determine the blood group and the RH factor of the fetus, detect possible anemias and evaluate the mother’s immune state against certain infections, such as toxoplasmosis, rubella, syphilis and HIV. An early ultrasound is also carried out to detect possible morphological alterations, a urine crop and a biochemical screening that calculates the risk of Down syndrome and Edwards syndrome.
The ultrasound of the second quarter is carried out around week 20 to evaluate the development of the organs and structures of the fetus, as well as the state of the placenta and the amniotic fluid. During this period there is also a blood test that includes the control of hepatitis B.
In addition, the O ‘sullivan test is carried out to observe how the organism responds to glucose. If the result is altered, a glucose tolerance curve is performed to rule out a possible gestational diabetes. In cases where the mother has a negative Rh blood group, the anti-D gammaglobulin vaccine is administered, and, if at birth the baby is also negative Rh, a second dose is applied.
In the third and last quarter, blood analytics evaluates the status of coagulation, a key aspect of childbirth. The ultrasound of this stage allows to verify the growth of the baby, its position and the amount of amniotic fluid. If in week 36 the fetus is not in the cephalic position – that is, head down – external manipulations can be performed to try to correct its posture and avoid a caesarean section.
A vaginal and rectal crop is also made to detect the agalactiae streptococcus, a microorganism that could affect the baby during childbirth. Towards the end of pregnancy, if there are suspicions of amniotic bag break, a vaginal touch can also be performed.
What are the alarm signs?
During pregnancy, it is common to experience mild symptoms, such as stomach ardor, nausea or vomiting, swelling on feet and legs or constipation. It is also common to have low intensity contractions. However, there are alarm signs that require urgent medical care. These are regular or painful contractions before week 37, loss of blood or liquid, fever, vision alterations, abdominal pain, intense headache or urinary discomfort. In addition, as Comadrona Martínez points out, “at the end of pregnancy it is necessary for the baby to always be noticed. Therefore, the decrease in fetal movements is a criterion to go to the emergency room.”
At the end of pregnancy it is necessary for the baby to always notice. Therefore, the decrease in fetal movements is a criterion to go to the emergency room
To minimize complications associated with pregnancy and childbirth, health professionals recommend following certain healthy habits. It is essential to maintain a balanced diet to prevent excessive increase in weight and diseases such as gestational diabetes or preeclampsia.
In addition, as Comadrona Martínez points out, “you should avoid contracting two food infections: Listeria and Toxoplasmosis.” It is also important to do physical exercise and avoid the consumption of toxics such as tobacco and alcohol, since they can produce alterations in the fetus. Finally, maintaining proper oral hygiene is essential for general health during pregnancy.
There are also a number of complications associated with Human papillomavirussuch as spontaneous abortion, premature delivery or restriction of intrauterine growth. In addition, there is a risk of transmission from the mother to son. For this reason, it is essential to perform an exhaustive exploration to detect possible infections.
In the postpartum, some problems may arise and, therefore, it is important to be attentive to the alarm signs. It is essential to go to the doctor if there are smelly or excessively abundant loquios, fever, intense pain in the abdomen or in the scar, very painful or inflamed hemorrhoids, redness or breast pain, pain when urging or persistent emotional symptoms, such as continuous sadness or intense fears.
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