Antenatal Care

Antenatal Care

A.   CONSULTATIONS WITH DOCTOR

If you think you may be pregnant or have just had a positive pregnancy test, what do you do?

If you are not on folic acid 800 micrograms daily, start it immediately.

You can come to Primavera Medical Centre and have a blood test as explained below:

5-6 weeks – Blood test (BHCG) will be done to confirm pregnancy. Once pregnancy is confirmed, BHCG may be repeated after 2 days to confirm the viability of the pregnancy and see the rise in pregnancy hormone. You may also be tested for immunity to toxoplasmosis and your progesterone hormone level may also be measured.

6-7 weeks – Ultrasound can be performed to check for fetal viability and to check if the pregnancy is inside the uterus; i.e. exclude an ectopic pregnancy.

Around 9-10 weeks:

a)    Formal Antenatal Notes will be started. 

b)    Folic Acid supplements are changed to pregnancy vitamins (Multi-vitamins, Omega 3s, Calcium/Vit D). 

c)    Booking Blood test will be done. (Complete blood count (CBC), Indirect Coombs Test, Blood group + RH, Thyroid stimulating hormone (TSH), HBsAg, HIV 1/2 Abs, VDRL (Syphilis), Rubella (German Measles), Random Blood Glucose (RBG), Urine Culture and Sensitivity, Urine Microscopy). We can also check for Varicella (Chicken pox) but this is optional. A Vitamin D level is also checked as so many residents in the UAE are deficient

d)    Screening for Down’s Syndrome is offered and discussed.

- The NT (Nuchal Translucency) Scan is where the thickness behind the baby’s neck is measured by an ultrasound (listed under Ultrasound Scans below). In addition, a blood test for biochemical markers is done from the mother. It is a screening test for Downs Syndrome with very good pickup. The result will come back as a risk assessment e.g. 1:1000.

- Non-Invasive Prenatal Testing (NIPT) – eg. a Harmony or a Panorama test - is a new DNA test on fetal DNA extracted for the mother’s blood. It is therefore risk free while still giving a very accurate assessment of fetal health. This also needs to be combined with an US scan.

e)    Early Pregnancy Information Booklet will be given to you.

Visits to the obstetrician will be every 4 weeks up to 28 weeks.

At 28 weeks: A OGTT (Oral Glucose Tolerance Test) (please refer to attached information sheet titled Gestational Diabetes and Pre-Diabetes for details) is done together with a Complete Blood Count (CBC) & S. Ferritin (Iron stores).

Visits will be every 2 weeks up to 36 weeks.

At 34-36 weeks:

a)    A LVS (Low Vaginal Swab) will be taken to check if the woman is a carrier of GBS (Group B Streptococcus) which if present in the vagina during birth can infect the baby http://www.rcog.org.uk/files/rcog-corp/uploaded-files/PIPreventingGBSInfection0107.pdf. Please refer to additional information that will be to you in the 2nd info booklet

b)    Blood is taken for a Complete Blood Count.

c)     Your Antenatal notes together with admission booking form and consent form will be sent to your chosen hospital usually Mediclinic City Hospital and American Hospital (However other hospital can be chosen upon agreement with the doctor). You will also receive a copy of these notes to keep with you.

d)    Doctor’s Delivery fee will be explained by the reception/nurses.

e)    2nd Pregnancy Information Booklet will be given to you.

Visit will be every week from 36 weeks.

From 36 weeks onwards

- Weekly visit with the doctor during which labour and delivery will be discussed.

- Induction date set if pregnancy goes beyond dates.

 

B. ULTRASOUND SCANS

In addition to frequent screening US that monitor the baby’s growth and well-being, 3 formal ultrasounds are done during pregnancy.

a)    10-12 weeks – Nuchal Translucency (NT) Scan. (referred to above)

This is done at Primavera Medical Centre. The results will be given to the doctor and you will receive a copy of the results at the time of the scan.

b)    20-22 weeks – Anatomy Scan

This is when the organs of the baby are checked to make sure they have developed properly. This is also done at Primavera Medical Centre. Again the results will be sent to the doctor, you will again receive a copy of the results.

c)    30-32 weeks - Doppler studies: this is an ultrasound of fetal well-being where the blood flow between the uterus and the placenta, the placenta and the baby and the distribution of blood within the baby is studied.