About Pregnancy

Duration of pregnancy

Pregnancy lasts about 40 weeks, counted from the first day of the last menstruation. In the case of IVF, the age of pregnancy is calculated from the time of conception (IVF) to which 2 weeks are added.
The probable date of birth is not an exact date.
The birth is considered term if it takes place between two weeks before and two weeks after the calculated probable date.

What are the usual symptoms of pregnancy?

❖ Delayed menstruation
❖ Fatigue
❖ Intolerance to some foods
❖ Increased sensitivity to odors
❖ Nausea and vomiting
❖ Tension and breast enlargement
❖ Frequent urination
❖ Accelerated breathing
❖ Frequent mood swings
❖ Constipation
❖ Headache
❖ Changes in body weight

Prenatal checkups

Routine prenatal checkup is done:
❖ Monthly between weeks 4 and 28
❖ Bimonthly between weeks 28 and 36
❖ Weekly after week 36

Pregnant women at high risk for pregnancy may need more frequent prenatal check-ups.

The first prenatal visit consists of:
❖ Evaluation of medical history
❖ Medical examination
❖ Blood and urine tests
❖ Checking blood pressure and weight
❖ Calculation of probable date of birth (DPN)
❖ Lifestyle recommendations

The following prenatal checkups include:
❖ Blood pressure check
❖ Assessment of weight gain
❖ Palpation of the abdomen to evaluate the fetus
❖ Checking the fetal heart rate
❖ Urine analysis

Usual investigations in charge:

✓ Blood group and Rh
✓ Complete blood count
✓ Screening for Hepatitis B and C, HIV and syphilis
✓ Antibodies Rubella, CMV, Chickenpox, Toxoplasma
✓ Cervical smear – PAP test
✓ Chlamydia and Mycoplasma Screening
✓ Screening for Streptococcus group B
✓ Urine and urine culture summary – recommended monthly

Special investigations in charge:

Detection of fetal abnormalities in the first trimester:

Blood tests – routine or optional:
❖ Double test – between weeks. 11 and 14 – calculate the risk
❖ Non-invasive prenatal test – between weeks. 10 and 12 or
❖ Extended prenatal test (for several possible diseases)
They can detect up to 99% of genetic abnormalities.

Ultrasound to assess fetal morphology in the first trimester – at about 12 weeks – may detect some visible fetal malformations at this stage.

Fetal assessment in the second trimester:

Blood test
Alpha-fetoprotein (AFP), triple test, quadruple test –
between 15 and 18 weeks of pregnancy – estimates the risk

Chorionic villus biopsy
Detects fetal genetic abnormalities by aspirating some
cells in the placenta at 11-13 weeks.

amniocentesis
It involves aspirating an amount of amniotic fluid.
It is performed between 15 and 20 weeks to detect genetic abnormalities or in advanced pregnancies, to inform about the degree of maturation of the fetus.
Non-Stress Test (TNS)
Fetal heartbeats and their reaction to movements are recorded to assess the condition of the fetus.

Ultrasound
Periodic ultrasound determines the position, size and condition of the fetus, evaluates the placenta and amniotic fluid.
Ultrasound to assess fetal morphology in the second trimester is done at 18-20 weeks and can detect most visible fetal and placental abnormalities.

Tips for adapting your lifestyle

Medication, natural therapies
During pregnancy, any administration of medicines or natural remedies that have not been previously approved by the obstetrician should be avoided.
Essential chronic medication, such as thyroid hormones, anticonvulsants, insulin, may be given, but the dose is adjusted by a specialist.

Natural or complementary therapies should be avoided; few have been tested and considered safe in pregnancy.

Alcohol
Alcohol is toxic to both mother and baby.
Avoid alcohol throughout pregnancy.

Smoking
Many complications of pregnancy are associated with smoking.
Avoid smoking and cigarette smoke (passive smoking).

Nutrition
A folic acid supplement is recommended before conception and in the first 12 weeks of pregnancy.
Vitamin D intake is also important during pregnancy and lactation (10 micrograms per day)
Excess vitamin A (over 700 micrograms) is associated with an increased risk of malformations.
Excess weight, especially obesity, are associated with severe complications in pregnancy: hypertension, eclampsia, gestational diabetes, fetal intrauterine death, thromboembolism, premature birth.
Keep your body weight under control during pregnancy!

Toxoplasmosis and other infections
Toxoplasmosis is an infection that can cause miscarriage or fetal malformations. A pregnant woman can become infected if she ingests undercooked meat or comes in contact with excrement from an infected cat.
Thermally cook the meat, do not ingest it raw.
Unwashed food, raw or unsafe fish and seafood can cause digestive infections.
Wash your hands thoroughly after contact with pets or objects touched by them.

Service
Work at work can be continued, unless there are special contraindications.

Physical activity
Moderate exercise is not a risk.
Sports that involve abdominal trauma, falls, jumps or straining joints should be avoided.

Sexual intercourse
Sexual intercourse can be safely continued throughout normal, uncomplicated pregnancies.

Travel by plane
Long flights have been associated with an increased risk of edema and venous thrombosis.
In the general population, wearing special compression stockings and moving the legs reduce this risk.

Traveling by car
The seat belt is worn under or over the abdomen and never over the pregnant uterus.

When it is necessary to contact the doctor

❖ Any fluid leaking from the vagina
❖ Vaginal bleeding
❖ Headache that does not yield to treatment
❖ Visual disturbances
❖ Sudden weight gain
❖ Intense or persistent abdominal pain
❖ Fever
❖ Itching when urinating
❖ Uterine contractions 10 minutes or more often
❖ Persistent vomiting
❖ Reduction of fetal movements