You are encouraged to see your doctor (GP) as soon as you think that
you may be pregnant.
Your doctor may confirm your condition by doing
a simple urine test for HCG (human chronic gonadotrophin).
It is important to see your doctor as early as possibe in pregnancy
a baseline of recordings and observations can be made. It is much
easier then to see if any abnormalities occur later.
advice can be given about health and lifestyle to promote a healthy
Your doctor should explain to you about the choices available to you
regarding antenatal care and where you want your baby to be born.
A general health check may be performed (weight, blood pressure and
urine test) and advice given about diet, smoking and lifestyle.
Blood tests may be performed for rubella antibodies, haemoglobin
estimation and grouping.
If you choose to have a hospital delivery, your doctor will refer
you to the local maternity unit, and you will be sent an
appointment to attend the booking clinic.
The booking clinic is the first visit to the hospital antenatal
clinic (ANC). A bed is booked for the time the baby is due.
Several observations, tests and recordings are made and information
is put into your hospital notes.
General Particulars Accurate records of your name, age, address, GP and midwife are
taken during early stages of pregnancy.
Present Pregnancy Calculation of the expected date of delivery (EDD) - You are asked
the date of the first date of your last menstrual period (LMP).
Nine calendar months are counted forwards and seven days added,
LMP: 1.1.99, add 9 months and 7 days = EDD: 8.10.99.
Health during your early stages of pregnancy is accessed, for example you may report
excessive sickness, vaginal bleeding or any other abnormality.
Previous Pregnancies Details of previous pregnancies are recorded, because this may affect the
care given during this pregnancy, for example...
Any illnesses affecting you is recorded, especially if they may affect the
baby, for example diabetes or heart disease.
Twins, multiple births, genetic conditions or medical problems are recorded.
The Midwife's Examination
Weight is recorded as a base measure for future weight gain. The average gain
in pregnancy is 12-15kg.
Height may indicate the size of the pelvis.
Urine Test The urine is tested for protein, ketones and sugar. These substances are not
usually found in the urine; if they are present further investigation will
protein - possibly an early sign of toxaemia of pregnancy, or it may be caused by
an infection or contamination of the specimen.
ketones - produced by the breakdown of body cells to provide energy. Dieting or
constant vomiting may be the cause.
sugar - not uncommon in pregnancy because the kidneys are less efficient than
usual; it could, however, be an early sign of diabetes.
Blood Pressure (BP) This provides a baseline for future recordings. High BP in pregnancy may be
the first sign of toxaemia of pregnancy.
A full medical examination will be performed by an obstetrician. This will
include the examination of...
heart and lungs
lower limbs, for varicose veins or swelling (oedema)
internal vaginal examination to check the size of the uterus; an ultrasound
scan will give an even more accurate assessment. A cervical smear will be
done if neccessary.
At the first visit to the ANC (antenatal care clinic), a sample of blood is taken for a variety of
Rhesus factor - with information from this test, blood can be cross-matched
without delay in the case of anaemia or bleeding during pregnancy, when a transfusion
may be needed.
Serology - to detect syphilis (a veneral disease), which can be treated to prevent
damage to the baby.
Haemoglobin - the iron content of the blood is recorded and is taken at monthly
Rubella - blood test is tested for rubella antibodies.
Serum alpha-fetoprotein (SAFP) - this test is taken at 16 weeks of pregnancy
when a raised level of SAFP indicates that the baby may have spina bifida;
this high level could mean that it is a multiple pregnancy or that the date
of the LMP is incorrect. An amniocentsis is offered if you have a raised SAFP,
and a detailed ultrasound scan will usually be performed to check for twins
and to examine the spine.
Triple test - this test may be offered to women over 35 years of age, or it
may be requested. It measures levels of serum alpha-fetoprotein (SAFP),
human chorionic gonadotrophin (HCG) and oestriol (placental hormones).
In conjunction with maternal age, the test calculates the risk of the baby
having Down's syndrome and spina bifida. An amniocentesis may be offered
to you if necessary.
The Co-operation Card
Every pregnant woman is given a co-operation card to record every antenatal
assessment made by the hospital, GP or midwife.
As its name implies, the card is to enable co-operation between all the providers
of ANC as well as you.
You should carry it with you at all times because
pregnancy is not predictable - a problem could occur at any time, even when
out for the day or on holiday.
Whoever cares for you will need to know the progress of your pregnancy so far,
so that the best treatment can be offered.
As the pregnancy progresses, it will be possible to record the fetal heart and
feel the fetal parts when you are examined.
You will begin to feel the baby
move, at about 20 weeks for a first baby, and earlier for subsequent pregnancies
because an experienced mother will recognise the sensation of fetal movement.
These observations will be recorded at each antenatal visit together with records
height of the fundus
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