Prenatal: essential preparation for the arrival of the baby

Many people are not aware of this, but unfortunately, not all pregnant women perform prenatal care. As much as the subject is discussed a lot, some people do not understand the importance of closely monitoring the evolution of pregnancy and only seek a doctor when the pregnancy is well advanced or when delivery is close.

In this way, it is always valid to emphasize the importance of prenatal care, remembering that it is what will guarantee a healthy pregnancy and a risk-free delivery, both for the mother and the baby.

According to Isaac Yadid, gynecologist and obstetrician, specialist in human reproduction and medical director of Primordia Medicina Reproductiva, in Rio de Janeiro, several studies point to the relationship between prenatal care and the health of the baby. “Maternal complications such as urinary tract infection, high blood pressure, placental abruption, diabetes, thyroid disorders, congenital infections (toxoplasmosis, cytomegalovirus, syphilis, HIV), use of alcoholic beverages and illicit drugs, and poor diet are determinants for prematurity. and other serious complications for the newborn”, he explains.

“A recent statistic from the Ministry of Health, for example, shows that between 2011 and 2013, 419 babies under one year old died as a result of congenital syphilis, which is transmitted by the mother. In 2011, that number was 211. The syphilis test is one of those included in the prenatal routine and the transmission of the disease from mother to baby is due to non-diagnosis or lack of adequate treatment during pregnancy”, adds the doctor. gynecologist.

What does prenatal mean?

But what exactly is prenatal care?

Isaac Yadid explains that prenatal care includes a series of exams and medical consultations that pregnant women must undergo throughout the period leading up to the birth of the baby.

The ideal is to start it in the first trimester, as soon as the woman finds out about the pregnancy. Or, if possible, before pregnancy, during planning.

“It is important for monitoring and evaluating the health status of mother and child. It is during prenatal care that we are able to identify and reduce various health problems in both, such as diseases, infections or dysfunctions can be detected early and treated quickly “, highlights the gynecologist.

Essential prenatal checkups

Below you know which are the main tests that are/should be done in prenatal care:

1. Blood count

When will it be done?

As explained by Yadid, the blood count is one of the first tests that will be requested for the pregnant woman, usually in the first consultation. It may be requested at other times during pregnancy.

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“It is through it that we can identify several changes, such as infections and anemia. During pregnancy, the doctor may request it more often according to the mother’s clinical conditions”, highlights the gynecologist.

Exam preparation

The most appropriate thing is for the pregnant woman to fast for three hours, according to Yadid.

2. Blood glucose

When will it be done?

According to Yadid, this test is usually requested at the first appointment. “And, if everything is within the standards, it should be repeated between the 24th and 28th week of pregnancy, when the body has more difficulty assimilating sugar”, she says.

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The gynecologist explains that the blood glucose test indicates the amount of glucose present in the blood, and detects glucose intolerance and diabetes.

Exam preparation

To do this test, according to Yadid, you need to fast for eight hours.

3. ABO system and Rh factor

When will it be done?

This exam is requested at the first consultation, right at the beginning of pregnancy, as highlighted by Yadid.

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“The ABO System identifies the mother’s blood type; and the Rh factor, whether it is positive or negative. If the mother is factor negative and the baby is factor positive, a condition called erythroblastosis fetalis can develop. When the blood of mother and child comes into contact at birth, an anti-Rh is formed in the mother’s body, which can destroy the red blood cells of the next Rh+ baby she has. Knowing this difference in factors, a drug is given after childbirth that prevents these antibodies from forming”, explains the gynecologist.

Exam preparation

The exam does not require prior preparation.

4. Serology for HIV and VDRL

When will it be done?

Yadid points out that these tests are also requested at the first consultation.

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“The HIV test detects the presence of the AIDS virus in the mother’s body; the VDRL, the presence of syphilis”, explains the gynecologist.

Exam preparation

There is no need to prepare in advance for the exam.

5. Reaction to toxoplasmosis and rubella

When will it be done?

According to Yadid, these tests are ordered at the first visit and repeated in the third trimester.

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“They are also part of the prenatal routine and indicate whether the pregnant woman has had contact with the agent that causes toxoplasmosis (Toxoplasma gondii protozoan) or rubella (Rubella virus)”, explains the gynecologist.

Exam preparation

There is no need to prepare in advance for the exam.

6. Urine exam

When will it be done?

“This exam is requested at the first consultation and, according to the obstetrician’s evaluation, it can be repeated in other trimesters”, highlights Yadid.

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“It is a routine test, mainly to identify urinary infections, which may be related to premature birth”, explains the gynecologist.

Exam preparation

According to Yadid, there is no need to prepare in advance for this test, “but it is recommended that it be done with the first urine of the day, or after an interval of more than four hours between one pee and the next.”

7. Stool Examination

When will it be done?

“It is usually requested in the first consultation and can be repeated in case of diarrhea or other clinical symptoms”, explains Yadid.

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According to the gynecologist, this is an exam that is part of the routine, as it identifies the presence of verminoses.

Exam preparation

“For the parasitological examination of feces there is no need for preparation, but it is recommended that it be done in the morning”, explains the gynecologist.

8. Serology for hepatitis B and C

When will it be done?

According to Yadid, this is another type of test requested at the first appointment.

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“It identifies the presence of both types of virus (hepatitis B and C)”, he highlights.

Exam preparation

There is no need to prepare for the exam.

9. Pap smear

When will it be done?

“Pap smears are performed at the first appointment if the pregnant woman is not up to date with the exam”, explains Yadid.

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“With this exam, cervical cancer screening is carried out”, highlights the gynecologist.

Exam preparation

It is recommended that the woman maintain sexual abstinence in the 24 hours before the exam. She should also avoid, in the previous 48 hours, the use of douches, ointments or vaginal creams.

10. Ultrasound

When will it be done?

At the beginning of prenatal care, an ultrasound will be performed, which should/can be repeated as many times as the responsible doctor deems it necessary. There are professionals who perform it, for example, in all prenatal consultations.

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“It is indicated to confirm the chronology of pregnancy and for the prognosis of chromosomal diseases or malformations”, highlights Yadid.

Exam preparation

There is usually no need for any special preparation, but if so, this will be informed by your doctor.

11. Morphological ultrasound

When will it be done?

According to Yadid, morphological ultrasound is performed in the second trimester.

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“The exam aims to analyze the formation of fetal organs and indicates malformations”, highlights the gynecologist.

Exam preparation

There is usually no need for any special preparation.

Prenatal vitamins and supplements

Domingos Mantelli (CRM-SP: 107.997), gynecologist and obstetrician from the Faculty of Medicine of the University of Santo Amaro (UNISA) and Post-Graduate Medical Residency in the area of ​​Gynecology and Obstetrics, talks about vaccines and supplements that may (or may not) be needed in prenatal care.

1. Vaccines

Mantelli explains that the ideal is for the pregnant woman to update the vaccination schedule before pregnancy, and not during pregnancy. “During pregnancy, only those vaccines that the doctor deems necessary will be given, there is no rule,” she says.

He mentions that, basically, the pregnant woman can take:

• Influenza vaccine: anytime;
• DTPA: which is for Diphtheria, Tetanus and Pertussis, and which is given from 27 weeks.

“With the exception of these two vaccines, the obstetrician will assess whether or not there is a need for other vaccines”, highlights Mantelli.

2. Folic acid

The obstetrician explains that the ideal is for the pregnant woman to take folic acid at least three months before becoming pregnant and during the first trimester of pregnancy, at a dosage of 5mg a day.

“This folic acid is extremely important to prevent the early closure of the neural tube, which is part of the formation of the child’s central nervous system”, explains Mantelli.

3. Iron

The obstetrician explains that pregnant women do not always need iron supplementation, “except for those pregnant women who already had iron deficiency anemia before becoming pregnant”.

“If she has adequate iron levels, there is no need for iron supplementation. Who will have to evaluate and see the need for supplementation will be her obstetrician gynecologist”, highlights Mantelli.

4. Multivitamins

“Supplementation during pregnancy is indicated throughout the gestational period. There are multivitamins that the pregnant woman buys at the pharmacy – which she can use throughout her pregnancy – and they will supply the basic elements that the baby will need for training”, highlights the obstetrician.

5. Vitamin D

Again: it’s not a rule. “If there is an organic deficiency of vitamin D, then supplementation is worth it, as it is good for the baby during this period of formation. If the pregnant woman already has adequate levels, there will be no need for supplementation”, says Mantelli.

6. Omega 3

“Only if there is an organic deficiency of Omega-3 is it worth supplementing, as it is also good for the baby during this period of formation. If the pregnant woman already has adequate levels, there will be no need for supplementation”, highlights Mantelli.

“Once again, it is worth saying that it is the obstetrician who has to evaluate and indicate these substances. The indiscriminate use of them, with self-medication, can even bring problems. Then, only the obstetrician will be able to release it”, adds the doctor.

Precautions that pregnant women should have

Pregnancy is a magical phase in a woman’s life, but it is also a period that inspires care and often generates many doubts. It is worth mentioning, however, that, although the period requires attention, it is usually possible for the pregnant woman to maintain a routine without many restrictions.

Some of the things pregnant women can’t do are:

• Laser waxing;
• Drinking alcohol in excess;
• Eating raw foods or foods of dubious quality;
• Drinking too much coffee;
• Excessive consumption of sweets and pasta;
• Missing at…