Prenatal examination

　　Prenatal checks refer to a series of medical and nursing suggestions and measures provided for pregnant women, the purpose of which is to early prevent and detect complications through the monitoring of pregnant women and fetuses, reduce their adverse effects, and it is crucial to provide correct examination methods and medical advice during this period to reduce maternal and perinatal mortality rates. The main functions of prenatal checks include the following:
　　1. Prenatal checks can discover some diseases in pregnant women's bodies. If these diseases are not suitable for pregnancy, timely induced abortion can be performed.
　　2. Regular checks can understand the development of the fetus and the physiological changes of the mother, and if abnormalities are found, they can be treated early.
　　3. Through prenatal checks, pregnant women can obtain knowledge about the physiological hygiene, lifestyle, and nutrition during pregnancy from doctors, understand what should be paid attention to before and after delivery, and common knowledge about normal childbirth.
　　4. After systematic checks, it can predict whether there will be difficulties during delivery, and decide the mode and place of delivery, thus reducing the risk during or after delivery, ensuring the safety of childbirth.

　　The diseases detected in prenatal checks mainly include 7 malformations such as anencephaly, severe hydrocephalus, severe open spina bifida, severe chest and abdominal wall defects, visceral prolapse, single ventricle, and lethal chondrodysplasia. In addition, there are also cleft lip and palate, cystic hygroma, teratoma, hemangioma, and明显 fetal organ developmental abnormalities, etc.

　　The time for prenatal checks should start from the time of pregnancy confirmation, generally once a month before 28 weeks of pregnancy, every two weeks between 28-36 weeks, and once a week in the last month. If there are any abnormal conditions, the number of checks should be increased accordingly.

　　First prenatal check-up at 12 weeks
　　Most pregnant women start their first prenatal check-up around 12 weeks of pregnancy. Since this is a relatively stable stage, most hospitals will issue a 'Pregnancy Health Manual' for the mothers. In the future, when doctors perform various prenatal checks for each pregnant woman, they will also carry out and record the checks based on the items listed in the manual.
　　Perform various basic checks. The main items include medical consultation, weighing and measuring blood pressure, checking various parts of the body, listening to the baby's heartbeat, checking the size of the uterus, blood tests, urine tests, and screening for 'fetal nuchal translucency'.

　　Second prenatal check-up between 13-16 weeks
　　Down syndrome screening: Starting from the second prenatal check-up, pregnant women must undergo basic routine checks each time, including weighing, measuring blood pressure, consulting, checking the size of the uterus, and listening to the baby's heartbeat. If the pregnant woman is over 35 years old, it is recommended to do a Down syndrome screening by blood test after 18 weeks (the best time is between 16-18 weeks). If the nuchal translucency of the fetus is greater than 3.0mm and the probability of the blood test result is greater than 1/270, there is a possibility of having a Down syndrome child, and amniocentesis should be arranged. As for the time of amniocentesis, it is generally recommended to start between 16-20 weeks, mainly to see if there are any chromosomal abnormalities in the fetus.

　　3rd prenatal check-up from 17 to 20 weeks
　　Detailed ultrasound examination: An ultrasound examination is performed at 20 weeks of pregnancy to mainly check for any major developmental issues in the fetus. The doctor will carefully measure the circumference of the fetus's head, abdomen, the length of the thigh bone, and inspect for congenital abnormalities in the spine. By the 16th week, the gender of the fetus can be seen, but the accuracy is higher at 20 weeks. The first fetal movement, which is most anticipated by pregnant women, usually appears between 18 and 20 weeks.

　　4th prenatal check-up from 21 to 24 weeks
　　Gestational diabetes: Most screening for gestational diabetes and gestational cholestasis is done at the 24th week of pregnancy. The doctor will take a blood sample from the pregnant woman for screening tests. If gestational diabetes is found, dietary control and insulin injections should be used for treatment, and oral hypoglycemic drugs should never be used to avoid affecting the fetus. If bile acid levels are elevated, it indicates gestational cholestasis, and medication should be monitored until after delivery, and in some cases, premature termination of pregnancy may be necessary. After the mid-pregnancy period, anemia and calcium deficiency are more common, so more iron-rich foods should be consumed to supplement iron and calcium.

　　5th prenatal check-up from 25 to 28 weeks
　　Hepatitis B antigen and syphilis serum test: At this stage, the most important task is to draw blood from the pregnant woman to retest for syphilis, AIDS, and hepatitis B antigens and antibodies. The purpose is to reconfirm the tests performed during the early pregnancy of the pregnant woman, to check whether the pregnant woman herself carries or has been infected with hepatitis B. In addition, it is also necessary to recheck blood glucose and bile acid levels.

　　6th prenatal check-up from 29 to 32 weeks
　　Edema of the lower limbs: After 28 weeks of pregnancy, the prenatal check-ups for pregnant women are conducted every 2 weeks. The doctor will gradually check for edema in pregnant women. Since most preeclampsia occurs after 28 weeks of pregnancy, it is very important for pregnant women to undergo checks for blood pressure, proteinuria, and glucose in the later stages of pregnancy. If the blood pressure is found to be high, and there are symptoms such as proteinuria and edema all over the body, pregnant women should be more vigilant to avoid the risk of preeclampsia. In addition, an electrocardiogram and liver and gallbladder ultrasound are also necessary. Blood glucose and bile acid levels should be rechecked according to the condition of the pregnant woman. Pregnant women and their families can perform a simple self-check by pressing the thumb on the tibia of the lower leg, and if the skin clearly sinks in after pressing and does not recover quickly, it indicates the presence of edema. To prevent edema, pregnant women can wear elastic stockings, elevate their feet while sleeping, and lie on their left side.

　　7th prenatal check-up from 33 to 35 weeks
　　Ultrasound examination and assessment of fetal weight: By the 34th week of pregnancy, it is recommended that pregnant women undergo a detailed ultrasound examination to assess the current weight and development of the fetus, and to estimate the weight of the fetus at full term. If the fetus is found to be underweight, the pregnant woman should supplement more nutrients.
　　Attention: Pregnant women should take special precautions against preterm labor before 37 weeks of gestation. If the contractions last more than 30 minutes and continue to increase, and are accompanied by vaginal bleeding or leakage, they should go to the hospital for an immediate checkup.

　　8th prenatal examination at 36 weeks
　　Starting from 36 weeks, the expectant mother gets closer to the due date, and the prenatal examination at this stage should be conducted once a week as a principle, and the status of the fetus should be continuously monitored. At this stage, the expectant mother can start preparing some items for hospital admission to avoid being too hurried and disorganized on the day of birth.

　　9th examination at 37 weeks
　　Pay attention to the signs of labor. As the fetus grows, the fetal movements become more and more obvious, and the expectant mother should pay attention to the situation of the fetus and herself at all times to avoid premature birth. Symptoms such as a hard abdomen, severe urinary frequency, decreased fetal movements, and vaginal bloody discharge are all signs of impending labor. When the water breaks, one should lie flat immediately and rush to the hospital.

　　10th prenatal examination from 38 to 42 weeks
　　Fixed fetal position: Starting from 38 weeks, the fetal position begins to become fixed, and the fetal head has descended and is stuck in the pelvic cavity. At this time, the expectant mother should be mentally prepared for childbirth at any time. Some expectant mothers may not show signs of labor after 42 weeks, and should consider consulting a doctor for the use of Pitocin.

　　The growth and development of the fetus is closely related to the health status of the mother. The mother's physical health, nutrition, mental state, and lifestyle directly affect the health of the fetus. Therefore, during pregnancy, pregnant women should pay attention to the following aspects:

　　1. It is essential to maintain a comfortable mood and stable emotions, and to also do some fetal education at the right time, such as listening to beautiful music, then touching the fetus and having the husband talk to and tell stories to the fetus, and also giving the fetus some early benign stimulation and training, which can promote the healthy physical and mental development of the fetus. Moreover, it is also important to consume a balanced diet and pay attention to the intake of salt to prevent pregnancy poisoning.

　　2. Pregnant women should eat more foods rich in protein and vitamins, such as lean meat, poultry, eggs, milk, fish, and more fresh vegetables and fruits. It is important to eat well and drink enough before giving birth, preferably high-energy foods such as rice, white flour, brown sugar, and chocolate, which can increase the power of labor.

　　3. Good personal hygiene. Pregnant women are prone to symptoms such as gingival hyperemia, swelling, pain, and bleeding, so it is important to develop good oral hygiene habits. Soft-bristled toothbrushes should be used for brushing. Pregnant women have a strong metabolism, with increased secretion of sebaceous and sweat glands, and are particularly prone to sweating. Therefore, pregnant women must often wash their hair, bathe, and change their clothes frequently to keep the skin clean, promote overall blood circulation, and excrete waste in the body, thereby protecting their health. Bathing should be done with a shower, not a bath, and the water temperature should not be too high. Pregnant women have increased vaginal discharge, so they should clean the external genitalia with warm water every day and use sanitary napkins to keep the perineum dry and reduce the occurrence of vaginitis.

　　4. In order to be able to understand the development of the fetus and your own physical condition in a timely manner, pregnant women should regularly undergo routine prenatal examinations. Prenatal examination is a special examination performed by obstetricians on pregnant women. Starting from early pregnancy, pregnant women should have a check-up once a month; after 28 weeks of pregnancy, once every two weeks; and after 36 weeks, once a week. If any abnormal conditions are found during the examination, one should seek medical attention immediately.

　　5、孕期不要过于安逸，要进行适当地做家务和体育锻炼，以增强体力，提高子宫和腹肌的收缩力，但不要过于劳累。

　　5, Do not be too comfortable during pregnancy. It is appropriate to do household chores and physical exercise to enhance physical strength and improve the contraction force of the uterus and abdominal muscles, but do not overwork.

　　6, Women who have had cesarean section surgery, if they give birth again, generally need two years. This is because, after delivery, the incision on the uterine wall may not heal well in the short term, and the scar makes the incision lack elasticity and not firm, which is prone to scar rupture during the late pregnancy or delivery, leading to uterine perforation or rupture, causing massive bleeding and even threatening life. Therefore, to make the incision heal better, it is best to get pregnant and deliver after two years, so that the scar tissue at the incision site can heal better and reduce the risk of re-delivery. Moreover, as the pregnancy months increase, pay attention to observe whether the pregnant woman has any abnormal conditions, and it is advisable to be hospitalized for delivery one to two weeks before the expected delivery date.

　　What kind of laboratory tests should be done for prenatal examination
　　24, Prenatal examination is a check-up that every pregnant mother should do. Only by doing prenatal checks during pregnancy can we ensure the health of both the baby and the mother. In addition to the basic check items, such as height, weight, blood pressure, and abdominal circumference, it also includes the following checks.1, Nuchal translucency scan:
　　1, Nuchal translucency scan from 13 to 16 weeks of pregnancy, to assess whether the fetus may have Down syndrome.2, Chorionic villus sampling:
　　3, Chorionic villus sampling: to detect whether there is a chromosomal abnormality disease like Down syndrome.3, Down syndrome screening, to calculate the risk coefficient of Down syndrome and exclude Down syndrome.
　　4, Amniocentesis:4, Amniocentesis, to diagnose whether the fetus has chromosomal abnormalities and other hereditary diseases.
　　5, Fetal anomaly ultrasound:5, Prenatal ultrasound for fetal anomaly screening, the purpose is to exclude malformed fetus.
　　6, Diabetes screening:12, Diabetes screening from 24 to 28 weeks of pregnancy, used to screen for gestational diabetes in pregnant women.
　　7, Fetal heart monitoring:After 37 weeks of pregnancy, fetal heart monitoring should be performed to speculate whether the fetus in the uterus is experiencing oxygen deficiency.
　　8, Pelvic measurement:After 37 weeks of pregnancy, assess the size and shape of the pelvis to determine whether the fetus can be delivered vaginally.

　　Pregnant mothers need to pay attention to all aspects, especially in terms of diet, as the food they consume will be transmitted to the fetus through the mother's body. The diet during the early, middle, and late stages of pregnancy should pay attention to the following aspects:

　　1. Early pregnancy:Most pregnant women will experience nausea, vomiting, loss of appetite, and other pregnancy reactions during the early pregnancy, leading to a decrease in appetite.
　　1, The diet during the early pregnancy should be light and easy to digest and absorb.
　　2, Pregnant women should choose their favorite foods as much as possible.
　　3. To ensure the intake of protein, pregnant women can appropriately supplement dairy products, eggs, beans, and hard nuts.
　　4. Pay attention to consuming folic acid in the early pregnancy, as folic acid is related to the development of the fetus's nervous system. A lack of folic acid during pregnancy can easily cause fetal neural tube defects, such as anencephaly or spina bifida, and also increases the risk of cleft lip and palate. Many natural foods contain abundant folic acid, such as various green vegetables (such as spinach, lettuce, asparagus, Chinese cabbage, broccoli, etc.).
　　5. The supply of vitamins should be sufficient. If the pregnancy reaction of the expectant mother seriously affects normal eating, it is advisable to take comprehensive vitamin tablets under the doctor's advice.

　　2. Mid-pregnancy:Entering the second trimester of pregnancy, the appetite of expectant mothers gradually improves, not only to compensate for the nutritional loss in the previous period, but also to make up for the nutrition before the appetite decreases in the late pregnancy period.
　　1. Consume a balanced diet with both meat and vegetables, and combine coarse and fine foods, with a variety of food types.
　　2. Avoid being picky and eating unbalanced diets to prevent a lack of minerals and trace elements.
　　3. Avoid eating too much fried, greasy food, and sweets (including fruit) to prevent a rapid increase in body weight.
　　4. Pay attention to supplementing foods rich in iron, such as animal liver, blood, and beef, to prevent iron deficiency anemia. At the same time, supplementing vitamin C can also increase the absorption of iron.
　　5. The demand for calcium increases in pregnant women, so it is advisable to eat more foods rich in calcium, such as dairy products, soy products, shrimp shells, and kelp, etc.

　　3. Late pregnancy:Entering the final sprint stage, the storage of nutrition is particularly important for expectant mothers. Safe, healthy, and reasonable diet is a necessary prerequisite for the healthy birth of the fetus.
　　1. Ensure the quality and variety of food intake.
　　2. Appropriately increase the intake of calories, proteins, and essential fatty acids (eating more seafood can help supply DHA), and appropriately limit the intake of carbohydrates and fats (i.e., reduce the amount of staple foods such as rice and noodles), to prevent the fetus from growing too large and affecting an easy delivery.
　　3. Increase the intake of calcium and iron. Regularly consume dairy products, fish, and soy products; shrimp shells, animal liver, and blood contain high iron content and should be consumed regularly.
　　4. Pay attention to controlling the intake of salt and water to prevent edema, and even cause pregnancy-induced hypertension.
　　5. For high-energy foods such as sugar and honey, it is advisable to eat less to prevent a decrease in appetite and affect the intake of other nutrients.
　　6. Choose small in volume and high in nutritional value foods, such as animal products; reduce foods with low nutritional value and high volume, such as potatoes, sweet potatoes, etc.

　　Prenatal examinations can timely eliminate potential hazards, providing a better developmental environment for the fetus, which is extremely important for both the mother and the fetus. Common abnormal phenomena and countermeasures are as follows:
　　1. Abnormal fetal position
　　The normal fetal position is vertex (i.e., the fetus is head down and buttocks up in the abdomen). Abnormal fetal position refers to breech (head up, buttocks down) or transverse position (i.e., head and buttocks horizontal), which is prone to premature rupture of membranes, umbilical cord prolapse, difficult labor, and increases the risk of fetal asphyxia or birth injuries.
　　Countermeasures: Before 28 weeks of pregnancy, an abnormal fetal position may correct itself, but if the fetal position has not been corrected after 7 months of pregnancy, it is necessary to correct the fetal position.

　　2. Prenatal Bleeding
　　Prenatal bleeding refers to the phenomenon of vaginal bleeding during the middle and late stages of pregnancy, which is often caused by diseases such as placenta previa, early detachment of the placenta, and rupture of the marginal blood sinus of the placenta, etc. The amount of bleeding is large, which may pose a risk to both the mother and the baby, and timely diagnosis and treatment are required.
　　Countermeasures: 1. Regular prenatal examinations should be carried out to detect factors that may cause prenatal bleeding in the early stage, follow the doctor's instructions or hospitalize in advance; 2. Rest in a horizontal position immediately when bleeding occurs, remain calm, as panic and impatience may increase bleeding, and seek help from others or call 120 for rescue; 3. Regardless of the amount of bleeding, go to the hospital for examination to determine the cause of bleeding, do not be negligent due to the small amount of bleeding and delay the disease.

　　3. Premature Birth
　　Premature birth is an important cause of neonatal death, referring to the delivery of a baby between 28 weeks and 37 weeks of pregnancy. Due to the different months of premature birth, the weight and life ability of the fetus at birth also vary greatly. The lighter the fetus's weight, the weaker the life ability, and vice versa. The main manifestations of premature birth are intermittent abdominal pain, which is different from painless physiological uterine contractions. The latter has no fixed interval or duration and no tendency to shorten, while the signs of premature birth are regular abdominal pain, accompanied by a small amount of vaginal bleeding or discharge.
　　Countermeasures: 1. Be vigilant, especially for those with a history of miscarriage or premature birth, reduce activities and seek medical treatment in a timely manner when signs of premature birth appear; 2. Fetal protection drugs do not affect fetal development and can be used with confidence; 3. Once premature birth is inevitable, choose a hospital with conditions for the treatment of premature infants for delivery to improve the survival rate of premature infants.

　　4. Fetal Malformation
　　Fetal malformation refers to structural or chromosomal abnormalities that occur in the fetus in the uterus. The causes of fetal malformation are complex, including genetic factors of the fetus itself, maternal or external environmental factors, and so on.
　　Countermeasures: Most non-fatal congenital malformations do not require surgical intervention during pregnancy, such as congenital heart disease, and can be treated surgically after birth. However, some fetal malformations may affect the safety of the fetus in utero and require intervention during pregnancy.