Antenatal Care

Why is Antenatal Care Important?

Antenatal care is important because it:

• Allows for early identification and management of potential health problems during pregnancy, such as gestational diabetes, hypertension, or pre-eclampsia.
• Includes regular check-ups and tests to monitor the growth and development of the foetus, such as ultrasound scans and non-invasive prenatal testing (NIPT).
• Provides education and counselling on a wide range of topics related to pregnancy and childbirth, such as nutrition, exercise, labour and delivery, breastfeeding, and postpartum care.
• It helps reduce the anxiety and stress women may experience during pregnancy.
• Helps to coordinate care between obstetricians, midwives, and other doctors, as well as connecting new parents with support services as needed.
• Has been linked to better outcomes for both mother and baby, such as fewer premature births, low birth weight, and infant mortality.
• It offers a way for a woman to build a relationship with her doctor, which can be helpful when giving birth. This relationship can be especially beneficial for women who are anxious or have complicated pregnancies.

What to Expect During Pregnancy?

During pregnancy, a woman can expect to experience a wide range of physical and emotional changes as her body adjusts to the growing foetus.

Some of the most common changes that women experience during pregnancy include:

• Nausea and vomiting
• Fatigue
• Breast changes
• Mood changes
• Cravings and aversions
• Constipation
• Heartburn and indigestion
• Back pain
• Swelling
• Changes in the skin
• Weight gain
• Vaginal discharge

Every pregnancy is different, and not all women will experience all of these symptoms. It is also essential to have regular antenatal check-ups with a doctor to ensure that both mother and the baby are healthy throughout the pregnancy.

Tips for a Health Pregnancy

To have a healthy pregnancy, it is essential to:

• Get early antenatal care
• Eat a healthy diet
• Take antenatal vitamins
• Avoid alcohol, tobacco, and drugs
• Get regular exercise
• Get enough sleep
• Manage stress
• Follow the doctor's instructions

Consult with our doctors to determine which healthy habits will most benefit you during your pregnancy.

Possible Pregnancy Complications

Pregnancy can be a joyful and exciting time, but it can also come with certain complications that can be dangerous for both the mother and the baby. Some possible pregnancy complications include:

• Miscarriage: A miscarriage is the loss of a pregnancy before 20 weeks. About 10-25% of all pregnancies end in miscarriage.
• Ectopic pregnancy: An ectopic pregnancy occurs when the fertilised egg implants outside the uterus, usually in the fallopian tubes. This is a severe condition that requires immediate medical attention.
• Preterm labour: Preterm labour occurs before 37 weeks of pregnancy. Preterm birth is associated with several health problems for the baby, such as respiratory distress and developmental delays.
• Placental abruption: Placental abruption occurs when the placenta separates from the uterus before delivery, which can cause bleeding and can be life-threatening for both the mother and the baby.
• Gestational diabetes: Gestational diabetes is a type of diabetes that develops during pregnancy. It can cause high blood sugar levels, which can be dangerous for the mother and the baby.
• Preeclampsia: Preeclampsia is a severe condition that can occur during pregnancy and is characterised by high blood pressure and protein in the urine. If left untreated, it can lead to serious health problems for the mother and baby.
• Stillbirth: A stillbirth is the loss of a baby after 20 weeks of pregnancy.
• Congenital disabilities: Some congenital disabilities, such as neural tube defects, can occur during pregnancy, which affects the baby's brain and spinal cord.
• Group B streptococcus (GBS) infection: GBS is a bacterial infection that can occur during pregnancy and cause serious illness in newborns.
• Postpartum Haemorrhage: excessive bleeding after childbirth, which can be life-threatening if not treated quickly.

Most pregnancies proceed without complications. It is crucial to have regular antenatal check-ups to detect any potential problems early on and to follow the doctor’s instructions to ensure a healthy pregnancy and delivery.

Antenatal Screening and Counselling

Antenatal care includes regular medical visits, screening tests, and diagnostic tests to help assess your health status and keep you and your baby healthy during pregnancy. 

The routine visits to the doctor are scheduled so any problems present may be recognised and treated well in advance. These visits also educate you on handling various aspects of your pregnancy. Your doctor will discuss healthy eating, activity, screening tests necessary and what can be expected during labour and delivery.

There are several antenatal tests to assess the development of the baby in your womb. Antenatal tests are done at a stipulated time, from 8-10 weeks of gestation to 20 weeks. Before an examination, counselling will assist you in deciding the type of test based on the advantages and disadvantages of each.

Antenatal screening tests such as ultrasound and first-trimester and second-trimester screening are done to determine whether your baby is at risk of having a particular genetic condition such as Down's syndrome or other abnormalities. You should have antenatal screening done mainly if you have the following conditions:

• One of your near relatives or your previous child has a severe genetic anomaly
• If you or your partner are "carriers" of a faulty gene
• You are in your mid 30's or older
• Long-term exposure to chemical or other harmful environmental agents

However, it is always better to have antenatal screening tests done, irrespective of age or family history.

First Trimester Screening

The first-trimester screening is done between 11 and 14 weeks of gestation, including blood tests and an ultrasound examination. It is done to detect the risk of abnormalities such as Down's syndrome and trisomy 18. 

The blood tests determine the level of pregnancy-associated plasma protein-A and human chorionic gonadotropin in your blood.

The nuchal translucency screening test, ultrasound examination, measures the thickness of the back of the foetal neck. Ample space or increased space indicates Down's syndrome, trisomy 18 or other chromosomal abnormalities. 

If first-trimester screening tests are positive, your doctor may suggest a more detailed examination at around 20 weeks of pregnancy.

Second Trimester Screening

During this period, multiple marker screening is done to screen for Down's syndrome, trisomy 18 and neural tube defects. The test measures the concentration of alpha-fetoprotein and hormones estriol, human chorionic gonadotropin, and inhibin-A in the mother's blood. These tests are done between 15 and 20 weeks of gestation.

Combined Screening

The combined reports of the first and second trimesters may yield more helpful information about diagnosing Down syndrome.

Suppose the screening tests indicate a problem in the baby. Further diagnostic tests such as detailed ultrasound, amniocentesis, chorionic villus sampling and cordocentesis may be done to check whether the baby has a defect.

After the screening, genetic counselling will support you with other decisions if your baby is found to have an increased risk for developing a chromosomal abnormality or if a problem is detected with diagnostic testing. Genetic counselling provides you with the chance to discuss the following issues:

• The outcome of the results of antenatal tests
• Options available
• Additional testing, its advantages and disadvantages
• The course of action that can be taken