Pregnancy Journey

When you find out that you are pregnant, it is time to make an appointment with Eve Care Obstetrics Gynaecology!

Routine Antenatal visits:

First visit (around 10w): Specialist and  Midwife

• Complete History
• Physical examination
• Dating scan by Specialist
• Formulate a management plan for pregnancy
• Advice re exercise, diet, vaccinations
• Request blood tests 
• Request Screening tests for Down syndrome 
• Request anatomy scan
• Arrange registration with your chosen hospital

15 w visit- Specialist 

   19-20w - Anatomy scan with an external provider

20 w visit- Specialist 

   after 20 w visit to GP for Pertussis vaccine

24 w visit- Specialist 

    24-28 w - Fasting blood tests (GTT, Group and antibodies, FBC, Ferritin)

28 w visit - Specialist 

30 w visit - Midwife 

                     - comprehensive maternity care plan

32 w visit - Specialist

                     - alternate visits can be scheduled with the other doctors on the on-call list 

34 w visit - Specialist 

36 w visit - Specialist 

                    - Swabs for Group B Streptococcus

37 w visit - Specialist 

38 w visit - Specialist 

39 w visit - Specialist 

(also seen at 40 w if not in labour, delivery usually recommended by 41)

Delivery:

Elective Caesarean sections for instance repeat caesarean sections, Caesarean section for breech or low lying placenta, are done at 39 weeks.

• The due date is calculated for when a woman will be 40 weeks pregnant
• If a baby is born before 37 weeks it is regarded as preterm
• We recommend delivery by 41 weeks because it reduces the risk of fetal distress in labour 
• Certain conditions in pregnancy may lead to premature deliveries eg early rupture of membranes or preterm labour
• Certain conditions may cause high blood pressure or growth restriction

Postnatal visits: 

2 weeks post-delivery - Midwife



6 weeks post-delivery - Specialist

•  Discuss birth
•  Examination of the pelvic floor if a repair was done
•  Contraception options discussed
• CST did if due (cervical screening test, a test to prevent cancer of the cervix, replaced Pap smears)
•  Intrauterine device (eg Mirena, Kyleena, Copper IUD) inserted if requested
•  Referral for other tests, investigations if needed

The following  tests are routinely done on all pregnant women

• Blood tests: Blood Group and Antibodies, Full Blood Count, Syphilis, Hepatitis B, Hepatitis C, HIV, Rubella, Ferritin (iron stores), TSH (to assess thyroid function)
• Urine tests:  Microscopy, Culture and Sensitivity (to rule out infection), Chlamydia and Gonorrhoea
• A Cervical Screening Test (CST) if due
• Screening tests for genetic diseases ie a First Trimester Screen(FTS) or Non-Invasive Prenatal Testing(NIPT)
• Ultrasounds: an early ultrasound to ensure the pregnancy is in the uterus and is viable, a scan at 11-13 weeks as part of FTS or an early anatomy scan at 13-14 weeks if NIPT has done, an anatomy scan 19-20 weeks
• We recommend Influenza vaccinations (when it becomes available) and Pertussis vaccine  (after 20 weeks) for all pregnant women
• Swabs for  Group B Streptococcus at 36 weeks for all women planning to have a vaginal birth

Pregnancy complications

Most pregnancies are healthy and remain low risk throughout.  Unfortunately, this is not the case for everyone.  If complications do arise:

• Women are seen more frequently
• More tests are done eg blood tests, ultrasound scans
• Women may have to be delivered early