In providing care for a woman who is pregnant, a doctor may recommend:
- An ultrasound at least once during the pregnancy to ensure that progress is satisfactory. This can also help date a pregnancy if the delivery date is uncertain. It can help detect multiple pregnancy or potential risks such as placenta previa and ectopic pregnancy, the positioning and size of the fetus
- Taking steps to monitor the fetus if it appears to be in distress
- Procedures to diagnose before birth any abnormalities the fetus may have such as hydrocephaly, congenital heart defects, bowel or urinary tract obstructions or polycystic kidney disease.
- A fetoprotein (AFP) test should be given at 15 to 16 weeks. If AFP levels are high, it may mean that the fetus has spina bifida or other neural tube defect, multiple pregnancies or an inaccurate due date. If AFP levels are too low, there may be genetic abnormalities.
- A screening for abnormal carbohydrate metabolism around the first 12 weeks or so of pregnancy if a woman has a history of large newborns, unexplained fetal losses, repeatedly has sugar in her urine or a strong family history of diabetes
After the first visit, a pregnant woman should see her doctor again on the following schedule:
- Once a month until she reaches the 32nd week of pregnancy
- Once every two weeks until she has reached her 36th week of pregnancy
- Once a week until the baby is delivered
This allows the doctor or the doctor's assistant to check her vital signs, including blood pressure, weight and the size and shape of her uterus as the baby grows. The doctor will listen for the heart beat of the fetus. The patient will be checked for swollen ankles. Her blood sugar levels and urine will also be checked.
An average sized woman should expect to gain 25 to 30 pounds during her pregnancy -- about two to three pounds a month. It is important that mother and fetus get good nutrition as the fetus grows. Too much weight gain too early can deposit fat on both the fetus and the mother making pregnancy, labor and delivery potentially more difficult.
During this time a woman should ask questions and prepare for labor and delivery. She, her spouse or other support person should attend childbirth education classes.
Because anything that a pregnant woman eats or drinks circulates to her fetus, she should avoid any drugs (including vitamins and aspirin) unless her doctor prescribes them.
A doctor may prescribe iron supplements or folic acid supplements. Folic acid can help prevent neural tube defects.