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“two means three, I wonder what fate is gonna decide.
We‘re just sitting around waiting on two pink lines, sitting around on waiting on two pink lines.”
Whether your pregnancy was meticulously planned, medically coaxed or happened by surprise, one thing is certain – your life will never be the same.
No two pregnancies are alike. Pregnancies may be different even in the same individual. The duration of a pregnancy is 280 days or 40 weeks. The pregnancy is divided into three trimesters as each has its own significant milestones.
1st trimester is the time from pregnancy detection till 12 weeks. Though there are no external visible physical changes, internally the pregnancy hormones cause various symptoms like nausea, vomiting, fatigue, intolerance to certain smells, breast tenderness etc.
During the first antenatal visit, the doctor will take a detailed history to identify possible risk factors and do a check on your booking weight, vitals, checking breasts to identify retracted or flat nipples. They will start the patients on folic acid if they aren’t already on the medication. Patients will be advised to abstain from alcohol and smoking. A few blood tests will be advised and ultrasound may be performed to confirm the wellbeing of the pregnancy.
2nd trimester is from 12 to 28 weeks. The first trimester symptoms usually subside and women start to feel a little better. Around 12 to 13 weeks, they will be asked to repeat an ultrasound where certain parameters will be checked on the developing fetus. These parameters identify the risk of Down’s syndrome and other chromosomal conditions in the fetus. The ultrasound is 70 - 80% sensitive in detecting such fetuses. To further enhance the sensitivity, a dual marker or double marker is performed. The sensitivity of detecting such fetuses increase to 80 to 90 % with the scan and blood test.
Tests like GTT is usually advised around 16 to 18 weeks to check for gestational diabetes mellitus ( GDM ).
The organogenesis phase ( formation and development of internal organs) in the fetus is usually complete by 18 weeks. Therefore an anomaly scan is usually advised around 19 to 20 weeks to ensure the development of internal organs.
Till now, the pregnant woman may or may not gain weight and some with symptoms of severe vomiting may even lose weight. After 20 weeks, women usually gain 1 to 2 kgs/month. The normal weight gain in pregnancy is 10 to 12 kgs. Any excessive increase in weight should warrant further testings to rule out GDM, pre-eclampsia ( high BP) etc.
The baby bump starts being visible around 16 to 18 weeks. The women will start feeling the movements around this time. Initially, it is felt as few flutters which become more pronounced as the pregnancy advances.
Iron and calcium supplements are started around the same time. Pregnant women are advised to consume a diet rich in dairy products, legumes, green leafy vegetables, fruits etc. Meat and eggs are good sources of proteins and should be consumed in moderation.
Regular exercises during pregnancy help you stay healthy, improve posture and help with backache and fatigue. It improves blood sugar levels in GDM and builds up stamina for labour and delivery. The American College of Obstetrics and Gynaecology recommends at least 30 minutes of exercise per day on most days.
In India, 2 doses of TT are recommended 4 weeks apart. CDC recommends 1 dose of the T Dap vaccine from 27 to 36 weeks.
Till 28 weeks, a low-risk pregnant woman needs to visit the doctor once a month where her weight gain, BP and baby growth are assessed clinically.
Blood tests like CBC, GTT and urine tests will be repeated.
3rd trimester is from 29 weeks till you deliver. The baby movements become more vigorous. The women may experience abdominal tightness, backache, fatigue, frequent urination, heartburn, constipation etc.
As the due date approaches, the women may experience painless uterine contractions called Braxton Hicks contractions.
From 29 to 36 weeks, visits will be fortnightly, and weekly henceforth till you deliver. During each visit, weight gain, BP, clinical size and position of the fetus and fetal heart rates are checked.
An ultrasound may be performed at 30 to 32 weeks to assess the growth of the fetus.
Closer to the due dates a vaginal examination may be performed. Watch out for any pain abdomen that starts increasing in intensity and frequency, any bleeding P/V, any leak P/V or reduced fetal movements. If any of these symptoms develop, please visit your doctor immediately.
Discuss the birth plan and the requirement of analgesics if needed. Knowing what to expect can have a positive birth experience.
This journey is nothing but nine months preparing to fall in love for a lifetime.
For normal delivery, visit Manipal Hospital the best gynecology hospital in Whitefield, Bangalore. They offer pregnancy checkups in Whitefield and have some of the best gynecologist in Whitefield, Bangalore working 24/7 to take of you and your baby.
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