Antenatal (pregnancy) check up
The duration of a normal pregnancy is 9 months and 7 days (40 weeks), calculated from the 1st day of the last menstrual period (LMP).
A full term pregnancy is anywhere between 37 to 40 weeks.
A full term pregnancy is divided into 3 trimesters:
- 1st trimester: Upto 12 weeks (3 months)
- 2nd trimester: 13- 28 weeks (6 months)
- 3rd trimester: 29- 40 weeks (9 months)
If you deliver before 37 completed weeks, it is said to be a preterm delivery.
Results of the test
A positive test result is almost certainly correct. If you get a negative result but still think you are pregnant, you must consult your obstetrician for further investigations.
Congratulations!!! If the pregnancy test is positive, what next?
- You must take an appointment with your gynecologist at the earliest. A thorough history and examination is the important to have a healthy mother and a healthy baby.
- Eat healthy, preferably avoid outside food.
All other instructions about tests required, medications needed and further check ups will be given to you.
Remember that pregnancy is not an illness or disease and you are not sick! You need to be careful and more cautious than normal but it is a natural phenomena which you body can handle. So don’t worry!!!
Antenatal Check up Schedule
Every once a month till 28 weeks (end of 6th month)
Every 15 days from 28 weeks till 36 weeks (end of 8th month)
Every 7 days from 36 weeks till delivery
If your gynecologist feels the need to see you more often, you will be told accordingly.
What do you expect in each trimester?
1st trimester (1st 12 weeks)
- Amenorrhoea – Missed period
- Morning sickness- Usually disappears after the 3rd or 4th month
- Frequency of passing urine – because the uterus presses on the bladder. It usually disappears after 3 months as the position of the uterus changes
- Breast discomfort –fullness or heaviness of breast, increase in breast size, darkening of nipple
- Fatigue and tiredness- due to hormonal changes
2nd trimester (13-28 weeks)
- Quickening- 1st feeling of baby’s movements usually around 18-22 weeks (5th month
- Enlargement of lower abdomen
- Pigmentation of forehead or cheeks, pigmentation in the midline of abdomen and stretch marks more on thighsBreast enlargement
- Fetal heart sounds can be heard by stethoscope around 18- 20 weeks and hand Doppler as early as 12-14 weeks
3rd trimester (29- 40 weeks)
- Enlargement of abdomen continues
- Lightening- sense of relief of pressure symptoms as the head starts going down
- Frequency of passing urine reappears as the head presses on the bladder
- Fetal movements are more pronounced
Minimum screening tests (done in all pregnant women)
- Blood group
- Urine routine and microscopy
- Blood sugar levels
- Thyroid function tests
- HIV, HBsAg, VDRL
- Screening for Down’s syndrome (Double marker test)
The above blood tests are done for all pregnant women in the 1st antenatal visit and repeated at regular intervals throughout pregnancy, which is necessary because at different stages of pregnancy, results of the tests are interpreted differently.
If any additional tests are required, your doctor will advise you and you must do it because each pregnancy is different and if you have any high risk factor complicating your pregnancy you will need additional special tests.
Important timings of sonography in pregnancy
- 1st trimester (9-11 weeks): Dating and Nuchal translucency (NT scan)
- 2nd trimester (18-20 weeks): Anomaly scan
- 3rd trimester 32 weeks: Fetal well being
- Full term 37 weeks: Estimated fetal weight, amount of liquor
The above are the minimum sonographies needed in pregnancy and give us very important information at the timings mentioned. These should not be missed. Depending upon your condition, if you need additional sonographies, you will be advised.
Diet in pregnancy
A healthy diet and lifestyle can help you to keep well during pregnancy and give your baby the best possible start in life. The older concept of “eating for two” in pregnancy is not entirely correct. However, you do require more micronutrients and macronutrients to support you and your baby. The mommy-to-be should eat every 2 to 3 hours, preferably 5 times a day – three regular meals and two small meals or snacks during the day.
Consuming products prepared from whole grain like chapatis, breads, pasta and noodles. It is important to consume five servings of fresh fruits and vegetables.
It is advisable to reduce the intake of sugary food products. Increase in blood sugar levels could increase your chances of gestational diabetes.
Try and eat home cooked food as far as possible. Avoid outside food. Avoid excess oil, spices and fats.
Which foods should you avoid?
- Alcohol – One of the reasons is that, even moderate drinking in pregnancy may affect child’s IQ.
- Avoid calorie rich food, food cooked in oil, poultry with fat on it.
- Avoid drinking preserved or packaged juices, it contains additional sugar and preservatives.
- Avoid excessive caffeine intake
Lastly, remember your diet has to be well balanced.
||Additional daily requirements for pregnant women
||300 (in the second and third trimesters
|Folate (folic acid)
Daily requirement of nutrients in pregnancy
Why do pregnant women need iron?
Since iron deficiency anaemia is prevalent in 50-60 % indian women, dietary consumption of iron rich foods is important throughout pregnancy. Iron deficiency anemia can lead to complications in the mother and baby. All patients will be prescribed iron tablets, which should be taken regularly in addition.
Sources of iron:
- Chicken, mutton chops, fish
- Vegetables – like broccoli and spinach, pumpkin, tomatoes, asparagus, beetroot, mushrooms, beans and lentils.
- Fruits- Watermelon, grapefruit, oranges, apples, banana, strawberries
- Whole grains
Sources of folic acid:
- Green veggies
Why do pregnant mothers need protein? : Along with iron, amino acids present in protein also forms as a component of the building blocks of cell formation. Protein intake increases in the second and third trimester.
Sources of protein:
- Poultry – lean meat
Healthy pregnant mothers need Fiber: Lack of fiber will leave you in pain and feeling uneasy. Constipation is caused due to lack of fiber, it can also cause piles.You can have an easy going pregnancy by avoiding certain foods for constipation.
Sources of fiber:
- Drink plenty of water
- Beans, broccoli, cabbage, carrots, French beans, green peas and spinach
- Cooked vegetables are better for the digestive process than raw veggies.
- Whole grains
- Fruits – Peaches, pineapple, pear, berries, apples and papayas
- Dried fruits
Why pregnant mothers need Calcium: Calcium helps in bone development.
Sources of Calcium:
- Dairy products
- Broccoli, green leafy vegetables
Why do pregnant mothers need Vitamin D?
Vitamin D maintains the proportions of calcium and phosphorus.
Sources of Vitamin D:
Weight gain in pregnancy
|BMI ( As per pre pregnancy)
||Recommended weight gain (kg)
|Underweight (less than 19.8)
||12.5 – 18
|Healthy weight (19.8 – 26)
||11.5 – 16
|Overweight (26.0 – 29.0)
||7 – 11.5
|Obese (more than 29.0)
||6.0 – 8.0
BMI = weight in kg/ height in m2
Exercise in pregnancy
The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain. It will also help you to cope with labour and to get back into shape after the birth.
Keep up your normal daily physical activity or exercise (sport, dancing or just walking to the shops and back) for as long as you feel comfortable. Don’t exhaust yourself, and remember that you may need to slow down as your pregnancy progresses or if your doctor advises you to. As a general rule, you should be able to hold a conversation as you exercise. If you become breathless as you talk, then you are probably exercising too strenuously.
If you were inactive before you were pregnant, don’t suddenly take up strenuous exercise. If you start an aerobic exercise programme, begin with no more than 15 minutes exercise, three times per week. Increase this gradually to a maximum of 30-minute sessions, four times a week.
Avoid any strenuous exercise in hot weather. Drink plenty of water and other fluids. Your body temperature should not increase suddenly during exercise.
Exercises safe in pregnancy
- Walking – 30 minutes per day
- Aquanatal exercises
If you go to exercise classes, make sure that your teacher is properly qualified and knows that you are pregnant and how far your pregnancy has progressed.
Exercises to avoid
- Lying flat on your back – particularly after 16 weeks. The ‘bump’ presses on the big blood vessels and can make you feel faint.
- Contact sports where there is a risk of being hit, such as kickboxing, tennis, judo or squash.
- Cycling, gymnastics, horse riding because there is a risk of falling.
- Scuba diving, because the baby has no protection against decompression sickness and gas embolism.
- Exercising at heights over 2,500 metres until you have acclimatized. This is because you and your baby are at risk of acute mountain sickness (decrease in oxygen).
In the first trimester all pregnant women will be prescribed folic acid supplements. Some may be prescribed progesterone tablets to maintain a healthy pregnancy. If you have any high-risk conditions, you may need additional medication.
From the 2nd trimester onwards, all women are prescribed iron and calcium tablets, which should be taken regularly. If you have any high-risk conditions, you may need additional medication.
DO NOT take any medication on you own or prescribed by any one other than your gynaecologist
Sex during pregnancy
Should be avoided in the first trimester and last 3-4 weeks of pregnancy. Otherwise it is not harmful. However, if you have any complications you may be advised against it.
Travel during pregnancy
Travel by vehicles having jerks and on bad roads is better avoided in the 1st trimester and the last 6 weeks of pregnancy. Long journeys are best restricted to 2nd trimester. Train is preferable to bus. Air travel is considered safe due to pressurized air cabins, but different airlines have different rules about the duration of pregnancy upto which travel is allowed.
Warning Signs/ When to report to the gynaecologist?
- Sudden, acute pain in abdomen
- Abnormal Rash anywhere on the body
- Vaginal spotting/ bleeding
- Burning while passing urine
- Abnormal vaginal discharge
- Excessive nausea and vomiting hampering your daily activities
2nd / 3rd trimester
- Pain in lower abdomen
- Excessive backache
- Vaginal spotting/ bleeding
- Sudden gush of watery fluid per vaginum
- Decreased/ absent fetal movements
- Severe headache
- Nausea/ vomiting
- Pain in epigastric (upper chest) region
- Blurring of vision/ Double vision
- Decreased urination
Most importantly, enjoy your pregnancy! A happy mother is the key to a happy pregnancy and healthy baby!
At Kale Women’s Wellness Clinic, we provide an all round package which takes care of all your pregnancy till delivery. We offer antenatal check ups and ultrasonography all under one roof. We ensure that you will have the best experience throught your 9 months with us!