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BOOKING IN IROUTINE TESTS
Your first ante-natal check-up will take place between eight and 12 weeks, either at your doctor's surgery or at the hospital where you plan to give birth. This first visit is usually referred to as the booking-in clinic. You will be asked a lot of personal questions about your health, family medical history, and possibly even about your and your partner's jobs and living accommodation. All this information is required to build up a picture of you and your pregnancy so that any potential risks can be spotted and help can be offered where needed.
If you have any questions or worries, this is a good time to discuss them. It's easy to forget to ask something important when there is so much to take in at one time, so it may help to write down things that you want to know about before you attend the clinic.
ROUTINE TESTS
Certain tests are carried out during pregnancy to ensure that both you and the fetus are progressing well. Some of these will be repeated at each ante-natal visit; others are only carried out at the booking-in clinic.
Blood pressure This will be taken at each visit. Increased blood pressure could develop into pre-eclampsia, which could endanger both you and the fetus.
Urine You will be asked to bring a sample of urine with you to each ante-natal visit. This will be tested for any infections that may require some treatment, as well as for sugar, protein, or the chemical substances known as ketones. Sugar in the urine could be a sign of diabetes; protein may indicate the onset of pre-eclampsia; and ketones may indicate that your kidneys are being adversely affected by your pregnancy.
Weight Your weight may be monitored regularly to see how the baby is growing, although not all doctors do this. You can expect to gain anything from 6 kg to 19 kg/20 lb to 40 lb during your pregnancy, with most of this extra weight going on after the 20th week. A sudden increase in weight could be an indication of pre-eclampsia.
Height You will be measured at your first appointment because your height gives a rough guide to the size of your pelvis. If your pelvis is too small to accommodate your baby's head at the birth, then a Caesarean delivery may be indicated. It is worth noting, however, that most babies are in proportion to the mothers who carry them.
Blood tests At your first appointment you will be asked to give a blood sample to confirm your blood group and to find out if you are rhesus negative or positive.
Your blood will also be checked to see if you are anaemic and if you are immune to rubella (German measles). Other tests are also carried out to detect any serious conditions that could affect your baby, such as syphilis and hepatitis B. If you are of Afro-Caribbean descent, they will test your blood for sickle-cell disease; if you are of a Mediterranean ethnic group they will test for thalassaemia.
Sometimes your blood will also be tested anonymously to see if the HIV or AIDS virus is present.
Internal examination You may have an internal examination at your booking-in clinic. This is to check for any abnormalities of the vagina, cervix, or uterus. If you haven't had a cervical smear test during the last three to five years you may well be given one.
Wrists and ankles These will be checked at each visit for swelling, or oedema, caused by fluid retention, since these signs could possibly indicate pre-eclampsia.
Palpation The doctor or midwife will palpate, that is press, your abdomen to feel the top of the uterus (fundus). He or she will then feel down towards the pelvis to check the size of the fetus and the way it is lying.
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