Antenatal Care

Combined medical services are provided free of charge by your family doctor (GP) and a hospital obstetrician through the Maternity & Infant Scheme.

We have developed this handout  help guide you through your pregnancy and it may be used as a document holder for any blood tests, correspondence or antenatal scans that you may have outside of the your routine  hospital antenatal attendance.

 

Confirmation of Pregnancy

At GP Care we offer a blood screen at your initial pregnancy assessment. This screen includes:

  • Full blood count (iron levels)
  • Blood type (incl. Rhesus status)
  • Kidney, liver and thyroid function tests
  • Vitamin B12 and folic acid tests
  • An infectious disease screen (HIV, Hepatitis B, Hepatitis C & Syphilis)
  • Antibody testing for Rubella
  • A parvovirus B19 (slapped cheek) antibody screen. may be advised for expectant mothers in regular contact with young children (childcare workers, teachers etc.)

 

Ante-Natal Visits

First Visits:

  • GP
    • Confirmation of pregnancy with nurse/doctor
    • Optional confirmation by blood test
    • Optional antenatal blood screen
    • Referral sent to hospital for antenatal care
    • Discuss vaccination
  • Hospital
    • Each mother should be seen in the hospital for a “booking visit” between 12 – 20 weeks
    • An ultrasound scan is usually performed to date the pregnancy and assess the development and health of the fetus

Following this initial assessment most visits involve:

  • Blood pressure check
  • Weight check
  • Measurement of fundus height (bump size)
  • Urine check
  • Doppler to measure fetal heart rate after 16 weeks
  • Management of any maternal concerns surrounding pregnancy

 

Schedule of Routine Appointments

  • Weeks 12 – 20   Hospital Visit
  • Weeks 21 – 27   GP Visit
  • Weeks 20 – 24   Hospital Visit (Fetal anomaly ultrasound scan)
  • Weeks 28 – 30   GP Visit
  • Weeks 31 – 32   Hospital Visit
  • Weeks 33 – 34   GP Visit
  • Weeks 35 – 36   Hospital Visit
  • Week 37               GP Visit
  • Week 38               Hospital Visit
  • Week 39               GP Visit
  • Week 40               Hospital Visit

 

Vaccination in Pregnancy

Vaccinations have been proven to be both safe and effective in safeguarding mothers and their babies. In pregnancy we offer two vaccines to expectant mothers:

Influenza

  • The seasonal influenza (Flu) vaccine is offered to all mothers and can be given at any time during pregnancy.  As pregnant women are much more likely to suffer the potentially life-threatening complications of influenza infection so we strongly promote that our patients receive the vaccine.

Pertussis (Whooping Cough)

  • The pertussis vaccine protects the new-born baby from whooping cough. Whooping cough can be potentially fatal in babies and  is unfortunately one infection for which there is little innate immunity from maternal antibodies. This vaccine can be given from 16 – 32 weeks of pregnancy.

 

Post-Natal Care:

Following delivery every baby is entitled to two free GP visits as part of the Maternity and Infant scheme. These scheduled visits are performed at two and six weeks of age during which time you will meet both the nurse and doctor. The visit is structured to check the following:

  • Any parental concerns
  • Baby’s weight and development
  • A full physical exam checking baby from head to toe
  • Assessment of feeding
  • Discussion of childhood immunisation scheme

Mother’s are  also entitled to a free visit at six weeks during which the following will be   assessed

  • Any concerns mum may have
  • Blood pressure
  • Weight
  • Contraception options if desired

 

Miscarriage and Bleeding in Pregnancy:

Miscarriage is always a concern during pregnancy and 1 in 5 pregnancies do end is miscarriage. Should you experience any bleeding it is therefore very important to contact your doctor for advice. Many women may have a small amount of bleeding (spotting) at the time of their missed period. This is sometimes called an ‘implantation bleed’. It happens when the fertilised egg implants itself in the wall of your womb (uterus) and is harmless.

Unfortunately, the most common cause of bleeding after the time of a missed period is miscarriage. Should you have bleeding after becoming pregnant, please contact the practice for advice. If bleeding is painless we will perform an abdominal examination, a blood test and arrange an ultrasound to assess for miscarriage.

Severe abdominal pain, with or without bleeding, especially if that pain is sharp or one-sided, may be a sign of ectopic pregnancy. An ectopic pregnancy is a pregnancy outside of the uterus and needs in-hospital care. If there is concern for an ectopic pregnancy an urgent visit to the hospital is advised.

Many women and their partners find that miscarriage is distressing. Feelings of shock, grief, depression, guilt, loss and anger are common.

It is best not to bottle up feelings but to discuss them as fully as possible with someone  who can listen and provide support.

If extra support is needed our doctors are always here to help.

 

Ultrasound Scans

Early Pregnancy Scan

From 8 – 13 weeks of pregnancy.

The Sonographer will

  • Check the baby’s heartbeat
  • Estimate expected due dates
  • Check for a twin/multiple pregnancy

High resolution images of your scan will be printed out and given to you with our reported clinical findings.

Estimating gestational age can be helpful, especially if you are unsure of your last menstrual period or have irregular periods. Early ultrasound evaluation has been proven to be the best prediction of gestational age especially before13 weeks gestation.

 

Gender Scanning

Performed from 18 weeks of pregnancy.

Gender assessment can never be guaranteed with ultrasound scanning but our highly experienced sonographers and state of the art equipment can give an opinion that will be 95% accurate.

High resolution images of your scan will be printed out and given to you with our reported clinical findings.

 

2nd and 3rd Trimester Scan

This scan is performed from 14 – 35 weeks of pregnancy.

A general overview of fetal wellbeing will be performed assessment

  • Presentation
  • Fetal movements
  • Fetal heart rate
  • Liquor (amniotic fluid) volume
  • Abdominal circumferance

If there are any concerns on this scan you will arrange urgent review with the GP or obstetrician as required.

 

Presentation Scan

This scan is performed from 36 weeks of pregnancy.

This scan will assess:

  • Placement of placenta
  • Presentation of baby

A report will be given for your records along with black and white images.

If there is any concern about the findings of this scan you will be referred for in-hospital assessment by your obstetrician.