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Hoots : Which of these things is needed for a first time pregnancy checkup? My wife and I are now expecting our first child. She is 4 weeks and 7 days at the time of writing this. We are both under 30. I currently live in Dubai - freshhoot.com

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Which of these things is needed for a first time pregnancy checkup?
My wife and I are now expecting our first child. She is 4 weeks and 7 days at the time of writing this. We are both under 30.

I currently live in Dubai where I am British Expat and medical costing is very high. I decided rather than pay for each scan - most people just buy a "Package". There are few maternity packages. The mains ones are "Antenatal Package" and the next one is the "Delivery Package"

Below is a standard Antenatal package. Can anyone shed light on this - pro, cons, needed, side affects of the steps?

1) Initial Consultation
2) Initial Consult - Fetal Medicine
3) Follow up Visits -(11 visits)
4) Routine Laboratory tests:
a) CBC -(2 tests)
b) Blood Type & Antibody
c) HIV
d) Hepatitis B
e) Rubella
f) C/S Urine
g) Urinalysis Dip Sticks – ( 11 Sticks )
5) Ultra Sound Examinations -( 3 Scans)
6) Glucose Screening
7) Vaginal Swab
8) RPR

Thanks


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I am going to try and tackle this. If anything isn't covered or is unclear, please leave a comment.

1) Initial Consultation

That is, I assume, just the initial doctor's visit - taking your wife's health history, weight, blood pressure, etc. That is, of course, completely reasonable.

2) Initial Consult - Fetal Medicine

I am not completely sure what is meant with this. It might be giving you information on how to have a healthy pregnancy (what to do, what to avoid), or on how to deal with problems with the fetus if they occur. I'd need more information on this.

3) Follow up Visits -(11 visits)

Reasonable. Over the course of 36 weeks (from initial visit to estimated due date), a normal schedule for a healthy is one visit every month until the last trimester, where visits might be every two and later every week (when going over the due date, for example). One visit during month 3, 4, 5, 6 = 4 visits. Every two weeks during months 7, 8, and 9= about 7,which works out to more or less 11. It could also be 12 or more if problems arise or there are risk factors, but I am assuming a pregnancy with no risk factors here. For comparison, the NHS lists 10 such visits in its example schedule.The NIH lists a few more, with one weekly appointment in the last month.

4) Routine Laboratory tests:
a) CBC -(2 tests)

Yes, reasonable. This is a complete blood count, for detecting things like anemia (low hemoglobin), which can be used problem during pregnancy, or high infection markers. Again, the NHS has more information on this (they call it FBC - full blood count) .

b) Blood Type & Antibody

Blood Type - reasonable. At the very least you need to know your wife's rhesus type to know if rhesus incompatibility could be a problem.

"Antibody" is not enough information. I'd need to know what antibody tests this means.

c) HIV

HIV status is usually checked during pregnancy to prevent passing HIV to the child.

d) Hepatitis B

Same with hepatitis B

e) Rubella

Rubella infection during pregnancy is very dangerous for the fetus, checking whether the mother is immune helps determining whether the mother needs to be careful to stay away from people who might have it.

f) C/S Urine

This is for diagnosing urinary tract infections. I think it might be argued whether this is really necessary to do at the beginning of a pregnancy, but it's also not invasive and treating a UTI means it can't turn into a worse infection.

g) Urinalysis Dip Sticks – ( 11 Sticks )

Reasonable. A Urinalysis at every visit can detect issues such as diabetes, kidney problems, or pre-eclampsia. These issues need to be treated, and can turn dangerous (especially pre-eclampsia).

5) Ultra Sound Examinations -( 3 Scans)

Three ultrasound examinations are standard with the NHS. More may be needed for complicated pregnancies. Ultrasounds are not harmful for baby or mother. This seems reasonable.

6) Glucose Screening

This is screening for pregnancy/gestational diabetes. As mentioned above, diabetes during pregnancy [can be dangerous], but can be treated when detected. It's only recommended by the NHS and the Mayo Clinic if risk factors are present. Talk to your doctor if you are unsure, but the test itself is non-invasive (if not particularly pleasant, or so I hear).

7) Vaginal Swab

For ruling out Group B Strep and STDs, which may affect the infant during delivery. A PAP smear is routine during pregnancy and not dangerous.

8) RPR

This is a test for syphilis. Many US states mandate screening for this at the first prenatal visit. . Syphilis during pregnancy should be treated.

All in all, I think this looks reasonable and doesn't differ too much from recommendations in other countries, for example the NHS guidelines.


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