If you have a normal pregnancy your scheduled visits will be monthly until 24 weeks, then every 2 weeks until 35 weeks, then weekly until delivery. At each visit we will record your weight and blood pressure, check your urine, listen to the baby’s heartbeat and assess the baby’s growth. A doctor will always see you at every visit. During your first visit we perform a thorough health assessment, gather information and perform an initial ultrasound.
Some appointments will include specific events as follows:
1st Visit– At your first visit you will have a detailed intake and you will meet your doctor. A pap smear will be performed if you are 21 or over and routine blood work will be performed. Tests for chromosomal abnormalties are optional tests available to help detect chromosome abnormalities such as Down syndrome. It is a personal decision whether to have these tests performed. Some reasons would be maternal age greater than 35 years old, a prior infant with abnormalities, or personal preference. If you are interested in these tests, we can have one or more scheduled.
6-12 weeks from last period- A pelvic exam and pap smear will be done as well as tests for vaginal infection. A standard panel of blood tests will be done to check your blood type, blood count, immunity to Rubella, as well as tests for exposure to HIV, hepatitis and syphilis. An ultrasound will be done to confirm your due date and check for viability. First trimester screening for Down’s syndrome and other chromosomal abnormalities (“Ultrascreen”) will be offered. Other necessary tests based on your individual health assessment will be done.
2nd visit– We confirm viability of your baby.
15-20 weeks from last period- An optional ultrasound may be performed to see the sex of your baby, if you want to find out early. This ultrasound is not considered medically necessary and will not be covered by insurance. An alpha-fetoprotein (AFP) test for spina bifida will also be offered. If you are having an amniocentesis it will be scheduled at about 16 weeks. A detailed ultrasound of the baby’s anatomy will be scheduled as a separate appointment between 20-22 weeks, at which time we can usually see the sex of the baby (this ultrasound is covered by most insurance.)
24-28 weeks– Testing for gestational diabetes will be done. You will be given a sweet drink and your blood will be drawn an hour later to screen for diabetes. If your first test is high you will be asked to do a second test that takes 3 hours. If your blood type is RH negative (eg. O-, B-, A-, AB-) you will receive a shot of Rhogam at about 28 weeks. It is very important that you obtain this medication so that your baby and all future babies can remain healthy.
At this time we will begin reminding you to register at the hospital, sign up for a childbirth class if desired, choose a pediatrician, and consider issues such as cord blood banking and circumcision.
35-40 weeks– Testing for GBS (Group B Strep) will be done with a vaginal/anal swab. GBS is a harmless bacterium that many people carry without symptoms, but can rarely lead to a serious neonatal infection. If you are a carrier we will give you antibiotics when you are in labor to prevent neonatal infection. Your cervix will be checked weekly for dilation and effacement, and to make sure the baby’s head is down. If you haven’t met all the doctors in the practice, you will be given an opportunity to do this before you deliver if you wish to.
Visit us if you are a resident of the greater Houston area, including The Woodlands, Cypress, Spring, Pearland and Sugar Land.