OB/GYN Visits During Pregnancy Trimesters

Aug 25, 2024

OB/GYN Visits in Trimesters

Introduction

  • Overview of what happens during OB/GYN visits in the first, second, and third trimesters.
  • Reference to maternity flashcards available at leveluprn.com.

First Trimester (up to 12 weeks)

  • Initial Visit: Typically only one visit unless pregnancy is confirmed very early (e.g., 6 weeks).
  • Ultrasound: Used to confirm fetal heartbeat, as the baby is too small for Doppler.
  • Laboratory Tests:
    • CBC: Check for anemia or infection.
    • STI Testing: Mandatory in many states.
    • PAP Test: Administer if due.
    • Blood Typing: Including Rh factor (important for later care).
    • Hepatitis B, HIV tests.
    • HCG levels for high-risk patients (multiple miscarriages).
  • Maternal Teaching: Overview of education about pregnancy and care.
  • Follow-up Visits: Monthly visits until 28 weeks.

Second Trimester (14 to 28 weeks)

  • Key Tests:
    • MSAFP: Maternal Serum Alpha-Fetoprotein testing between 14-18 weeks; abnormal results may lead to amniocentesis.
    • Gestational Diabetes Screening: For high-risk patients earlier than usual.
  • Anatomy Scan: Between 18-22 weeks to check for fetal abnormalities.
  • Fundal Height Measurement:
    • Begin measuring fundal height from pubic symphysis to the fundus.
    • Should correlate with gestational age (e.g., 24 weeks = 24 cm).
  • Gestational Diabetes Screening:
    • Routine testing between 22-24 weeks (one-hour oral glucose test).
    • Possible follow-up with a three-hour test.
  • Cervical Length Assessment: Transvaginal ultrasound for first pregnancies to assess preterm labor risk.

Third Trimester (28 weeks and beyond)

  • RhoGAM Administration: Given at 28 weeks if patient is Rh-negative.
  • Increased Frequency of Visits: Every two weeks after 28 weeks.
  • Patient Education:
    • Kick counts start at 30 weeks to assess fetal well-being.
    • TDaP vaccine offered at 30 weeks for maternal and fetal protection.
  • Nonstress Tests (NST): May be performed based on indications from 35 to 37 weeks.
  • Group B Strep Screening:
    • Vaginal and rectal swab between 35 to 37 weeks; treatment needed during delivery if positive.
  • Weekly Visits: Starting at 36 weeks until delivery.

Conclusion

  • Overview of care throughout the three trimesters.
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