What should I expect at each prenatal visit?
First trimester: Conception to 12 weeks
Initial prenatal visit
- You will have a thorough physical exam and review of your medical history.
- Documentation of your pregnancy begins and you’ll receive an estimation of your due date. (Fetal gestational age)
- Your physician will listen for fetal heart tones, if your initial visit is over 12 to 13 weeks gestation. At this time your doctor may also arrange for an ultrasound.
- You and your doctor might discuss setting up a consultation with a specialist, if certain risk factors are present. For example, if you are over 35, have a uterine fibroid, or have a chronic illness.
- Your doctor may make a request for your old medical records (if pertinent).
Routine First Trimester Visit
****Please go ahead and leave a clean catch urine sample, as soon as you are checked in, at each appointment.****Unless you are having an ultrasound.
- 10 weeks: You will start your genetic screening, if you choose to do so.
- A urine will be collected for a substance abuse screen with your consent.
11-13 weeks: You may choose to have a Nuchal Translucency, an ultrasound that is used to assess your developing baby’s risk of having Down syndrome (DS) and some other chromosomal abnormalities, as well as major congenital heart problems.
Second trimester: 12 to 24 weeks
Visits every four weeks, much like the routine visits of the first trimester, except with the addition of listening for fetal heart tones:
- During this time, your doctor will also determine fetal growth by serial fundal height determinations. If you have not enrolled in prenatal classes at your hospital or through private instruction, check with your doctor for good recommendations.
- Your physician will continue documenting your weight as well as checking your urine for protein and glucose to monitor for signs of preeclampsia and diabetes.
15 – 22 weeks you will have the option to continue genetic testing.
Third trimester: 24 weeks to Delivery
- Between weeks 24 and 28, you will visit your doctor every four weeks. Between 28 and 35 weeks, you’ll usually have a visit every two to three weeks.
- At around 26-28 weeks expect a 1 hour Glucose tolerance test to screen for gestational diabetes. You will also receive a Rhogam shot if have a negative blood type.
- Between weeks 28-32 you will receive a Tdap vaccine. This may protect your baby from contracting whooping cough.
- At 32 weeks your doctor will try to determine fetal position (this is the time a baby usually locks into position). A suspected breech baby in the third trimester can be a cause for concern and will usually necessitate an ultrasound.
- At around 35 weeks you will begin weekly cervical checks. At this time you will have a group B strep vaginal/rectal culture. Your doctor will discuss the signs of preterm labor and begin monitoring if indicated.
- At 36 weeks you will begin weekly visits or even more frequent visits if you’re experiencing a high-risk pregnancy. Your doctor may offer version of an abnormal position, or breech, to help move the baby into a vertex (head first) position.
- At 39 weeks your doctor can now offer induction if your cervix is ripe.
- Once you’re at 40 weeks you’ve reached your due date! If you have not yet had your baby, expect to begin post-dates surveillance and more frequent office visits.
Throughout your entire third trimester, we will keep and heightened vigilance for diseases and complications unique to pregnancy and watch you very carefully!
What medications are safe in pregnancy?
|Asthma||♦Budesonide inhaled or nasal spray (Pulmicort® , Rhinocort®)|
|Bladder infection (UTI)||♦Nitrofurantoin (Macrobid ®) – Avoid in patients with possible G6PD deficiency|
|Cough||♦Dextromethrophan (Robitussin DM sugar free ®)|
|Constipation||♦Metamucil ® , Citrucel ®
♦Milk of magnesia
♦Polyethyelene glycol (Miralax ®)
♦Glyburide (Micronase ®)
♦Metformin (Glucophage ®)
|Diarrhea||♦Loperamide (Imodium A-D®)|
|Gas||♦Simethicone (Gas-X ®, Mylicon ®, Phazyme ®)|
|Gastroesophageal reflux disease (GERD)||♦Ranitidine (Zantac ®)
♦Cimetidine (Tagamet ®)
|Hay fever, sneezing, runny nose, itchy watery eyes.||♦Chlorpheniramine (Chlor-Trimeton®, Efidac®, Teldrin®)
♦Diphenhydramine (Benadryl®) Clemastine (Tavist Allergy®) Loratidine (Claritin®)
|Headache or fever||♦Acetaminophen (APAP, Paracetamol, Panadol, Tylenol®)
♦NO Ibuprofen® or Naproxen®
|Heartburn||♦Tums or Pepcid® (Famotidine)|
|High blood pressure||♦Methyldopa (Aldomet®)|
♦Levothyroxine (Synthroid®, Levoxyl®)
♦Azithromycin (Zithromax ®)
♦Cepaholosporins: Cephalexin (Keflex®), Cefazolin (Ancef®), Cefaclor (Ceclor®)
♦Penicillin’s: Amoxicillin (Amocil®), Amoxicillin Clavulanate (Augmentin®), methicillin, carbenicillin.
|Insomnia||♦Doxylamine (Unisom Sleep Tabs®)|
|Motion sickness||♦Dimenhydrinate (Dramamine®)|
|Nasal congestion||♦Pseudoephedrine (Sudafed®)-Avoid in first trimester
♦Saline nasal spray
|Nasal congestion, sneezing, runny nose, itchy watery eyes||♦Actifed Cold and Allergy®
Ingredients: Triplidine, Pseudoephedrine-Avoid in first trimester
|Nasal congestions, sneezing, runny nose, itchy watery eyes, fever, headache||♦Actifed Cold and Sinus®
Ingredients: Acetaminophen, Chlorpheniramine, Pseudoephedrine-Avoid in first trimester
♦Pyridoxine 25mg by mouth 3x daily WITH Unisom Sleep Tabs (Doxylamine Succinate 25mg) ½ tablet 3x daily.
|Vaginal yeast infection||♦Clotrimazole cream (Gyne-Lotrimin®)|
Any medications, NOT on this list should be discussed with the doctor.