In your first visit lots of questions will be asked
as your doctor will want to know as much about you
as possible. It is the most comprehensive visit in
comparison to the other visits. Your medical history
along with a thorough physical examination, which
includes blood work, pelvic and breast exams, will
be done. Below are the common tests conducted in this
initial visit, which are by and large standard in
nature
Why the Blood Work?
You will most likely have blood
drawn at the very beginning of pregnancy. Sometimes
your initial lab work may double up as a pregnancy
test where the hCG (human chorionic gonadotropin)
level will be checked. This level should double every
2 days and for this reason this blood work may be
repeated in a few days.
This baseline blood work consists of a host of blood
tests including these:
Test for hemoglobin and hematocrit
Purpose: checks for anemia and determines whether
iron and other supplements are required
Test for blood type and RH factor
Purpose: to establish your blood type in case of blood
transfusions. Also to determine if you would need
a Rhogam shot
Test for platelets
Purpose: to establish the clotting factors within
the blood
Immunities
Purpose: checks for immunity against rubella and chicken
pox virus and if not immune, avoid people with measles
and get vaccinated after delivery
Infections
Purpose: checks for infections such as syphilis and
hepatitis; treatments may be required
Test for HIV
Purpose: checks the status; medication may be required
Other tests as needed
Depending on your ethnic background and medical history,
you may also be tested for sickle cell disease, Tay-Sachs
disease, cystic fibrosis and thalassemia. A glucose
challenge test may be done at the first visit if you
are a candidate for gestational diabetes.
Why
Urine Test?
Urine will be checked at every prenatal visit; a
small sample in a little plastic cup is all that
is needed. Various substances will be checked including
protein, sugar, ketones, leukocytes and blood cells
or bacteria. Antibiotics will be prescribed if treatment
is required for any infection.
Why
Blood Pressure check?
Just as your weight is taken at every prenatal visit
including the initial one, your blood pressure will
be monitored throughout your pregnancy. A slight
rise in BP or weight is fairly normal but a substantial
rise calls for concern. The rise could be a one-time
thing or a trend to watch. That is why it is important
to have these routine check-ups.
Why Pelvic Exam?
A pelvic test like urine and blood test will be
performed to confirm pregnancy and to make sure
all is normal with the pregnancy. Pelvic exam of
the uterus and cervix helps determine the uterus
size and also ensures that the cervix is properly
sealed and not bleeding. Mostly, this is the only
pelvic exam you will have to undergo until you are
a few weeks away from delivery. Complications will
call for more such exams.
Pap
smear
Purpose: cells from the cervix are scraped and sent
to the lab to detect abnormal cells. Unless you
have had one recently, your doctor will take a Pap
smear test at your first visit
Infections
Purpose: checks for infections such as Chlamydia
and gonorrhea; antibiotics may be required
Good
to know
Goodell's sign
Ordinarily the cervix is hard but after about 6
weeks of pregnancy, the vagina and cervix starts
to retain fluid and softens.
Hegar's sign
At 6th week of pregnancy the uterus will be softer
than normal. Your doctor will insert two fingers
into the vagina to check the size of the uterus
and ovaries.
Chadwick's sign
Vagina, vulva and cervix will change color - bluish
and violet after 2 months of pregnancy because of
increased blood volume and dilation of veins.
