Once your pregnancy has been confirmed, you should visit your doctor for a complete physical examination. This is usually done during the first six to eight weeks of pregnancy. Your doctor will take a detailed medical history, including chronic medical problems and complications of earlier pregnancies. You will also be given a pelvic and rectal exam to determine the size and position of your uterus. At this stage, routine lab tests will include blood tests for rubella (German measles), hepatitis B, syphilis and other sexually transmitted diseases. Your blood will also be typed and screened for Rh antibodies. HIV testing is recommended, as well as urine tests and a Pap test for cervical cancer. During this appointment, your doctor will also determine the expected date for the delivery of your baby.
After your first visit, you will normally see your doctor once a month for routine examinations, unless there is a medical reason for more frequent appointments. These monthly examinations will continue until the 28th week of pregnancy, when your appointments will increase to once every two weeks. As you approach the end of your pregnancy, your medical visits will be scheduled weekly.
If your doctor suspects that your pregnancy is high-risk for certain medical disorders, he or she may send you for chorionic villi sampling. This is a special test used to identify abnormalities in your fetus that could result in conditions such as cystic fibrosis or Down’s syndrome. The chorionic villi are located on the edge of the placenta and are genetically identical to your baby. A small probe is inserted through your vagina and into your uterus, to gather cell samples from the surface of the placenta. By analyzing these cells, a great deal of information can be gathered about the overall health of your baby. The test is usually performed at 10 to 12 weeks and results are available within one or two days. Chorionic villi sampling is similar to amniocentesis, in that both tests identify fetal abnormalities. Chorionic villi sampling gives you results much earlier, although it does carry a slightly higher risk of miscarriage.
The Second Trimester
The second trimester lasts from the 13th to the 28th week of pregnancy. Most women feel their best at this stage, because the discomforts of early pregnancy have subsided and the uncomfortable symptoms of the last trimester are still ahead. At this point you are probably sleeping better and your energy levels are returning to normal.