"I-sarang"" will help create a society where children bring happiness
When a woman becomes pregnant, even women previously indifferent to pregnancy will become interested in their future child. In children, genetic abnormalities in parents, medications taken during pregnancy, exposure to chemicals, physical trauma, nutritional deficiencies, radiation exposure, and exposure to infectious agents are all factors that increase the rate of birth defects or mortality in newborns. The purpose of prenatal care and diagnosis is to detect these risk factors, treat and prevent them early, and provide ongoing care to help give birth to a healthy child and build a happy family.
* The frequency of hospital visits may vary depending on the condition of the pregnant woman and the fetus.
| Tests | Timing |
|---|---|
| Maternal blood test(hemoglobin, blood type, blood type antibody), urine test, rubella antibody test, hepatitis B test, syphilis test, cervical cancer screening test, ultrasound test | First visit |
| Blood pressure, weight, fetal heart rate | Entire pregnancy |
| Fetal chromosomal abnormality screening: First trimester detailed ultrasound(fetal nuchal translucency), first integrated screening test, fetal DNA screening test(NIPT test)*, chorionic villus sampling* | Weeks 11~14 |
| Fetal chromosomal abnormality screening(for Down syndrome)(quad test or the second integrated screening test), amniotic fluid test* | Weeks 15~20 |
| Second trimester detailed ultrasound | Weeks 20~24 |
| Gestational diabetes screening test, anemia test | Weeks 24~28 |
| Immune globulin injection for a Rh-negative patient | Week 28 |
| Tdap vaccine | Weeks 27~36 |
| Evaluation of fetal growth and fetal well-being: Ultrasound examination or non-stress test(NST) is performed individually depending on the condition of the pregnant woman and the fetus | After week 32 |
(*Optional tests)
You must inform your doctor of any current or past medical history.
Taking medication during early pregnancy must be done under the guidance of a doctor.
When an infectious disease is prevalent, you need to take precautions to avoid infection and get the necessary vaccinations.
In addition to the ABO blood types(A, B, O, and AB), Rh factor is important in pregnancy.
A Rh-negative mother should receive an Rh immune globulin(RhoGAM) injection around the 28th week of pregnancy to prevent fetal hemolytic disease that may occur in the next pregnancy. To detect this, all pregnant women undergo a blood type test at their first visit.
※ An Rh-negative mother should receive an immune globulin injection around the 28th week of pregnancy. After birth, the baby's blood type must be checked. If the baby is Rh-positive, an additional vaccination must be administered within 72 hours.
The mother should be examined for anemia, and an anemic mother should additionally take iron supplements.
If the mother is hepatitis B antigen positive, the newborn needs to be vaccinated against hepatitis B and receive an immune globulin injection immediately after delivery because the virus can be transmitted to the newborn during pregnancy and delivery. When the mother lacks antibodies, she is vaccinated along with her newborn after birth.
Syphilis during pregnancy can cause miscarriage, stillbirth, and birth defects, so it is always important to get tested early. When syphilis is diagnosed, antibiotic treatment is necessary to prevent and treat congenital infection in the fetus.
If infected with rubella during early pregnancy, the fetus may develop congenital rubella syndrome(CRS), and the percentage of risk of giving birth to a child with congenital heart disease, cataracts, or hearing loss is close to 30%. Women found to be negative for rubella immunity during the rubella test should receive rubella vaccine after delivery.
This test is safe for both the mother and the fetus and is performed whenever necessary during the entire pregnancy to determine the location of the placenta, size of the fetus, twins, amount of amniotic fluid, presence of miscarriage, fetal position, and other conditions.
This test is necessary to diagnose the presence of diabetes, cystitis, urethritis, pyelonephritis, etc. during pregnancy and preeclampsia.
※ Urine tests are also performed periodically during regular checkups. A test is done to see if sugar or protein is detected in the urine. Sometimes sugar is detected in the urine during the third trimester of pregnancy. It is thought to be detected not because of diabetes, but because glucose is excreted due to the kidneys not reabsorbing it during pregnancy. Therefore, it is monitored without any special treatment. However, if glucose in the urine is detected during early pregnancy, if there is a family history of diabetes, or if the woman has been previously diagnosed with gestational diabetes, testing for gestational diabetes may be considered.
Korea recommends that women aged 20 and older receive regular cervical cancer screenings regardless of whether they are pregnant. Accordingly, when you first visit the hospital after pregnancy, your OBGYN will check your recent cervical cancer screening date and, if necessary, perform a cervical cancer screening. In some cases, cervical cancer is discovered after delivery at an advanced stage without being tested during early pregnancy. Therefore, it is recommended to get tested for cervical cancer during early pregnancy to prevent and treat it early.
Fetal nuchal translucency(NT) thickness is measured by ultrasound at 11 to 13 weeks of pregnancy, and it is used as a screening test for fetal chromosomal abnormalities(e.g., Down syndrome) and fetal structural malformations(e.g., congenital heart defects). If the NT thickness is within the normal range, it is used to assess the risk of the Down syndrome through an integrated screening test along with the mother's blood test.
This is a fetal chromosomal abnormality screening test that can screen for Down syndrome and Edwards syndrome in the fetus through a maternal blood test. Although it is sometimes used alone, it is often used in conjunction with a second trimester blood test to achieve a higher diagnostic rate. The integrated screening tests by test period are often called the first and second blood tests. It only assesses the risk of common chromosomal abnormalities such as Down syndrome and Edwards syndrome and determines the need for diagnostic tests such as chorionic villus sampling or amniocentesis. The maternal serum screening test is not a test to diagnose fetal malformations. Therefore, a low-risk group in the integrated screening test does not mean that the fetus is free of malformations, and a positive integrated screening test indicates a high-risk group. However, this does not mean that the fetus is malformed. Before the test, it is recommended to receive counseling on the differences and pros and cons compared to other fetal chromosomal abnormality screening tests such as the NIPT, chorionic villus sampling, and amniocentesis.
This test is one of the fetal chromosomal abnormality screening tests. It has a higher diagnostic rate and lower false positive rate than maternal serum screening tests, so it is mainly used by high-risk pregnant women. It is highly accurate by detecting fetal DNA in the pregnant woman's blood to assess the risk of Down syndrome, Edwards syndrome, and Patau syndrome, but itis expensive and, in a twin pregnancy, the result often yields an 'inconclusive' result and has lower accuracy. Although the NIPT is more accurate, it is still a screening test just like maternal serum screening and not a diagnostic test. Therefore, high-risk results should be confirmed with chorionic villus sampling or amniocentesis. You need to consult an OBGYN to decide whether to undergo maternal serum screening or NIPT for fetal chromosomal abnormality screening, and what the differences are between these tests and diagnostic tests such as chorionic villus sampling or amniocentesis.
Pregnant women who are at high risk for fetal chromosomal abnormalities or have a family history of genetic diseases may undergo chorionic villus sampling relatively early in pregnancy to check for fetal chromosomal abnormalities. This test is performed between 11 and 14 weeks of pregnancy by using an ultrasound to determine the location of the placenta and then removing a portion of the chorionic villus. The collected chorionic villi can be analyzed directly or cultured to diagnose a chromosome karyotype, then used to determine whether the fetus has chromosomal abnormalities or genetic disease. Although it is possible to detect fetal chromosomal abnormalities early, there is a risk of miscarriage due to the test, so consultation with a specialist is necessary.
(Source : MotherSafe)
If an abnormality is found in a basic blood test, an OBGYN will run additional tests and respond accordingly.
If the pregnant woman is Rh-negative, and the fetus is Rh-positive, an immune response may occur in the pregnant woman's blood, forming antibodies that can destroy fetal red blood cells. In such cases, the current pregnancy will have no problem, but in future pregnancies, an immune response may occur in the fetus' body, causing hemolysis that destroys red blood cells. This can cause severe anemia, which in extreme cases can lead to fetal death. Accordingly, if the pregnant woman is Rh-negative, she should receive an immune globulin injection around the 28th week to prevent this immune reaction in advance.
If your hemoglobin level is low, you should take iron supplements.
If a pregnant woman is a carrier of hepatitis B, there is a possibility that the baby will be infected. Therefore, if the pregnant woman is a carrier, the newborn should be given immune globulin and vaccines immediately after birth to prevent infection.
If you have a positive HIV test result, you will need to undergo a detailed examination to confirm further infection, because false positives can occur in HIV tests. If you are diagnosed with HIV through a detailed examination, you must receive appropriate treatment. Recently, thanks to advances in medicine, if treatment is received during pregnancy, the probability of the newborn contracting HIV is not that high. Therefore, if you have a positive test result, you need to get a detailed examination to confirm whether you are infected and receive appropriate treatment without worry.
Pregnant women with syphilis often have no symptoms because the infection is latent. Syphilis bacteria can cross the placenta and infect the fetus, causing miscarriage, stillbirth, or premature birth, and can result in the birth of a baby with congenital syphilis. If you have a positive result during early pregnancy, you should take antibiotics to treat it. If treatment is administered within 14 weeks, it will prevent fetal infection.
When a pregnant woman contracts rubella during early pregnancy, she may have a very high chance of miscarriage, or the fetus may develop congenital rubella syndrome. A diagnosis can be made by detecting characteristic clinical symptoms such as rash with the identification of specific antibodies, like IgM, via serological tests. However, a positive IgM rubella antibody response does not necessarily mean an infection, so various tests are needed to confirm the diagnosis.
Essential vaccinations during pregnancy include pertussis(whooping cough) and influenza. In the case of pertussis(whooping cough), the goal is to transfer antibodies to the fetus to prevent the baby from contracting the disease during infancy after birth, so it is recommended to get vaccinated between 27 and 36 weeks of pregnancy regardless of the mother's vaccination history. It is further recommended to get vaccinated for each pregnancy. The influenza vaccine is safe during pregnancy, and it is recommended that all pregnant women receive it every autumn, regardless of their gestational age or their pregnancy stage, to prevent influenza infection during the winter. This is because pregnant women are at high risk for flu complications. However, if you have had adverse reactions to a flu shot in the past or are allergic to eggs, you should inform your OBGYN in advance. Vaccinations that are safe during pregnancy include hepatitis B vaccine, hepatitis A vaccine, and pneumococcal vaccine, so you can get vaccinated if necessary, even during pregnancy. However, measles, mumps, and rubella vaccines(MMR), and the chickenpox vaccine, polio vaccine, and shingles vaccine are contraindicated during pregnancy due to being live viruses. You should consult your OBGYN before getting vaccinated.