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Prenatal Care

Importance of Prenatal Care

Prenatal care is needed to maintain a mother’s health level through the entire course of pregnancy so that the mother can deliver a healthy baby. Parents’ hereditary disease, drug use during pregnancy, exposure to chemical substances, physical wounds, nutritional deficiency, radiation test and exposure to a source of infection contribute to an increased risk of congenital deformation or death in newborn babies.

The purpose of a prenatal diagnosis is to detect the above risk factors as early as possible, take the necessary procedure to treat and prevent them at the early stage, and manage them consistently to help pregnant women to deliver healthy babies so as to reduce the rate of congenital malformation and death in newborn babies and, ultimately, create a happier family.

Prenatal Testing by Gestational Age

The most important thing in deciding the period and specific criteria of prenatal testing is the gestational age and the health condition of the pregnant mother and her baby. It is advised to decide on the prenatal testing that best suits them by considering the specific examination criteria, period and method depending on their health condition through an adequate consultation with an obstetrician or health care provider.

Period and Criteria of Prenatal Testing by Gestational Age table
Period and Criteria of Prenatal Testing by Gestational Age
Gestational Age First Trimester Second Trimester Third Trimester
Within 14 weeks 14-20 weeks 20-24 weeks 24-28 weeks 28-36 weeks 36 weeks - before delivery
Intervals Once every 4 weeks Once every 4 weeks Once every 4 weeks Once every 4 weeks Once every 2 weeks Once every week
Specific
  • 1. Basic Prenatal Testing
  • 2. Ultrasound exam
  • 3. Birth Defect Screening Test (10-13 weeks) Double marker test
  • 4. Chromosome test Chorionic villus sampling (10-13 weeks)
  • 1. Birth Defect Screening Test (16-18 weeks) Triple test Quad test
  • 2. Chromosome test Amniotic test (15-20 weeks, mostly 16-18 weeks)
 Precision Ultrasonic Waves
  • 1. Gestational diabetes screening test (24-28 weeks) 2. Anemia test(28-32 weeks)
 Test before delivery (if necessary) Blood test Urinalysis Breast X-ray test Electrocardiogram
  1. 1. The testing intervals may shorten if a pregnant woman has high-risk diseases or the physician considers more frequent testing necessary. Every diagnosis requires checkups on blood pressure, proteinuria, and weight.
  2. 2. The testing intervals may shorten if a pregnant woman has high-risk diseases or the physician considers more frequent testing necessary until she is found to be normal in the early stage of pregnancy.
  3. 3. An ultrasound exam will be undertaken whenever found necessary depending on the health condition of a pregnant mother and her baby.
  4. 4. The birth defect screening test will be carried out in either the first or the second trimester. In case of a birth defect screening test during the first trimester, a Maternal Serum Alpha-Fetoprotein Test (MSAFP) must be taken in 16 to 18 weeks into pregnancy to screen for Neural Tube Defects (NTD) in the fetus.
  5. 5. If either the chorionic villus sampling or the amniotic fluid test has been done, the birth defect screening test is not required. If If the chorionic villus sampling was performed, Maternal Serum Alpha-Fetoprotein Test (MSAFP) must be taken during 16 to 18 weeks into pregnancy to screen for Neural Tube Defects (NTD) in the fetus.

Basic Prenatal Testing

  1. ① Blood test: Check for anemia and decide on the period and amount of iron supplements intake.
  2. ② Blood type test: If a mother has Rh negative blood, the fetus hemolytic syndrome may occur. This is the test to take preventive actions for it.
  3. ③ Rubella test: A mother infected with rubella in the first trimester may cause malformation in her baby.
  4. ④ Syphilis test: A baby will contract syphilis from a mother in the form of congenital syphilis, causing malformation and miscarriage. Appropriate treatment is needed.
  5. ⑤ Hepatitis test: If a mother has hepatitis B, vertical transmission can occur. Proper preventive measures should be taken as soon as the baby is born.
  6. ⑥ AIDS test: If a mother has AIDS, vertical transmission can occur. Proper preventive measures should be taken.
  7. ⑦ Urinalysis: It is required to check for proteinria, diabetes and cystitis.
  8. ⑧ Uterine cancer: A uterine cancer test is needed on a regular basis.

Ultrasound Exam

It is the most important test to examine the health condition of a fetus. It is essential to confirm pregnancy, implantation position, gestational age, and the expected date of confinement during the first trimester. As for the second trimester, its main purpose is to check the size of the fetus, its position, placenta and amount of amniotic fluid.

Birth Defect Screening Test

It is performed to screen pregnant women whose risk of chromosome anomalies in fetus has exceeded the standard level, and to perform chorionic villus sampling and an amniotic fluid test on them. As for those who have high risks in neural tube defects, a precision ultrasound exam should be taken. Some cases may require an amniotic fluid test. One of the following three methods should be used. As for the double marker test, a Maternal Serum Alpha-Fetoprotein Test (MSAFP) must be taken during the first 16 to 18 weeks into pregnancy to screen for Neural Tube Defects (NTD).

  1. ① Double marker test (10 to 13 weeks into pregnancy): Chromosome anomalies screening test for Down syndrome and Edwards syndrome
  2. ② Quad test (16 to 18 weeks into pregnancy): Chromosome anomalies screening test for Neural Tube Defects, Down syndrome and Edwards syndrome

Gestational Diabetes Test

Gestational diabetes not properly controlled may cause hydramnios or a giant baby. This, in turn, not only increases the risks of a difficult delivery or Caesarean section, but also may cause a variety of complications to a fetus and newborn baby. This test is taken at 24 to 28 weeks into pregnancy. The testee should drink 50g of glucose and her blood will be taken after an hour to examine the blood sugar level. This procedure does not require the testee to go on a fast. If the blood sugar level is found to be over the standard level (130 mg/dL or 140 mg/dL), an Oral Glucose Tolerance Test of 100g must be taken to confirm the initial result.

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