Pregnancy process is followed in 3-month periods called trimesters.

 

The first trimester is a period in which the hormonal and physical changes in the expectant mother are followed, the adaptation process and the possible problems that may arise with it are tried to be determined.

 

In the first trimester evaluation, it is tried to determine the general health conditions of the mother and father-to-be and whether there are any conditions that may pose a risk in the pregnancy follow-up process.

With these principles, examinations and examinations of the expectant mother and, if necessary, the father-to-be are planned. These tests may vary depending on the presence of additional medical conditions.

 

Laboratory Examinations

• Blood group and Rh determination

• Whole blood and urinalysis

• Thyroid function tests 

• TORCH panel (determination of the immunity status of the mother-to-be against diseases that can cause infection in the baby in the womb)

• Serology tests (for hepatitis and HIV)

• Biochemistry assays showing kidney and liver functions

• urine culture
   

Baby examination with ultrasound

Whether the current pregnancy is located in the uterus

Whether the pregnancy is singular or multiple

Fetal heartbeat and beats per minute

Concordance of the declared gestational week with the gestational week determined by ultrasound

It is evaluated whether there is a problem in the uterus, ovaries and cervix (such as ovarian cyst, myoma, cervical insufficiency).

 

At the end of the examination, after presenting the findings, information about nutrition, exercise, lifestyle changes suitable for pregnancy and the evaluations to be made at the next examination  are given.

 

Second Trimester; This is the period in which genetic and physical problems that are compatible with life in the baby but will prevent mental retardation or life adaptation are screened with both ultrasound and laboratory tests. In this period, the sex of the baby is determined with a high probability.

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genetic screening tests

• Combined Test (between 11-14 weeks) (At the end of the first trimester)

• If necessary, extracellular free DNA analysis in maternal blood

• If necessary, triple and quadruple biochemical screening tests
   

Diagnostic tests are preferred in cases where a high risk is determined for the investigated conditions or in cases where a genetic diagnosis is required in the womb.

 

Genetic diagnostic tests

• Chorionic villus sampling (CVS)

• Sampling of amniotic fluid (Amniocentesis)

• Blood collection from the baby's umbilical cord (cordocentesis) (at the end of the second trimester)
  
  Apart from these evaluations, the complaints and expectations of the expectant mother, if any, are listened to. Consultancy services are provided regarding these situations.

 

Towards the end of the second trimester, a detailed examination of the internal organs of the baby is done with ultrasound. The current medical condition of the expectant mother is reassessed. Evaluations are made in terms of gestational diabetes and gestational blood pressure.

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Towards the end of the second trimester, although our baby can hear us, life adaptation skills, which are called viability, increase. Towards the end of this process, shopping can be started for the baby.

 

In the third trimester, the effects of the current pregnancy on the expectant mother are evaluated in this process where the mother and the baby are followed more closely. The baby's well-being and development are evaluated by ultrasound, color ultrasound (Doppler) and, if necessary, additional tests (Non-stress test NST). In this process, the thoughts and expectations of the mother and father-to-be are listened to and information is given about the birth process and possible forms of birth. With laboratory tests, the medical condition of the expectant mother is tried to be determined. The last part of this process results in weekly, sometimes more frequent, examinations.

 

Risky Pregnancy

The concept of risk in pregnancy generally emerges with the determination of problems that occur outside the normal process in the expectant mother or baby.

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Problems detected in the expectant mother

• Multiple pregnancy

• advanced maternal age pregnancy

• Presence of additional disease and the risk of adversely affecting this situation from the pregnancy process

• Positioning problems of the baby's partner specific to pregnancy (placental insertion or invasion problems)

• Cervical insufficiency (Cervical Insufficiency)

• Problems in the previous pregnancy that caused the premature termination of the pregnancy and/or situations that did not result in a live birth.

• Postpartum problems

• consanguineous marriage

• Blood incompatibility

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Problems identified with the baby

• Internal organ anomalies

• genetic diseases

• Conditions with slow fetal development

• Conditions with rapid fetal development

• Too little or too much amniotic fluid

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In the above-mentioned cases, it is very important to determine the current risk at the first examination. According to the identified risk, additional drug use, frequency of follow-up, follow-up planning together with the relevant specialties, and diagnosis and treatment approaches to be applied are determined. The main starting point in the risky pregnancy follow-up process is to ensure the birth of an individual who can adapt to life without adversely affecting the health of the expectant mother.