Office visits with an Ob-Gyn provider will vary in frequency in each pregnancy based on individual needs and risk factors. The goal of prenatal care is to ensure all patients are cared for during and after pregnancy to ensure safe and healthy pregnancies and deliveries. The typical frequency of office visits is as follows for uncomplicated pregnancies:
- Initial office visit around 8-10 weeks of pregnancy, a patient should be seen earlier if concern for ectopic pregnancy
- Then every 4 weeks for the first 28 weeks
- Then every 2-3 weeks until about 36 weeks gestation
Typically the most detailed and lengthy appointment is the initial appointment with your Ob-Gyn. Some things to expect during the initial appointments includes:
- First Prenatal Visit (around 8-10 weeks gestation)
- History including family medical history and genetic history
- Physical Exam, including exam to confirm pregnancy
- Assessment for tobacco, alcohol, drug use
- Domestic violence screening
- Screening for depression
- Prescription for prenatal vitamins and iron supplementation as needed
- Education & counseling regarding expected course of pregnancy, routine labs/testing, genetic counseling, high risk conditions, nutrition, exercise, and practices to promote health maintenance in pregnancy
- Routine laboratory testing includes blood type and screen, CBC, Hepatitis B surface antigen, syphilis screening, HIV screening, Cervical Cancer screening if patient is due, urine culture and urine analysis
- Gestational diabetes can be tested in the first prenatal visit if the patient has a pre-pregnancy BMI>30kg/m, history of gestational diabetes, or a known impaired glucose metabolism
- During Subsequent Prenatal Visits:
- Every appointment includes; Vital signs, weight, fetal assessment, uterine size, domestic violence screening, assessment of tobacco use and smoke exposure, and urinalysis for protein and glucose
- 11-14weeks: offer screening tests for aneuploidy
- 15-20 weeks: schedule anatomic survey ultrasound around 18-20 weeks, second trimester aneuploidy testing, review signs/symptoms of pre-term labor
- 24-28weeks: screening for gestational diabetes, select baby’s medical provider, discuss normal fetal movement, discuss prenatal classes, discuss postpartum contraception
- 27-36weeks: Tdap vaccine administration and education regarding administration for family members, repeat type and screen and if Rh negative to receive Rhogam, repeat CBC, discuss cord blood banking, if at risk population than to repeat sexual transmitted disease testing, Group Beta Strep Screening and Management, confirm fetal position, labor and delivery education
- 36-38weeks: review signs of labor, discuss agina postpartum contraception
- >41weeks: non stress test and ultrasound and labor induction plans
