Op. Dr. Volkan AktemurObstetrician & Gynecologist

Pregnancy Care and Delivery

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Representative image for Pregnancy Care and Delivery
Representative image

In any surgical or interventional procedure, results may vary from person to person. You are advised to obtain a detailed opinion from your physician before the procedure.

Preconception counseling

When a pregnancy is being planned, general health, long-term conditions, medicines and previous pregnancies are reviewed. Folic acid supplementation, which is recommended to start before pregnancy, vaccination status and any necessary blood tests are discussed at this visit. Conditions such as diabetes, thyroid disease or high blood pressure should ideally be brought under control before pregnancy.

Check-ups during pregnancy

At check-ups, blood pressure, weight, urine and blood values and the baby’s growth are monitored. How often check-ups take place is planned according to the week and the course of the pregnancy.

General timeline of screening tests

  • Early pregnancy: ultrasound assesses the location of the pregnancy (whether it is inside the uterus) and the gestational age. Very early on, the pregnancy sac may not yet be visible; in that case the scan is repeated. Blood group, a blood count and certain infection tests are requested.
  • Weeks 11–14: first-trimester screening for certain chromosomal conditions in the baby (nuchal translucency measurement and a blood test) may be performed.
  • Weeks 18–22: the baby’s organs are examined with a detailed ultrasound. A detailed ultrasound cannot detect every difference.
  • Weeks 24–28: screening for gestational diabetes (glucose tolerance test) is carried out. In people with risk factors it may be done earlier.
  • Final months: the baby’s growth and position and the amniotic fluid are monitored.

Chromosomal screening tests do not make a diagnosis; they only show whether the risk is high or low. Whether to have this screening is the person’s own decision after receiving information. In pregnant women whose blood group is Rh negative, additional monitoring for blood group incompatibility is carried out and a preventive injection is given when needed.

Deciding how to give birth

The mode of delivery is decided by considering together the course of the pregnancy, the baby’s condition and position, the location of the placenta, previous births and the mother’s health. If there is no medical reason against it, vaginal birth is considered the first option; a cesarean section is recommended in certain medical situations. The benefits and risks of both are discussed during pregnancy. The plan may change according to developments during labor. Options for relieving pain in labor (for example, epidural analgesia) are also discussed in advance.

After the birth

The first six weeks after birth are known as the postpartum period. Check-ups during this time assess bleeding, healing of stitches or the wound, breastfeeding, mood and blood pressure. If diabetes or high blood pressure developed during pregnancy, follow-up continues. Contraception and a suitable interval before the next pregnancy are also discussed at these visits.

Frequently asked questions about Pregnancy Care and Delivery

When should the first pregnancy check-up take place?

It is recommended within the first three months, after a positive pregnancy test. At this check-up, the location of the pregnancy and the gestational age are assessed with ultrasound. Very early on, the pregnancy sac may not yet be visible; in that case the scan is repeated. People with a long-term condition or who take regular medicines benefit from seeing a doctor before pregnancy, if possible.

What is the difference between a screening test and a diagnostic test?

Screening tests show whether the risk of certain chromosomal conditions in the baby is high or low; they do not give a definite diagnosis. If the risk is high, diagnostic tests such as amniocentesis may be discussed. Whether to have these tests is the person’s own decision after receiving information.

Can someone who has had a cesarean have a vaginal birth?

In some cases, yes. The number of previous cesareans, the type of incision on the uterus, the interval between births and the course of the current pregnancy are assessed together. The main risk is that the previous cesarean scar opens during labor (uterine rupture). This is uncommon but requires emergency care. For this reason, a vaginal birth after cesarean is planned in a facility able to provide emergency care; its benefits and risks are discussed during pregnancy.

Which symptoms during pregnancy and after the birth need prompt assessment?

During pregnancy, vaginal bleeding, leaking fluid, regular and frequent contractions, a marked decrease in the baby’s movements, severe or persistent abdominal pain, severe headache, visual disturbance, sudden swelling of the face and hands, fever, chest pain, shortness of breath, fainting and severe vomiting that does not stop need prompt assessment. After the birth, increasing bleeding, foul-smelling discharge, fever, severe headache or visual disturbance, chest pain, shortness of breath, a painful swollen leg and thoughts of harming oneself or the baby also need urgent assessment. In these situations, the nearest health facility or emergency department should be contacted without delay.

The information on this page is for general information only and does not replace a medical examination, diagnosis or treatment. The suitability, scope and possible risks of any procedure vary from person to person and are assessed during a consultation.

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