I just found out I am pregnant. What do I do now?

All pregnant women want a happy and healthy baby. We are fortunate to live in Malaysia where the accessibility to medical care for pregnant women is a top priority. As a pregnant woman, you can choose to either access government or private healthcare facilities or even both.

As a doctor, I advise you to seek medical care even before you get pregnant. This is because a healthy woman is more likely to be a healthy pregnant mother. So, you should check yourself for diseases such as anemia, diabetes and hypertension before you start trying to get pregnant. If you actually have any medical condition, you should get it treated and under control before you get pregnant. Once you are trying, you should take folic acid supplements daily. Folic acid is important to reduce the risk of your baby developing abnormalities of its brain, spine or spinal cord. This condition is called neural tube defects.

 

What kind of medical care that I should seek as a pregnant woman?

Usually you will find out yourself that you are pregnant through urine pregnancy test. I advise that you come and seek medical care soon after finding out that you are pregnant,  Your first visit to seek medical care in pregnancy is called the antenatal booking. This visit will focus on getting your full medical history, physical examination, basic blood investigations and basic ultrasound scan. All these are done to manage you according to your health risks. This means you will be referred early to specialist care if you have certain medical conditions. If your health puts you in the low risk category, then follow-up in a general practice clinic will be sufficient for the first few months of your pregnancy. You will only need specialist care later in your pregnancy to discuss delivery plans.

At each clinic visit during pregnancy, your physical well being and baby’s progress will be assessed. The doctor will measure your blood pressure and weight. Your baby’s growth will also be assessed through abdominal examination or ultrasound scan when necessary.

What investigations will I need in pregnancy?

Blood investigations

1. Full blood count: This is mainly to look at your hemoglobin level. If it is low, then you have anemia in pregnancy. You should do this test at your first visit. You should repeat the test at least another time between 24 to 28 weeks of pregnancy.

2. Blood grouping and rhesus antibody screening: This is to determine your blood group type and rhesus antibody status. If you are found to have rhesus negative blood, further investigation and treatment will be discussed.

3. Modified glucose tolerance test: This test is to diagnose diabetes in pregnancy or gestational diabetes. You should do this test if you have risk factors for gestational diabetes. Some factors include family history of diabetes, gestational diabetes in a previous pregnancy or being obese. If you have any risk factors, it is advisable to do this test as soon as possible. The test will be repeated again between 24 to 28 weeks of pregnancy if the first test is normal. If you have no risk factors but you are 25 years old or more, then you should take this test anyway between 24 to 28 weeks of pregnancy.

4. HIV and syphilis screening: The blood investigation is to determine your status for these infections. If you are found to be positive, treatment can be administered to reduce the risk of your baby getting the same infection.

Urine investigations

  1. Urine analysis: In pregnancy, this test can detect if you are having urinary tract infection even though you do not have problems with urination. You can then be treated before the infection causes more problems. Another example is if you have hypertension in pregnancy, urine protein test is done for disease monitoring.

Ultrasound scan

I will discuss more on basic ultrasound scan and detailed ultrasound scan in other articles.

So that is all the medical care I need as a pregnant woman?

In a nutshell yes, if your pregnancy is uncomplicated. Therefore I cannot stress enough the importance of early consultation with a doctor once you find out you are pregnant. Then only a medical care plan can be constructed to suit your health needs. After all, pregnancy should be a wonderful journey with a joyful outcome of a healthy baby.