The time of pregnancy is an exciting and hopeful time, with a great deal of happiness and intense experiences. Many new things will come upon you, and many questions will arise regarding the development of your child. Regarding this very special experience in your life, you will be asking yourself:
With this information I would like to make available to you valuable information and practical advice, which will explain to you the course of your pregnancy care at our practice.
The legally mandated motherhood regulations offer you a broad spectrum of medically necessary services. This preventative care program will only benefit you and your baby, however, if you make use of it on a regular basis. Continual examinations are the prerequisite for being able to recognize and treat pregnancy risks as quickly as possible.
Beyond this, however, further examinations and measures may be sensible and desirable. In this way we will be able to pursue your wish for risk reductions.
After I have determined that you are pregnant, a series of examinations will take place.
This examination will first be done at approximately 4 week intervals, and later on in shorter intervals, depending on the course of the pregnancy. During the first examination, in addition to a thorough anamnesis, the vagina and the uterus will be examined. As part of this, a pap smear will be taken from the cervix and checked for chlamydia (a special type of bacteria), since a chlamydia infection can negatively influence the course of your pregnancy.
The following examinations are done as part of the routine in the further preventative care appointments:
Blood pressure test
Determination of hemoglobin, iron content, depending on the previous findings
To begin with, the blood group as well as the rhesus factor are determined, and an antibody search test is performed in order to determine whether there is any blood group incompatibility between yourself and your child early on. This antibody search test is repeated between the 24th and 28th week of pregnancy. In the event you have been determined to have the blood group characteristic “rhesus negative,” you will receive an injection between the 28th and 30th week of the pregnancy in order to prevent a possible incompatibility. Additionally, a search test for sexually transmitted diseases and a rubella antibody test are also legally mandated. This last test is important, since an infection with the rubella virus during pregnancy can cause deformations in your child. I would additionally like to recommend that you have an HIV (AIDS virus) performed.
After the 32nd week of pregnancy, a blood sample is taken once again. This sample is supposed to reveal a possible infection with the hepatitis B virus. If present, such an infection could cause your child to become infected with this disease during birth.
Three times during the pregnancy, an assessment of the development of the child is performed using ultrasound (the so-called screening test).
First screening: 9th to 12th week of pregnancy
Second screening: 19th to 22nd week of pregnancy
Third screening: 29th to 32nd week of pregnancy
With the help of these ultrasound examinations, any eventual developmental disturbances in the child can be recognized early in many cases, in order to be able to begin appropriate diagnostic or therapeutic measures as necessary. In this regard, the motherhood regulations also provide for further medically justified the examinations.
Here I would like to explain a further ultrasound examination which I consider to be sensible. However, you must pay the cost for this examination out of pocket.
1. Additional ultrasound examination in the 12th to 13th week of pregnancy, to measure the child’s neck transparency.
The capabilities of modern medicine can substantially reduce the risk of having a disabled child. The risk of having a chromosomally damaged child is very low, however, but exists with every pregnant woman, and increases substantially with the age of the mother. The most frequently occurring chromosome disorder is Down's Syndrome, which is also known as Mongolism.
Determining the transparency of the nape of the neck is a special ultrasound examination which can be combined with additional blood tests. This examination can only be carried out between the beginning of the 12th and the end of the 13th week of pregnancy. This special examination makes it possible to estimate the risk for trisomy 21 (Down Syndrome or “mongolism”). In case of an increased probability for the presence of this illness, the determined elevated risk can be more precisely clarified through further procedures (examination of amniotic fluid).
The “Fetal Medicine Foundation” headquartered in London has developed a program based on a study with over 100,000 pregnant women, through which the risk is determined. This method of calculating the risk is superior to other procedures, such as for example the Tripple test (in this test the risk is determined using a blood test during the 16th to the 18th week of the pregnancy).
I am participating in this study and use the computer program of the “Fetal Medicine Foundation,” which is made available to the participants in this study following the appropriate training and under constant quality control.
I am happy to perform this additional examination outside of the regular pregnancy preventative care according to your express wish. The costs of €122.40 are not covered by the public health insurance systems, and must be paid out of pocket. The additional blood test would increase the reliability of the test by approximately 5%. The laboratory costs associated with this test are €55.96.
If you are interested in this examination, the team at my practice as well as myself are naturally available at any time to answer any further questions you may have.
“With every person some-
thing new is introduced
into the world, which has
not yet existed, something
singular and unique.“
Martin Buber (1878-1965),
Jewish religious scientist and philosopher