Meeting your expectations
Pregnancy Care
Pregnancy lasts an average of 40 weeks from the first day of the last menstrual period. These 40 weeks of pregnancy are divided into 3 stages called trimesters, each lasting about 14 weeks.
The first trimester
During the first trimester from conception to about 14 weeks of pregnancy, the fetus is undergoing the stages of embryogenesis. Complications that may occur during this time include miscarriage, ectopic pregnancy and the development of fetal malformations.
It is important to avoid substances that may cause fetal malformations. If you are diabetic, strict control of your sugars will reduce the risk of fetal structural problems. If you smoke, now is a good time to consider quitting, and Brian can help you achieve this. It is recommended that all pregnant women take folic acid during this time to reduce the risk of neural tube defects.
You should aim to meet with Dr Hollis during this time. He will arrange the routine pregnancy blood tests to check your health and will also discuss the options of pre-natal screening for chromosome abnormality. If you wish to take this up, it is best performed by the nuchal translucency plus (NT+) test, which involves a blood test and an ultrasound scan of the fetus between 11 and 14 weeks of pregnancy.
The second trimester
By 14 weeks the nausea and vomiting of pregnancy has settled for the majority of women, and most women enjoy this stage of pregnancy. It is also a time when the risk of miscarriage and other complications is low.
Brian normally arranges a second visit with his patients after the first trimester ultrasound scan. At this visit, he will go over all the test results as well as arrange the paperwork for you to book into your chosen hospital.
At 18-20 weeks, a further ultrasound scan of the fetus is recommended. This scan is a detailed morphology scan to check that there are no structural abnormalities present in the baby. As this is a relatively trouble- free period of pregnancy, Brian arranges monthly appointments with his patient’s at 20, 24 and 28 weeks.
The third trimester
By 28 weeks of pregnancy the fetus weighs about 1200 -1400 grams and then enters the phase of most rapid weight gain. Routine tests are carried out at this time to exclude gestational diabetes and anaemia.
This third stage of pregnancy is where fetal growth restriction secondary to placental insufficiency is likely to reveal itself. Possible complications of pregnancy such as pre-eclampsia are also more common at this time, and for these reasons an appointment is scheduled with Brian every 2 weeks until 36 weeks of pregnancy, and then weekly until labour and delivery.
At 36 weeks of gestation, the position the baby adopts in the uterus is likely to be its position at the start of labour. About 1 in 25 (4%) of babies adopt a breech position (feet or bottom down) at 36 weeks. This is a risky position for labour and if this is the case, Brian will discuss with you the option of external cephalic version (ECV).
The due date
The expected delivery date is calculated at 40 weeks from the first day of your last period, or from the fetal size at a first trimester ultrasound scan. However, only about 3% of women deliver on their estimated due date. Most deliveries occur between 39 and 41 weeks, with a smaller number of women going into labour before 39 weeks and some women still pregnant at 41 weeks, one week after the due date.
At 41 weeks gestation you have the choice of admission to hospital for an induction of labour, or waiting a bit longer for the onset of natural labour. Under normal circumstances 9 out of 10 women will have delivered by 42 weeks of pregnancy (2 weeks after the due date).