{"id":2645,"date":"2018-06-21T21:35:57","date_gmt":"2018-06-21T21:35:57","guid":{"rendered":"http:\/\/localhost\/testsakas\/egkumosuni-toketos\/"},"modified":"2021-07-29T07:08:50","modified_gmt":"2021-07-29T07:08:50","slug":"pregnancy-childbirth-obstetric-gynecological-center-athens","status":"publish","type":"page","link":"https:\/\/www.gyn-care.gr\/en\/pregnancy-childbirth-obstetric-gynecological-center-athens\/","title":{"rendered":"PREGNACY – CHILDBIRTH"},"content":{"rendered":"
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Pregnancy, Childbirth<\/h1>\n<\/div>
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We calculate pregnancy from the first day of the last period (TEP) and lasts forty weeks. We divide it into three unequal quarters. The first trimester lasts until the twelfth week. After that, the second trimester lasts from the twelfth to the twenty-fourth week.<\/p>\n<\/div>

Finally the third trimester, which is the longest in duration, starts from the twenty-fourth week and lasts until childbirth. The first visit takes place after the sixth week, when we are late 15 days on our period.<\/p>\n<\/div>

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Historical Context<\/h2>\n<\/div>

The doctor will obtain a full and detailed history on the first visit. He\/she will ask you about inherited diseases that you or your partner may have, as well as your families. For illnesses you have had in the past or are suffering from, as well as medications given before pregnancy.<\/p>\n<\/div>

The gynecologist will ask you about your period, its duration, or any problems you may have. They may also ask you about first intercourse, your partners, frequency of contact and any sexually transmitted diseases you may have had in the past. For the contraception you were taking, for previous pregnancies or their abortion.<\/p>\n<\/div>

Finally, we will ask you for any gynecological surgeries, as well as, other surgeries. In case it is not the first pregnancy we will ask you about the duration of the previous pregnancy or the previous ones, as well as about the outcome and the weight of the child\/children.<\/p>\n<\/div>

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Physical Examination<\/h2>\n<\/div>

In each visit, the doctor will examine your legs for varicose veins and swelling. A slight swelling as the pregnancy progresses is normal due to fluid retention, but excessive swelling is a sign of preeclampsia usually in the third trimester.<\/p>\n<\/div>

The gynecologist will palpate the breasts to see if there are any tumors. He\/she will measure your weight and pressure.<\/p>\n<\/div>

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Gynecological examination<\/h2>\n<\/div>

During the gynecological examination, the gynecologist will inspect the vagina to determine any anatomical abnormalities of the vagina or the cervix. The doctor must always do the examination carefully due to pregnancy. If you have not had a Papanicolaou smear (Pap test) for more than a year, he will do that test too.<\/p>\n<\/div>

The Pap test is especially useful for us. It helps us know the condition of the cervix in early pregnancy, since during pregnancy a large increase in hormones can differentiate the condition of the cervix faster than usual.<\/p>\n<\/div>

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Weight measurement<\/h2>\n<\/div>

During the first visit, the doctor will record the weight of the pregnant woman. The gynecologist will weigh the pregnant woman at each visit to check if it is in line with the week of pregnancy she is going through. The total weight gain should be 9-12 kilos throughout pregnancy.<\/p>\n<\/div>

A slight weight loss during the first trimester is normal due to morning sickness and vomiting. But a larger-than-normal increase should draw our attention to nutrition.<\/p>\n<\/div>

A sharp increase may be a sign of preeclampsia.<\/p>\n<\/div>

Excessive weight gain during pregnancy creates fetuses larger than the woman\u2019s body type and disproportional during childbirth. The disproportion (large fetus in relation to the pregnant woman\u2019s pelvis) leads to a cesarean section.<\/p>\n<\/div>

Excessive weight gain is also responsible for diabetes mellitus in pregnancy, a dangerous situation during pregnancy.<\/p>\n<\/div>

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Vaginal Fluid Culture<\/h2>\n<\/div>

In the first weeks of pregnancy, we always do a vaginal fluid culture to see if there is an infection that could cause problems throughout pregnancy. It is cultured for common germs, such as streptococcus B, gardenela vaginalis, etc., sexually transmitted diseases, gonorrhea, hair follicles, etc., as well as for chlamydia, mycoplasma, ureaplasma. Germs can cause problems in pregnancy, premature birth and fetus infection. In case of infection, we give the appropriate treatment and we repeat the culture after its end.<\/p>\n

Fertility specialists repeat the vaginal fluid culture during the eighth month to investigate any germs that could infect the fetus during childbirth.<\/p>\n<\/div>

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Ultrasound<\/h2>\n<\/div>

We do the first ultrasound on the first visit. We will determine the kind of the pregnancy (intrauterine or ectopic) as well as the number of fetuses (one or more). Also, after 6 weeks we can see on the transvaginal ultrasound the heart of the fetus that beats.<\/p>\n

We will measure the fetus so that we can determine its ultrasound age and determine the probable date of birth.<\/p>\n<\/div>

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Examination<\/h2>\n<\/div>

In the first trimester, the woman will do a series of blood tests. Their results will provide useful information.<\/p>\n<\/div>

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<\/i><\/i><\/span>General blood exam<\/span><\/a><\/h4><\/div>

In general blood tests, we check the basic characteristics of the blood, such as hemoglobin (Hb) levels, white blood cells, hematocrit, platelets. Hemoglobin is the basic protein that contains iron and carries oxygen to the tissues and the fetus.<\/p>\n<\/div>\n

Low hemoglobin levels mean anemia. You need to enrich your diet with iron supplements and foods rich in iron. White blood cells are part of the immune system and if they increase, it means that you have an infection.<\/p>\n<\/div>\n

Platelets show the ability of blood to coagulate in the event of bleeding.<\/p>\n<\/div><\/div><\/div><\/div>

<\/i><\/i><\/span>General Urine exam<\/span><\/a><\/h4><\/div>

In the general urine tests we check the condition of the kidneys, organs that are overactive during pregnancy. Detection of many pyospheres is an indication of a urinary tract infection, which is more common during pregnancy due to an increase in vaginal fluid.<\/p>\n<\/div>\n

In this case, we will perform a urine culture to detect the germ and give the appropriate treatment.
\nIf we find urine sugar in two consecutive tests, this is a sign of gestational diabetes. In this case you should have a special blood test to check your blood glucose levels.<\/p>\n<\/div>\n

High urine albumin is a sign of preeclampsia or urinary tract infection.<\/p>\n<\/div>\n

The presence of ketone in the urine indicates metabolic disorders and is a sign of diabetes. It is the cause of malignant vomiting during pregnancy.<\/p>\n<\/div><\/div><\/div><\/div>

<\/i><\/i><\/span>Blood sugar<\/span><\/a><\/h4><\/div>

Blood sugar testing is very important that can detect gestational diabetes. Even from the beginning of pregnancy, which is more common today. If we find an increase in blood sugar in early stages of pregnancy, then we will perform a frequent examination.<\/p>\n<\/div><\/div><\/div><\/div>

<\/i><\/i><\/span>Blood and rhesus group<\/span><\/a><\/h4><\/div>

These tests will reveal blood type and rhesus factor. The blood type is important in case of transfusion. Rhesus factor is more important in pregnancy. It is a protein that when it is on the red blood cells we have rhesus positive, in its absence we have rhesus negative.<\/p>\n<\/div>\n

In a rhesus negative woman, if her partner is rhesus positive, or has given birth to another rhesus positive child, then she needs special attention during pregnancy. We check the Rhesus factor every month.<\/p>\n<\/div><\/div><\/div><\/div>

<\/i><\/i><\/span>Iron and Ferritin<\/span><\/a><\/h4><\/div>

Iron is a key component in the production of hemoglobin and the transport of oxygen. Usually, women with menstrual blood loss due to menstruation are deficient in iron. We give iron supplements during pregnancy, due to the increased need of the mother and the fetus.<\/p>\n<\/div>\n

Ferritin is the iron transporter in the blood.<\/p>\n<\/div><\/div><\/div><\/div>

<\/i><\/i><\/span>Hemoglobin electrophoresis<\/span><\/a><\/h4><\/div>

Hemoglobin electrophoresis shows whether you are a carrier of the stigma of Thalassaemia or other anemia. If the test is positive, the father should be checked to see if he is also a carrier.<\/p>\n<\/div>\n

If we have two positive results we must check the fetus for Thalassaemia or other type of anemia.<\/p>\n<\/div><\/div><\/div><\/div>

<\/i><\/i><\/span>Toxoplasma<\/span><\/a><\/h4><\/div>
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Doctors test the patient for toxoplasma. Toxoplasma is a parasite that lives in cat feces. In case of infection, apart from pregnancy, the woman develops antibodies against the germ that usually protect her for the rest of her life.<\/p>\n<\/div>

However, if she is infected during the first trimester of pregnancy, when there are no antibodies, then the germ infects the fetus, causing miscarriages or severe problems in the fetus. In case the pregnant woman has not come in contact with toxoplasma, special attention to hygiene is recommended and the antibodies are checked regularly.<\/p>\n<\/div>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>Rubella<\/span><\/a><\/h4><\/div>

This test determines if the pregnant woman has antibodies against rubella. If he is not immune then he should avoid contact with people who have it. If she gerts infectioned during the first trimester, then the fetus is at risk of blindness, deafness and heart problems.<\/p>\n<\/div>\n

In case of infection in the first trimester, the pregnancy is usually terminated. In non-pregnant women who are planning a pregnancy, the vaccine is recommended if there is no immunity.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div>

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<\/i><\/i><\/span>Megalocytosis (CMV)<\/span><\/a><\/h4><\/div>

It is a virus that should not affect the pregnant woman in the first and second trimester, because it creates problems in the fetus.<\/p>\n<\/div><\/div><\/div><\/div>

<\/i><\/i><\/span>Hepatitis<\/span><\/a><\/h4><\/div>
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If the pregnant woman suffers from hepatitis, she must take special care in any operation during pregnancy to prevent the virus from being transmitted to the fetus. The period of childbirth and the puerperium is more important so that we do not have a virus infection of the fetus.<\/p>\n<\/div>

After childbirth, we perform immunoprophylaxis and vaccination in the fetus.<\/p>\n<\/div>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>Listeria<\/span><\/a><\/h4><\/div>
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Listeria is a germ we find in feces. There must be special hygiene and in case of infection treatment. It can cause premature births and miscarriages.<\/p>\n<\/div>\n<\/div><\/div><\/div>

<\/i><\/i><\/span>Syphilis<\/span><\/a><\/h4><\/div>

Syphilis is a rare disease today. If a woman is infected with this germ she should be treated before pregnancy. During pregnancy, it transmits the germ to the fetus, which causes severe damage.<\/p>\n<\/div><\/div><\/div><\/div>

<\/i><\/i><\/span>Cardiological examination<\/span><\/a><\/h4><\/div>

The heart is an organ that over-functions in pregnancy, so a cardiological examination and an electrocardiogram are necessary to rule out any problems that may be caused by the pregnant woman’s heart.<\/p>\n<\/div><\/div><\/div><\/div>

<\/i><\/i><\/span>Ultrasounds<\/span><\/a><\/h4><\/div>
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It is the use of ultrasonic acoustic waves, which we do not hear or feel but give the image of the fetus and placenta. Ultrasounds are safe for both you and your fetus, so you can repeat them as often as your doctor recommends. During pregnancy, ultrasound is a very useful diagnostic tool. At the beginning of pregnancy, we use them to determine the time of pregnancy, the number of fetuses and their viability.<\/p>\n

Later we evaluate the fetus growth rate, the position of the placenta, the amount of amniotic fluid as well as any anatomical abnormalities of the fetus.<\/p>\n

If your pregnancy is going smoothly, you will not need to do more than three ultrasounds. An ultrasound is also used as an adjunct to invasive methods such as amniocentesis and trophoblast retrieval. It can diagnose 70% of serious abnormalities and 40% of minor abnormalities with which a child may be born.<\/p>\n

The most usual are during:<\/h5>\n<\/div>