A mum from Singapore wants to know when she should make her first visit to the gynecologist when pregnant and what she should expect.
Reader: Hi Dr Dana. I just did my pregnancy test and got a positive result. I believe I’m in the 5th week as of now. When should I go visit my gynecologist and what should I expect during the first visit?
Dr Dana: You can visit any doctor and get a blood test done. This test will tell you how much of the pregnancy hormone, Human Choroid Gonadotrophin (HCG), is in your blood and approximately how far along you are.
The HCG hormone starts to circulate your body once the embryo has implanted in the uterus. It is actually the fertilized egg that secretes HCG. This hormone stimulates the cyst on the ovary, the corpus luteum, to produce more progesterone, which will maintain the pregnancy.
This HCG/progesterone system sticks around till about 12-14 weeks until the placenta is fully functional and takes over progesterone production. At that point the cyst goes away and HCG levels drop and aren’t needed.
Many doctors do a quantitative blood test to measure the exact amount of HCG present and make sure it is doubling every 2-3 days. If it isn’t then there might be complication or the pregnancy might be in danger. You might have several of these blood tests done in the first 2-3 weeks to make sure all is good. Some doctors don’t bother to do a quantitative test and just do a yes or no confirmation blood test, the qualitative test. It basically says the same thing as a home urine test.
A way to calculate the Estimated Due Date (EDD) by dates is to subtract 3 from the month, and add 7 to the day, of the first day of your last menses.
Once the pregnancy has been confirmed, you will come in for your first gynecologist appointment at approximately 6-8 weeks along. You will get a series of tests done. Besides the normal blood pressure, temperature, and urine protein test, you will have a huge blood draw at this time. You will also be asked about you and your partner’s complete medical history and immediate family’s medical history. You may also get a pelvic exam to see how you are progressing and that all is normal. You may get to see a first ultrasound picture of your baby, without the full features of course.
A complete series of tests will be performed on this blood to rule out many possible complications.
Here is a list of the tests that your gynecologist will run on your blood at this time.
1. Full blood cell count (FBC).
2. Blood typing and screening for Rh antibodies.
3. Syphilis, hepatitis, gonorrhea, chlamydia, and other sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV).
4. Previous exposure to some viral diseases, especially German measles (rubella).
5. Others, depending on your past medical history, eg thyroid diseases.
If you are wondering what questions to ask your gynecologist during your first visit, do read my article “Pregnancy questions for Doctors in Singapore”.
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