For pregnant mothers, “antenatal care” is very important because it takes care of the mother and the baby in the womb continuously until the day of delivery. This involves quite a lot of details, including checking the development of the fetus, monitoring for risks or complications that may arise, and providing advice on proper behavior during pregnancy to ensure the baby is born healthy. Hence, choosing the right place for antenatal care will give mothers peace of mind in caring for their unborn child with a team of specialists, modern equipment, and standard services
What is antenatal care?
Antenatal care is the care of the pregnancy from the start or when it is detected, usually between 4–8 weeks of gestation. It is recommended to receive antenatal care at a medical facility with experienced obstetricians, including specialists in maternal and fetal medicine (MFM) for comprehensive care. This involves monitoring the growth and preventing any abnormalities in the fetus, providing close consultation and advice, and preparing the mother physically and mentally for a safe pregnancy and delivery, resulting in a child with complete and strong development.
What should be checked in the first trimester (beginning of pregnancy to 14 weeks of gestation)?
Once the obstetrician confirms a normal intrauterine pregnancy, the next step is to proceed with antenatal care. The obstetrician will take a medical history and perform a basic physical examination to assess any risks and areas needing special attention for the pregnant mother.
Besides the history taking and basic physical examination, blood and urine samples of the pregnant mother will be collected for laboratory tests to assess the initial readiness, including:
- Complete blood and platelet count to indicate the concentration level of blood (anemia), size and shape of red blood cells, white blood cell count, and platelet quantity in the body.
- Screening for thalassemia carriers by checking if the individual is a carrier of thalassemia, including Alpha-thalassemia trait, Beta-thalassemia trait, Hemoglobin E trait, and Homozygous Hemoglobin E.
- ABO blood group to determine if the blood type is A, B, O, or AB.
- Rhesus blood group test to check if it is normal (Positive) or Negative which is very rare.
- HIV antibody test to check for antibodies created in response when HIV enters the body. A negative result indicates no HIV infection.
- Syphilis screening by blood test to detect syphilis infection.
- Hepatitis B antibody (Anti-HBs) or Hepatitis B Surface Antibody test to find body antibodies against the surface of the hepatitis B virus.
- Hepatitis B antigen test (HbsAg) or Hepatitis B Surface Antigen test to find protein substances from the surface of the hepatitis B virus. A positive result indicates an infection.
- Hepatitis B core antibody (HBcAb) test to find body antibodies against the core of the hepatitis B virus.
- Hepatitis C antibody test to find antibodies created by the body against the hepatitis C virus.
- Rubella immunity test to check for immunity against rubella virus; if infected during pregnancy, it risks congenital disabilities or miscarriage.
- Thyroid function test to evaluate thyroid function as abnormalities may adversely affect pregnancy.
- Vitamin D level test as pregnant women are at risk of vitamin D deficiency. A level below 32 ng/ml (80 nmol/L) indicates deficiency.
- Complete urine test to check sugar levels indicating gestational diabetes, protein as a sign of preeclampsia, ketones to check fat metabolism, and bacteria and white blood cells indicating a urinary tract infection, which may increase the risk of premature birth.
Why is Down syndrome screening important?
Down syndrome (Down Syndrome) is a condition caused by having an extra chromosome 21, leading to various abnormalities in the baby, such as intellectual disabilities, abnormal facial features, heart defects, etc. The primary cause is abnormal chromosome division during egg fertilization, meaning all pregnant mothers can potentially have babies with Down syndrome, with risk increasing with maternal age. Therefore, Down syndrome screening is crucial. Modern screening methods provide highly accurate results by examining fetal DNA fragments in maternal blood (Cell-Free Fetal DNA), known as NIPT (Non-Invasive Prenatal Testing), which can be conducted as early as after 10 weeks of pregnancy.
Why is preeclampsia screening important?
Preeclampsia is a complication where the pregnant mother has high blood pressure and protein leakage in urine, considered severe during pregnancy, which can be life-threatening due to brain hemorrhage, convulsions, and death. It usually occurs after 20 weeks of gestation. Therefore, first-trimester preeclampsia screening is highly important as it can indicate the risk of the condition in a pregnant woman. This evaluation considers personal history, blood pressure assessments, blood biochemical markers (Placental Growth Factor- PlGF), and uterine blood flow assessment through ultrasound. If results show a high risk, medication (Aspirin) is prescribed to prevent preeclampsia in the future. However, this screening and aspirin usage should be advised thoroughly by an obstetrician.
What should be checked in the second trimester (14-28 weeks of pregnancy)?
The 14-28 weeks pregnancy ultrasound is essential for assessing fetal health, any abnormalities, or disabilities, and can be conducted as advised by the physician to check for congenital structural abnormalities of the fetus, such as amniotic fluid, placenta, umbilical cord, skull, brain, limbs, chest cavity, lung tissues, heart, abdominal wall, and internal organs, measuring fetal size to ensure growth and prevent overdue pregnancy. Seeing fetal movements strengthens the mother-child bond.
Pregnancy ultrasound includes 2D, 3D, and 4D ultrasounds
- 2D ultrasound is the standard examination for pregnant mothers, showing details of both internal and external fetal organs. It provides the most information, especially between 18–22 weeks, the optimal period for in-depth organ assessment by a maternal and fetal medicine specialist (MFM).
- 3D ultrasound adds depth to 2D views, showing the fetus’s external body and face, helping the mother visualize her baby’s appearance.
- 4D ultrasound is a three-dimensional examination with an added dimension of time, showing real-time fetal movement images.
Why is gestational diabetes screening important?
Normally, gestational diabetes screening is conducted between 24–28 weeks, when the placenta produces hormones increasing the mother’s blood sugar risk. If diagnosed with gestational diabetes, dietary management and close blood sugar monitoring are necessary.
What should be checked at 28 weeks of pregnancy (third trimester)?
At 28 weeks, the third trimester begins, and the fetus is almost fully developed. Additional tests prepare for birth, including:
- Complete blood and platelet count to reassess blood concentration, red blood cell size and shape, white blood cell count, and platelet quantity before delivery.
- Syphilis screening to detect syphilis infection.
- HIV antibody rest to recheck the mother’s antibodies created in response to HIV entry.
- Streptococcus Group B screening (GBS) for bacteria in the vagina and rectum, which may cause urinary tract infection, blood infection, and serious or fatal neonatal infections.
- Fetal health assessment, measuring fetal heart rate and uterine contractions (Non-Stress Test – NST) for confirming fetal health and abnormalities after 28 weeks of pregnancy.
Vaccines pregnant mothers should receive
Vaccines pregnant mothers should receive during pregnancy to prevent fetal abnormalities include:
- Influenza vaccine because flu strains change annually, and symptoms and complications can be severe. Pregnant mothers should receive one dose per pregnancy, preferably after 12 weeks.
- COVID-19 vaccine as the virus is still spreading, and if contracted during pregnancy can lead to severe symptoms. It’s recommended to get vaccinated between 12-20 weeks.
- Diphtheria, pertussis, and tetanus vaccine as these infections spread easily. Especially pertussis can be transmitted from mother to child or tetanus is severe if not fully vaccinated. Pregnant mothers should get vaccinated at 20-32 weeks.
- RSV vaccine (Abrysvo) is recommended for pregnant mothers to pass immunity against the RSV virus to the baby through the placenta, providing protection from birth until six months. The vaccine is recommended at 24-36 weeks.
Advantages of antenatal care
- Mothers maintain physical and mental health, care for the pregnancy, and practice correctly.
- Respond promptly to any fetal abnormalities during pregnancy.
- Reduce miscarriage, premature birth, and in-utero fetal death rates.
- Lower the risk of complications during pregnancy.
- Prevent fetal inflammation and infections.
- Deliver a healthy, strong baby with a suitable weight.
It can be seen that quality antenatal care involves many different aspects. Therefore, choosing the right place for antenatal care can alleviate the mother’s worries during pregnancy, ensuring a smooth process until the day of delivery, so the little one can come into the world safely and effectively.
Maternal and fetal medicine specialist
Dr. Weerawich Pornwattanakrilert, an obstetrician specializing in maternal and fetal medicine, Women’s Health Center, Bangkok Hospital
You can click here to make an appointment yourself
Maternity and fetal medicine specialty hospital
Women’s Health Center, Bangkok Hospital is ready to look after pregnant mothers throughout the antenatal care period with an obstetrician, specialists in maternal and fetal medicine, and a multidisciplinary team ready to support every aspect until the delivery day, ensuring the mother’s health and the little one enters the world perfectly.
Antenatal care packages
Antenatal care packages starting at 69,000 baht
