Pregnancy Check-up Guide: Schedule and Details

Prenatal check-ups are an important part of pregnancy health care. Systematic and regular check-ups can monitor the health status of the mother and fetus, and detect and deal with abnormal situations in time.

Prenatal Check-up Schedule

First Trimester Check-ups (1-12 Weeks)

Weeks 6-8: First Prenatal Check-up

Pregnancy Confirmation Check

• Urine HCG Test: Confirm pregnancy
• Blood HCG Test: Quantitative test to assess embryonic development
• Ultrasound (B-scan):
  • Confirm intrauterine pregnancy
  • Exclude ectopic pregnancy
  • Check fetal pole and fetal heart
  • Determine gestational age

Basic Check-ups

• Height and Weight: Calculate BMI, assess basic health status
• Blood Pressure: Basic blood pressure monitoring
• Blood Type: ABO blood type and Rh factor identification
• History Taking: Personal history, family history, obstetric history

Laboratory Tests

• Blood Routine: Check for anemia, platelets, white blood cells
• Urine Routine: Check for protein, sugar, ketones
• Liver Function: ALT, AST and other indicators
• Kidney Function: Creatinine, urea nitrogen
• Blood Glucose: Fasting blood glucose check
• Infectious Disease Screening: Hepatitis B, Syphilis, AIDS, etc.

Thyroid Function

• TSH Test: Thyroid Stimulating Hormone
• FT3, FT4: Free thyroid hormones
• Significance: Abnormal thyroid function affects fetal intellectual development

Weeks 11-13+6 Days: NT Scan

Nuchal Translucency (NT) Scan

• Purpose: Early Down syndrome screening
• Normal Value: <2.5mm
• Method: Abdominal ultrasound
• Significance: Increased NT thickness suggests risk of chromosomal abnormalities

Early Down Syndrome Screening

• Time: 11-13 weeks + 6 days
• Content: Maternal blood PAPP-A, β-hCG
• Risk Calculation: Combined with NT, age, gestational age
• Accuracy: About 85-90%

Registration Procedures

• Establish Prenatal Check-up File
• Receive Maternity Handbook
• Schedule Next Check-up

Second Trimester Check-ups (13-28 Weeks)

Weeks 16-20: Mid-term Down Syndrome Screening

Down Syndrome Screening

• Time: 15-20 weeks
• Content: AFP, β-hCG, uE3
• Risk Calculation: Combined with age, gestational age
• Accuracy: About 60-70%

Non-Invasive Prenatal Testing (NIPT)

• Target Group: Advanced age, high risk in Down screening
• Time: 12-24 weeks
• Accuracy: >99% for Trisomy 21
• Limitation: Cannot replace amniocentesis

Routine Check-ups

• Weight and Blood Pressure: Checked every time
• Fundal Height & Abdominal Circumference: Assess fetal development
• Fetal Heart Sound: Audible at 18-20 weeks

Weeks 18-24: Anomaly Scan

Fetal Structural Malformation Screening

• Time: 18-24 weeks is best
• Content:
  • Head: Ventricles, intracranial structures
  • Face: Cleft lip and palate screening
  • Heart: Four-chamber view check
  • Spine: Spinal integrity
  • Abdomen: Stomach bubble, bladder, kidneys
  • Limbs: Femur length, limb structures

Important Structure Checks

• Heart Check: Exclude congenital heart disease
• Nervous System: Exclude neural tube defects
• Urinary System: Check kidneys, bladder
• Digestive System: Check stomach bubble, intestinal tract

Placental Position Assessment

• Placenta Previa Screening: Placenta position too low
• Placental Maturity: Assess placental function
• Amniotic Fluid Assessment: Amniotic fluid index measurement

Weeks 24-28: Gestational Diabetes Screening

Oral Glucose Tolerance Test (OGTT)

• Time: 24-28 weeks
• Steps:
  1. Fasting blood draw (fasting for 8-12 hours)
  2. Oral intake of 75g glucose water
  3. Blood draw 1 hour after sugar intake
  4. Blood draw 2 hours after sugar intake

Diagnostic Criteria

• Fasting Glucose: ≥5.1mmol/L
• 1 Hour Glucose: ≥10.0mmol/L
• 2 Hour Glucose: ≥8.5mmol/L
• Diagnosis: GDM is diagnosed if any value is abnormal

Related Check-ups

• Urine Routine: Check urine sugar, ketones
• Weight Monitoring: Control weight gain
• Blood Pressure Monitoring: Exclude gestational hypertension

Third Trimester Check-ups (29-40 Weeks)

Weeks 28-32: Routine Check-ups

Basic Check-ups

• Weight and Blood Pressure: Checked every time
• Fundal Height & Abdominal Circumference: Assess fetal development
• Fetal Position Check: Confirm fetal position
• Fetal Heart Monitoring: Routine starting from 32 weeks

Blood Retest

• Blood Routine: Recheck anemia status
• Urine Routine: Check protein, sugar
• Liver Function: Retest if necessary

Ultrasound Check

• Fetal Growth and Development Assessment
• Amniotic Fluid Assessment
• Placental Maturity Check
• Umbilical Artery Blood Flow Measurement

Weeks 32-36: Enhanced Monitoring

Non-Stress Test (NST)

• Frequency: Every 2 weeks for 32-34 weeks, every 1 week after 34 weeks
• Time: 20-40 minutes
• Normal Standard:
  • Fetal heart rate 120-160 bpm
  • Good baseline variability
  • Acceleration reaction present

Biophysical Profile (BPP)

• Content:
  • Fetal breathing movement
  • Fetal movement
  • Fetal muscle tone
  • Amniotic fluid volume
  • NST result
• Scoring Standard: 2 points for each item, total score 8-10 is normal

Weeks 36-40: Pre-labor Check-ups

Delivery Preparation Assessment

• Fetal Position Confirmation: Cephalic, Breech, Transverse
• Cervical Check: Bishop score
• Pelvic Assessment: Determine if suitable for natural delivery
• Placental Function: Assess placental maturity

Fetal Maturity Assessment

• Lung Maturity: Determine if lung maturation promotion is needed
• Weight Estimation: Estimate fetal weight by ultrasound
• Amniotic Fluid Check: Amniocentesis if necessary

Special Check-up Items

Genetic Testing

Amniocentesis

• Indications:
  • Advanced maternal age (≥35 years old)
  • High risk in Down screening
  • Previous birth of child with chromosomal abnormalities
  • Family history of genetic diseases
• Time: 16-24 weeks
• Content: Fetal chromosome karyotype analysis
• Risk: Miscarriage risk about 0.5-1%

Chorionic Villus Sampling (CVS)

• Time: 10-13 weeks
• Pros: Early diagnosis available
• Cons: Risk slightly higher than amniocentesis
• Applicability: Clear indications

Cordocentesis

• Time: After 18 weeks
• Pros: Quick results
• Cons: High technical requirements
• Applicability: Mid-to-late term diagnosis

Obstetric Complication Screening

Preeclampsia Screening

High-Risk Factor Assessment

• Past History: Previous preeclampsia
• Underlying Diseases: Chronic hypertension, diabetes
• Family History: First-degree relative with preeclampsia history
• Primipara: First pregnancy

Screening Indicators

• Blood Pressure Monitoring: Checked every prenatal visit
• Urine Protein Check: Regular urine routine
• Blood Tests: Platelets, liver function
• Uterine Artery Doppler: If necessary

Placenta Previa Screening

Ultrasound Check

• Time: Screening starts around 20 weeks
• Diagnostic Criteria: Lower edge of placenta covers internal cervical os
• Follow-up Frequency: Review every 4-6 weeks

Clinical Manifestations

• Painless Vaginal Bleeding
• Abnormal Fetal Position
• High Floating Fetal Presentation

Fetal Growth Restriction (FGR) Screening

Assessment Indicators

• Fundal Height & Abdominal Circumference: Continuous measurement lower than normal
• Ultrasound Assessment: EFW below the 10th percentile
• Doppler Check: Abnormal umbilical artery blood flow

Monitoring Frequency

• Every 2-4 Weeks: Ultrasound monitoring
• Weekly: Fetal heart monitoring

Interpretation of Check-up Results

Normal Range Reference Values

Blood Test Normal Values

• Hemoglobin: 110-160g/L
• Platelets: 100-300×10⁹/L
• White Blood Cells: 4-10×10⁹/L
• Fasting Blood Glucose: 3.9-6.1mmol/L

Urine Test Normal Values

• Urine Protein: Negative or trace
• Urine Glucose: Negative
• Urine Ketones: Negative
• White Blood Cells: <5/HPF

Blood Pressure Normal Values

• Systolic Pressure: <140mmHg
• Diastolic Pressure: <90mmHg
• Mean Arterial Pressure: <100mmHg

Handling Abnormal Results

Low Hemoglobin (Anemia)

• Mild Anemia: 90-110g/L
• Moderate Anemia: 60-90g/L
• Severe Anemia: <60g/L
• Treatment: Supplement iron, Vitamin C

Elevated Blood Pressure

• Gestational Hypertension: BP≥140/90mmHg
• Preeclampsia: Hypertension + Proteinuria
• Treatment: Antihypertensive treatment, close monitoring

Abnormal Blood Glucose

• Gestational Diabetes: Abnormal OGTT
• Treatment: Diet control, exercise, insulin if necessary

Check-up Precautions

Preparation Before Check-up

Fasting Check

• OGTT: Fasting for 8-12 hours
• Liver and Kidney Function: Fasting for 6-8 hours
• Lipid Check: Fasting for 12 hours

Ultrasound Check

• First Trimester: Need to hold urine
• Second and Third Trimesters: No need to hold urine
• Wear Loose Clothing: Convenient for examination

Fetal Heart Monitoring

• Before Check: Avoid fasting
• Choose Time: When fetal movement is active
• Stay Relaxed: Avoid tension

Precautions After Check-up

After Amniocentesis

• Rest for 24 Hours: Avoid strenuous activity
• Observe Symptoms: Abdominal pain, bleeding, fluid leakage
• No Sex: 1 week
• Timely Follow-up: Seek medical attention immediately for abnormal conditions

After Ultrasound Check

• Save Reports: Keep check-up reports properly
• Regular Review: Review as required by the doctor
• Record Fetal Movement: Pay attention to changes in fetal movement

---

Friendly Reminder: Prenatal check-ups are important measures to ensure maternal and infant safety. Please strictly follow the time recommended by the doctor for check-ups. If there are any abnormal symptoms or abnormal check-up results, please consult a professional doctor in time.