1. The first sign of pregnancy is usually a missed period.
2. Some hormonal changes that occur cause development in the mammary glands, which causes fullness and tenderness in the breasts.
3. Hypersensitivity to odors and nausea and vomiting, especially painful in the morning, can be seen approximately from the 6th week of pregnancy. Although this situation usually regresses on its own after the 3rd month, it may rarely continue during pregnancy.
4. Weakness, fatigue and constant desire to sleep are the most prominent complaints of early pregnancy.
5. Usually, with the increase in body temperature, it becomes difficult to tolerate the heat at that time.
6. Metallic taste is felt in the mouth, salivation increases.
7. Due to hormonal changes in the first months of pregnancy and in the last three months due to the pressure of the baby on the bladder, the number of daily urinations increases.
8. Constipation is a common condition due to slowing of bowel movements.
9. There may be excessive emotionality.
10. Baby movements are felt from the fifth month in the first pregnancies and from the fourth month in the following pregnancies.

• Maternal age less than 18 or older than 35
• Beginning pregnancy with excess weight (body mass index over 30)
• Previous gynecological diseases or surgeries
• Drugs used by the expectant mother
• More than 4 deliveries
• The expectant mother has another systemic disease (hypertension, diabetes, heart and kidney diseases)
• Facing problems such as premature birth, growth retardation in the baby, stillbirth, pregnancy poisoning, miscarriage 3 or more consecutively in previous pregnancies
• Blood incompatibility (mother's RH-, father's RH+)
• Consanguineous marriages.

Ultrasonography is an important diagnostic tool that shows the condition, development and structure of the baby.

Most major fetal anomalies can be demonstrated by ultrasound, but their value in diagnosing small fetal anomalies that do not greatly disrupt the infant's structure is less clear.

The best example of this is Down Syndrome. In addition, many genetic and developmental disorders cannot be diagnosed by ultrasound.

Some diseases may occur as a result of the growth or failure of the relevant organ of the fetus in the later weeks of pregnancy.

The fact that these diseases were not seen by the physician who performed the ultrasonography before does not always indicate that the physician missed the diagnosis of this disease.

The probability of detecting abnormalities in the baby by ultrasonography varies between 20% and 80% depending on the experience of the person and the technical characteristics of the ultrasound equipment.

Weeks 5-6

At this stage, the baby size is equal to apple seed.

He floats in a fluid-filled bladder. At the end of the 6^th week, heartbeats begin and heartbeats can be monitored on ultrasound.

At 7^th week, the embryo size is equal to a small grape. It reaches the size of a strawberry in 8^th week.

 

Weeks 9-12

During these weeks, the baby's head, body, arms and legs begin to be clearly distinguished.

At 12^th week, the baby's height is approximately 6,5 cm and his weight is 18 g.

It is expected that the mother will gain 1-2 kg in the first 3 months. Mothers with excessive vomiting may have less weight gain.

During this period, the mother gains the expected weight during pregnancy.

 

Nuchal thickness Measurement

Measuring the nuchal thickness of the baby with ultrasound at 11^th-14^th weeks gives us an idea in the diagnosis of Down Syndrome, other genetic diseases as well as heart problems.

 

Pregnancy Follow-up Double Test

In addition to the measurement of nuchal thickness, the risk of having a baby with Down Syndrome is calculated with the measurement of serum hCG and PAPP-A levels in the mother's blood, this is done by mean of the "DOUBLE TEST".

With this screening test, 90% of babies with Down Syndrome can be detected.

 

Week 16

At this week the expectant mother has entered the second trimester of pregnancy. She feels better. The skin begins to darken, especially around the nipple and surrounding

The venter begins to become obvious. During second trimester, the mother should gain 5-7 kg. The baby's height is 16 cm, and the average weight is 135 g.

 

Between Weeks 16-19

16^th-18^th weeks is the most critical period in the detection of anomalies in the baby.

The "Triple Test", which is made by using the mother's blood with the detailed ultrasound performed during this period, gives very important information for the health of the baby. Especially women’s family who have hereditary diseases, have given birth to a baby with anomaly, have a stillbirth or are over the age of 35 should definitely have these tests done.

The triple test determines the risk of the baby having Down Syndrome by evaluating the levels of the hormones called total HCG, free estriol and alpha-fetoprotein in the mother's blood, together with the maternal age and gestational week.

64% of babies with Down Syndrome can be detected by using triple test.

 

Double and triple tests only show risk. For definitive diagnosis, a sample is taken from the placenta in the first trimester of pregnancy, and a sample or samples are taken from the fluid in which the baby is in the second trimester.

Amniocentesis is the process of taking a sample of the baby's fluid from the mother's womb through a thin needle.

 

The baby's cells are obtained from the samples taken and the chromosomes number is calculated.

Between Weeks 19-24

The mother's venter began to become more evident. Baby's movements can now feel comfortably. As the baby grows, the mother's appetite tends to increase. Breasts are enlarged. Breast milk may come from the nipples. There may be bleeding in the gums

The baby’s height is approximately 25 cm, and its weight is 340 g. In these weeks, when the baby's organs are completed and reach certain sizes, the probability of detecting fetal anomalies with detailed (Target) ultrasound increases.

 

Week 24

During this period, close monitoring of blood pressure and weight is important. Disruption of sugar metabolism is a common problem during pregnancy, so "50 g Glucose tolerance test" should be done for every pregnant woman.

During this period, more fluid intake is very important as the pregnant woman will be more sensitive to heat and will lose more water than a normal person.

 

Examinations to be Done in Week 24

• According to the result of 50 g Glucose Tolerance Test, if necessary, 100 g glucose tolerance test
• Complete blood count,
• Complete urine analysis
• RH- pregnant Indirect Coombs test is repeated.
• With ultrasonography, the development of the baby, amniotic fluid and placenta are evaluated, the flow of the uterine vessels are examined.
• If the mother has not been vaccinated for tetanus in the last five years or will not deliver in hospital conditions, she should have a tetanus vaccine.

 

The Baby in Weeks 24-28

• Begins to see, to open and close his eyes.
• Can hear voices and react to loud noises.
• Frowns and may open and close his mouth.
• Begins kicking and punching.
• Experiences irregular sleep periods.
• Sucks his thumb, swallows the amniotic fluid that surrounds him, if drinks too much, gets hiccups, urinates into the same fluid.
• Begins to make respiratory movements.
• The sense of taste develops during this period.
• From the 7^th month, it is estimated that his personality also develops.

 

The Mother in Week 28

• Excess weight begins in the abdomen, as well as in the hips and thighs.
• As the uterus grows, heartburn, indigestion and cramps begin to appear due to the pressure.
• Pink-lilac-colored incisures begin on the abdominal skin.
• There may be short-term and irregular contractions called false labor pains, but they usually do not cause pain.
• From this week on, lying on the bed to the left increases the circulation of both the baby and the mother.
• Until the 28^th week, the mother should gain about 9 kg, after that, it is appropriate to gain about 4-5 kg more.

 

What to Do in Week 28

• Direct Coombs test if there is blood incompatibility
• Pregnant women with blood incompatibility should be given a blood incompatibility injection, if necessary, according to the results of this test.
• The development of the baby, amniotic fluid and placenta should be evaluated with ultrasound again.

 

Week 32

In this period, the baby now has a body proportional to the whole.

Even if the birth is premature, babies can be kept alive under intensive care conditions and with necessary precautions.

As the baby grows, can press on the internal organs and cause complaints such as breathing difficulties or frequent urination in the mother.

The mother's sleep may be disturbed, she may not be able to sleep as well as before. Mild discomfort may be felt in the abdomen and legs as the joints around the pelvis enlarge in preparation for childbirth. In these weeks, the baby's height is approximately 40,5 cm and his weight is 1600 g The mother's weight gain rate slows down.

 

 

Week 36

Now that the baby has almost completed his development, if the birth is premature, baby can live without medical support.

The baby's head begins to enter the pelvis. baby cannot move in the abdomen, but the number of kicks increases.

The baby's height is approximately 46 cm and its weight is 2500 g. After that, he takes about 28 g per day.

There may be swelling in the mother's ankle and there may be clear varicose veins.

During this period, until birth, follow-up care should be once a week.

The 40^th week is the expected birth week, but birth may be occurred 2 weeks before or 2 weeks later.

There may be irregular and infrequent false labor pains.

The baby's movements will decrease relatively compared to the previous period. But if it moves less than 10 times in a day, it may be an indication that the baby may be in distress inside.

Real labor pain is pain that comes at regular intervals, starts from the waist and spreads to the groin and the entire venter, causing hardening in the venter.

• There may be bloody, slimy vaginal discharge.
• After the pain starts, or even before it starts, the amniotic fluid in which the baby lives can be discharged, this is an indication of the onset of labor.
• The weight gained until the last day should be 10-12 kilograms and it is not recommended to gain more than 15 kilograms.
• From the 32^nd gestational week, the baby's well-being is evaluated with NST (NONSTRESS TEST) and USG in the follow-ups.
• NST is active in a normal pregnant woman and the baby's breathing, tone (posture), movements and water are evaluated in USG.
• If the birth has not started spontaneously despite the completion of the 41^st week of pregnancy, the birth is initiated by the physician.

 

NONSTRESS TEST = NST

It is a technique in which both the variability of the baby's heartbeat and uterine contractions are monitored.

It can be used in line with the mother's complaints, especially from the 24^th week of pregnancy.

But it is most commonly used to evaluate baby heartbeat from 32^nd weeks onwards.

It is also very helpful in the diagnosis of preterm labor.

In addition, the baby's heartbeat is monitored with this device during labor.

In Which Situations Should a doctor Be Consulted During Pregnancy Follow-up?

• Heavy vaginal discharge or burning sensation while urinating
• Fever rise
• Severe venter or groin pain
• Vaginal bleeding
• Decreased or not felt baby movements
• Amniotic fluid discharge
• Feeling rhythmic contractions (pain) that come at regular intervals
• Diffuse body edema (swelling), visual disturbances, severe stomach pain or headache

Labor pains do not start even though the expected date has passed.