Zwanger & Zo | Pregnancy
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Pregnancy

Check-ups

The first check-up of your pregnancy is around 8 weeks pregnancy, counted from the first day of your last period.

This check is intended to introduce you to the practice and to map your health situation. The midwife will inform you about healthy pregnancy. Also, there will be an appointment for the first ultrasound and a blood test. The first check takes about 50 minutes.

Further check-ups

In total, you will come for check-ups around fourteen times during  the pregnancy. In the beginning of pregnancy  there is a greater time in between check-ups, at the end of the pregnancy we see you every week.

The checks take less time than your first appointment, on average 15 minutes per check.

During the follow up, we will measure your blood pressure, discuss pregnancy symptoms with you and answer questions. Of course, we check every appointment how the baby is growing and we listen to the heart of the baby.

We assist you with the preparation for childbirth and breastfeeding.

For more information about pregnancy also read the leaflet ‘Pregnant!’.

What do you have to arrange?
  • Kraamzorg, apply around 16 weeks, the midwife will give you more information about this.
  • Let your health insurance know.
  • When you are not married, arrange the last name of the baby at city hall.
  • If you wanna give birth in a hospital or birth centre, make sure they have your name and insurance number.
Echoes and investigations

During your pregnancy you will be offered several ultrasounds and blood tests. The midwife will present it to you and you can then choose whether you want to run this.

 

First ultrasound:

During the first appointment we will make an appointment for the first echo. This ultrasound is to determine the due date.

The term echo occurs at 10 weeks gestation. This echo is reimbursed by your insurance.

 

Prenatal screening

During the first appointment, the midwife can inform you of the possibility of prenatal screening.

In the Netherlands, every pregnant woman has the opportunity to carry out additional investigations in pregnancy. This is called the prenatal screening.

Prenatal screening includes the combined test / nuchal translucency measurement and the 20-week ultrasound.

 

Nuchal translucency measurement:

This test gives you a probability calculation to Down’s syndrome (trisomy 21), of Edwards Syndrome (Trisomy 18) and Patau’s syndrome (trisomy 13).

Participation in this survey is voluntary, you choose whether you want to perform this test.

This test uses:

¥ A blood test to two hormone levels between 9 and 14 weeks of pregnancy

¥ An ultrasound to measure the baby’s nuchal fold between 11 and 13 weeks of pregnancy

¥ The age of the mother

The result you get is a probability. The test does not guarantee that you child has of hasn’t of the above syndromes.

A high probability give you the possibility to do further investigation.

More information on this test can be found in the brochure: “Information on the Down’s syndrome screening.

 

The 20-week ultrasound:

You can make this ultrasound to look vor abnormality’s in the baby. This research is done around 20 weeks gestation. This echo looks at the development of the child’s organs. It also looked at whether the fetus is growing properly and whether there is enough amniotic fluid.

Participation in this study is voluntary.

 

Examples of variations which could be seen at this echo:

¥ Spina bifida

¥ heart disease

¥ breakage in the diaphragm

¥ rupture in the abdominal wall

¥ Abnormalities of the bowel

¥ Absence or deviate from the kidneys

¥ Absence or deviate from bones

¥ Abnormalities of arms or legs

 

The 20-week ultrasound is a reliable method to detect serious congenital defects. Yet this research does not guarantee a healthy child. Not all disorders can be seen on ultrasound.

If your unborn child has a physical defect, the consequences for the child are not always clear.

The examination takes about half an hour and is fully reimbursed by your health insurer.More information about the 20-week ultrasound, you can read in the brochure.

Miscarriage and blood loss

Early pregnancy:

Blood loss in early pregnancy can have various causes. In about half of cases, this bleeding is innocent, such as blood loss caused by the implantation of the embryo in the womb. The bleeding will stop automatically.

 

In the other half of the cases, blood loss is caused by a miscarriage.

During a miscarriage the fetus is expelled. The blood loss is often associated with menstruation-like cramps.

The cause of miscarriage is almost always an abnormality in the chromosomes that happens to result from the fertilization of the ovum.

This leads to a disturbance in the construction of the pregnancy so that the pregnancy can not continue to grow.

 

What should you do to blood loss?

Have the midwife informed, they can answer your questions and make an appointment for an ultrasound.

If you have severe abdominal pain, you should immediately informe the midwife

A miscarriage can give blood loss as a menstrual period. If you feel unwell or faint you should call immediately.

If you have fever, you should call the midwife.

 

Period after a miscarriage

The physical recovery after a miscarrage or curettage is usually smooth. For 1 to 2 weeks, often there is still some loss of blood and / or brown discharge. The next period will appear after about 4-6 weeks. Many women (and their partners) have an emotionally difficult time. The processing of a miscarriage is different for everyone. A new pregnancy can be more exciting after experiencing a miscarriage. Take for that reason at the time to contact the midwife for guidance.

 

2nd and 3rd trimester:

When later in pregnancy, after 16 weeks, there is blood loss, it is always wise to call the midwife. They can assess the severity of the blood loss and an appointment schedule.