Medical Care During Pregnancy

Medical Care During Pregnancy (Pregnancy Follow Up) Turkey

For those patients who would like to give birth in Ankara, pregnancy follow-up is made by Dr. Burcu Saygan Karamürsel who is a perinatologist in our private clinic and 4 D ultrasound examination is performed at every antenatal visit. Cesarean or natural delivery can be performed by the same perinatologist in affiliated private hospitals in Ankara, namely TOBB ETÜ University Hospital and Güven Hospital.

For patients who deliver by vaginal birth, epidural anesthesia can be performed by an experienced anesthesiologist team. Spinoepiduarl anesthesia can be applied by the same team when cesarean section is indicated.

For those patients whose birth is not covered by private insurance policies, a birth package can be offered, which includes pregnancy follow-up visits by 4D ultrasound, routine laboratory tests, NST tests, targeted ultrasound by perinatologist at 20 weeks of gestation, birth package at the affiliated private hospitals including epidural anesthesia and baby’s first pediatric examination and vaccinations. When possible, fetal 4D ultrasound pictures and videos can be recorded and given to the family as memento at each antenatal visit.

Preconceptional Visit:

A preconceptional visit to a gynecologist is recommended for every patent who is planning to get pregnant. At this visit a general gynecological check up and pap smear test can be made. In addition, patient’s risk status can be evaluated before pregnancy and if she has any health issues, necessary consultations can be made with departments such as cardiology, endocrinology, genetics etc.

You can visit our recommendations to increase your chance of getting pregnant, page if you are planning to conceive.

At the antenatal visit:

• Your prepregnancy risk status will be evaluated.If you have problems such as thyroid disease, diabetes, hypertension or cardiac disease,you will be recommended to have a consultation with the appropriate specialist and get pregnant after your medical condition is stabilised.
• You will be checked for your rubella immune status and you will be offered to get a Rubella vaccine if you are not immune. If you get a Rubella vaccine, you should not get pregnant for at least during the next 3 months because it is a live attenuated vaccine.
• Ideally you should start taking a 400 microgram-folic acid supplement at least 3 months before getting pregnant.
• You should try to reach your ideal body mass index by starting a balanced diet and exercise programme before pregnancy.
• You should start taking an iron supplement before pregnancy, if you have iron deficiency anemia.
• You should stop consuming cigarettes and alcohol before pregnancy to reduce the risks to you and your baby.
• If you have to use any drugs regularly, they should be evaluated for any potential risks to the fetus and changed with alternatives that are safer for the baby during pregnancy.
• You should undergo a routine gynecological examination, have a Pap smear and a routine breast check up before pregnancy.
• You should be checked for any genetic risk factors for your fetus and referred to a genetic center if you have any family history of genetic conditions.

Pregnancy Week by Week

First Month

• Fertilised egg is implanted into uterine wall where some of the cells will form the placenta and some of the cells will form the embryo.
• Fetal extremities, brain and spine start to develop
• Lungs and heart start to develop and fetal heart starts to beat at the end of the first month

Second Month

• The eyelids are formed but they are closed
• Inner ear starts to develop
• Bones can be seen, wrists, ankles and fingers and toes are formed
• Genital organs start to develop
• At the end of the second month, all organs start to develop.

Third Month

• 20 toothbuds are formed for future teeth
• All internal organs are formed but still need to develop
• Fingers continue to develop and nails are formed
• Muscles and bones start to grow
• Intestines start to develop
• The spine is still soft and flexible
• The skin is almost transparent
• Hands are better developed than the feet
• Arms are longer than legs.

Fourth Month

• Eyebrows,eyelashes and nails are formed
• Arms and legs can be flexed
• External genital organs are formed
• Fetal skin is wrinkled and covered by vernix caseosa (creamy layer covering skin) and lanugo (fine hair)
• Placenta is totally formed
• External ear starts to develop
• Fetus can swallow and hear
• Fetal neck is formed
• Kidneys are formed and they produce urine.

Fifth Month

• Sucking reflex is present and fetus can suck its finger if it enters the mouth.
• The fetus is more active and its movements can be felt by the pregnant patient
• The fetus has regular sleep-wake up cycles
• The gall bladder starts to secrete bile for digestion
• The oocytes are formed in the ovaries in female fetuses
• The testes descend from the abdominal cavity into the scrotum in male fetuses.

Sixth Month

• The hair starts to grow
• The brain starts to develop fast
• The eyes start to open
• Fingerprints start to develop
• The lungs are totally formed but are not functional.

Seventh Month

• The eyes start to open and close and start to feel light changes
• Lanugo starts to disappear
• The fetus starts kicking and stretching
• The fetus starts to react to voices and starts to catch.

Eighth Month

• Most organs are formed and the fetus starts to gain weight faster
• The bones harden but the skulli is still soft and flexible enough for vaginal birth
• Different parts of brain start to develop
• Taste buds are formed on the tongue and the fetus can differeciate sweet and sour tastes
• Fetus starts hick up movements.

Nineth Month

• Fetus is mostly turned with the head down for natural birth
• The fetal skin is less wrinkled
• The lungs are totally formed
• Fetal sleep patterns are developed
• Fetus gains about 200 grams per week.