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Hello. What is up, guys? Welcome to another episode of four Vaginas. Only this episode is gonna be on early prenatal care. Hello and welcome to four vaginas. Only the podcast about everything. Female. I'm your host, Dr Celestine, bringing you important information about understanding your health and body in the way you wish your doctor would actually explain it. Hey, guys, it's me, Dr Cellasene here with another episode of four vaginas. Only this episode is on prenatal care, especially early prenatal care. All of the important things you need to know about the very beginning of your pregnancy went to start getting care how we determine what your due date will be, When and why do you need certain ultrasounds and also talk about some of the lab work that we do and why that's needed as well. So sit back, relax. And let's talk about the things you need to know in the beginning of your pregnancy. Okay? So first things first. Ah, lot of people want to know. When do you start prenatal care? When do you start going to the O. B. Julian for your pregnancy? The general answer is as soon as you possibly can, um, the specific answer would be in the first trimester earlier is always better, because there's a host of things that we need to do in order to make sure that the pregnancy is a healthy pregnancy. So the sooner you come in, the better you know, you will be. Um but I would say generally, as long as you come in the first trimester, which is before 14 weeks of the pregnancy, then you should be in good shape when you come for your first visit, One of the initial things that your physician will d'oh will be to determine what the due date is for your pregnancy that is done in a conjunction or with the conjunction of two things. So the first thing that you need to know when you go to the doctor's office is what was the first day of the last menstrual period that you had? That's very important information to come to the doctor's office with, because that helps us determine what you're correct. Due date is yes, we do also do an ultrasound as well, but it's best if you use the dating from the ultrasound in conjunction with the dating from the first day of your last menstrual period in order to get closer to what the exact due date should be. Some people do come to the office. They're not sure of their first menstrual period or they get very irregular periods, and that's okay, too, as long as you come early on in the first trimester. The ultrasound alone should Bree pretty accurate. But if you can make sure you know the first day of your last menstrual period. Now, when I see patients for the very first time that our newly pregnant I go through a whole host of things about what to expect with their prenatal care. The majority of that I will discuss with you guys today. But there is a lot more that I can't go into full detail with on a podcast list. You want to listen to like, an hour long episode. But you know, the initial thing that I talk about is what to expect in terms of visits. So what is recommended is that you come to the physician's office. You're over Joan's office every four weeks until you're about 28 weeks pregnant than every two weeks until you're 36 weeks pregnant. And then, after 36 weeks, you come weekly. Now I know that differs in many different over Julian's office offices. It even differs where I work, um, by a little bit, and it can also change depending on what is going on in your pregnancy. If you are a higher risk pregnancy, or if there's a concern for something in a period of time during the pregnancy, then you might need to come more frequent to the doctor's office. Okay, so back to determine your due date just really quick. We do the ultrasound, and we compare that to the first day of your last menstrual period in order to find the due date. Like I said now, when you come earlier on in the pregnancy, if it's about five days different than we stick with your period due date, if it's more than five days different than it changes and as you come if you come later on in the pregnancy for your very first visit, that gap changes a lot more later on. It's a seven day difference, a 10 day difference, a 14 and 21 day difference. So the earlier you come to the office with the first day of your last menstrual period, the better off you'll be in terms of the exact babies or the exact due date for your baby. And aside from that initial ultrasound where we take a look and see how many babies you're carrying, a CZ well as what the due date could possibly be based on the size of the baby at that time, that all happens in the first trimester. There's also an additional ultrasound in the second trimester, around 18 to 22 weeks where we look at the baby's anatomy. How the limbs air forming, how the brain is forming a little bit about how the heart is forming so that we can make sure that the anatomy of the baby up to that point is normal. Now, a lot of people usually want or request more than just those two ultrasounds, which I totally get. I mean, you know you're having a baby, you're very excited. You want to see how it's doing all the time, but there's a couple of reasons why Ah, lot of doctor's offices don't do multiple ultrasounds. One is because we really only do ultrasounds aside from those two when they're clinically indicated. So if there's something else going on in the pregnancy or something else that we're concerned about, if you've had vaginal bleeding or you know if you're having severe pain or anything like that, then we will do an ultrasound. The other reason why we do bless ultrasounds then you would probably want is because not all insurances will pay for all these ultrasounds. Now, To be honest, I do not know much about insurance, which is really a shame. But what I do know in general is that there's only a certain number of ultrasounds that insurance carriers will pay for. So you don't want to end up getting an ultrasound. But you really don't need for any abnormal reason and then have to pay some monstrous bill. Because of that, there's many other things that we do during your prenatal care to make sure the baby is OK. I know you want those pictures, but we really only do it. If it's indicated all right, then we get to the lab work. Now I know that there are a lot of labs that we do during pregnancy in this episode. I'm really only gonna talk about the ones that we initially do and why we do them. I have a lot of people that, you know, hate needles. They don't want to do this blood work. Um, but it's important, and the earlier you get it done, the better. That's because we need to identify certain conditions that may affect the pregnancy outcome. And just like anything else, the earlier you find out anything that might be wrong, the better chance you have of treating it or correcting it, or at least monitoring it to make sure it doesn't get worse. Okay, so two things that we check for in this initial blood work are your blood type and your R H type. Now your blood type is important to know just in case down the line. After you deliver, you might need a transfusion. It's also important to know for the pediatrician because the pediatrician needs to compare your blood type to the baby's blood type after delivery. The R H type is important for something called I So immunization that can make the baby very sick while still in the uterus. If you turn out to be R H Negative. Then you will need an injection of a medication called program at about 28 weeks and also possibly after you deliver in order to prevent this problem and not this pregnancy but your future pregnancies. Another thing that we check for in this initial blood work is your complete blood count, or CBC, which includes your hemoglobin and your him adequate levels. Now that tells us whether or not you are anemic. And if we need to supplement with iron pills during the pregnancy, there are studies out there that show that severe iron deficiency during pregnancy can lead to preterm delivery or having a low birth weight. Baby. We also do a urine culture, and that's where we test your urine for bacteria. When you're pregnant, we test for something especially called asymptomatic back to area, which means that you have bacteria in your urine and it doesn't feel like a U T. I. You have no symptoms. You're not having the burning with urination or anything like that. But there is bacteria present. That is because this asymptomatic bacteria in your urine can lead to things such as premature birth or low birthweight infants and also increases your chance of having a kidney infection during the pregnancy. We also test you for hepatitis B, and that is because if you do have it, if you're positive, the baby needs treatment immediately after delivery. So it's important to know ahead of time and we check for certain Sexually transmitted disease is one of the things we check for is syphilis, which can lead to a stillbirth or improper fetal organ development. So it's important to know early on we also check for gonorrhea or chlamydia at your very first visit. And if you are less than or equal to 25 years of age, we also check for it again in the third trimester. That's because not only do these or can these lee to preterm delivery as well, but they can both lead to severe eye infection and blindness in the baby. If you has active gonorrhea, Orkla media at the time of delivery so we can treat for it in pregnancy and we also retest you about 3 to 6 months after to make sure that it's completely gone. The other thing we test for his HIV because there are medications that we can give early on in pregnancy to prevent the transmission of the HIV virus to the baby and separate from all that we test for tuberculosis as well. Okay, now I would like to touch on a few of the vaccines that you can get during your pregnancy. Many people don't love these vaccines. Like I said, people that don't are afraid of needles are afraid of what these vaccines might do during pregnancy. But these are The vaccines that are safe during pregnancy have been tested and researched. The 1st 1 is the flu vaccine. Now there's different types of the flu vaccine and pregnancy, especially, you need the inactivated virus. And also it's important to note if you are allergic toe eggs, because the way the flu vaccine is made, if you get the regular inactivated flu vaccine, you can have a reaction to it. But there's also a flu vaccine that you can get if you are allergic to eggs, so you have to make sure that you bring that up with your physician. The flu vaccine can be given in any trimester of the pregnancy, and now I know the flu vaccine this year wasn't was not the best, but in general, if you are pregnant during flu season, then you should get the flu vaccine another vaccine, which is not really in early pregnancy. But I'm just gonna touch on it since we're talking vaccines right now. Is the teed up vaccine longer name being tetanus, diphtheria and protest? It's vaccine that is given between the 27 36 week range of your pregnancy. The reason that we give that vaccine is especially for the per Tutsis factor. You get immunized so that that protection can go to your unborn baby is that when it's delivered, it's protected against pertussis, which is also known as Wu Ping Cough. The baby itself cannot get vaccinated until it about two months of age, and it's actually more susceptible to the whooping cough prior to the time where it could be vaccinated. So it's important for you as a pregnant mom to be vaccinated during that time period. Other vaccines that can be given during pregnancy hepatitis A hepatitis B, pneumococcal vaccine, those air in special situations, but they are okay in pregnancy. But talk to your physician about whether or not you may need those okay. And lastly, one of the things that we do early on in pregnancy is checking for chromosomal abnormalities. We use different markers in a combination of blood work and ultrasound in order to look for what we call an employee or chromosomal abnormality is one of the most common ones being down syndrome. And there's another test called cell free D, a name, which is a blood test that can look for the common abnormalities as well and, if requested, also the sex chromosomes. So you can see if you're having a boy or a girl based on the mom's blood work. However, the scope of the conditions that are detectable by this cell free DNA blood tests continues to evolve. And therefore, you know at the time that you might be pregnant or you might be listen to his podcast. The things that we can test for might expand. I don't want to get too much into that. Right now. I feel like testing for an employee and downs and German things like that I'd liketo have as a separate podcast episode, preferably with a maternal fetal medicine or high risk doctor. So if you are out there and you listen to this podcast. You like to come on and talk about that? Then send me an email at Dr See at f ve only dot com, okay. And for really lastly, this time I would like to in general just talk about weight gain. So a lot of times and pregnancy, people want to know exactly how much weight they should be gaining during their pregnancy. Now, it depends on what your weight was before you were pregnant. In order for me to tell you exactly how much weight you should be gaining during the pregnancy. So it depends on something called your body mass index or your B m I. The way you calculate b m I is your weight in kilograms divided by your height in meters squared. Yeah, that's, you know, weird formula. You don't have to memorize that literally. If you Google b m I calculator, you can put in some information and find out what your B m I is now based on your B m. I. They're certain ranges of weight that you should be gaining and pregnancy. If your b m I is less than 18.5, you should gain between 28 £40. If it's your B M eyes between 18.5 toe 25 you should be gaining between 25 £35. If you are being my is 25 to 30 you should be getting between 15 to £25. And if your B M I is greater than or equal to 30 you should be gaining between 11 to £20 during pregnancy. Those are just ranges. They differ depending on each person, and they also differ depending on each pregnancy. For example, if you're having twins, you're going to gain more weight than that. But that's just what my quick little tidbit on weight gain during pregnancy. And that's all, folks, that is the end of the early prenatal care pot gets Episode 44 vaginas only. There's a few things I did not touch on. A lot of that is on purpose because I'd like to do them in more detail episodes later on for you guys. You have a better idea and understanding of those particular things, but in general that's what you can expect to have done in the very early parts of your pregnancy. So take this knowledge with you. Bring us your doctor's office, discussed them with your doctor and discuss what extra things my even be recommended for you because of your specific family history or your specific pregnancy concerns or problems. If there's anything else that you need to know or any other questions you have for me, you can reach me at Dr C at f b only dot com. There's also a four vaginas only Facebook group, as well as a four vaginas on Lee Instagram page, where I receive messages on as well. So check those out and you could always check out the four vaginas on Lee Blawg at f ve only dot com. So that's it, and I'll see you guys next time.