Routine OB Office Visits and Tests

We have listed below a general outline of when you will have visits and certain lab work and ultrasounds that will be performed at these visits. We will typically see you every four weeks for the first and second trimesters, then more frequently in the third trimester. During the last 4-6 weeks of pregnancy, we will see you weekly. This is a general summary, and you may require more visits or lab work depending on symptoms you develop or health problems you may already have. The description of these tests can be found by following the links.

All visits:

1. Urine screen—We are checking the urine for the presence of glucose (sugar) and protein. Large amounts of sugar can be a sign of diabetes. Protein in the urine can be a sign of infection, kidney disease, or preeclampsia (high blood pressure associated with pregnancy).

2. Fetal heart rate check—we will check for the baby’s heart rate at every visit. Early on we may not be able to hear it through the belly. In this case, we detect the fetal heart rate with ultrasound.

3. Weight—we will follow your weights throughout the pregnancy. Please see the section labeled Weight Gain (LINK) for more information on healthy weight gain during pregnancy.

4. Blood pressure

New OB visit: Typically around 7-8 weeks. For more detailed information regarding this first visit, please see the section labeled “New OB Visit Test and Labs(LINK).” We will perform a Pap, ultrasound, and blood work to include:

1. Blood type and antibody screen

2. CBC

3. Rubella

4. Hepatitis B virus

5. Syphilis

6. HIV

Please see section labeled “New OB Visit Labs and Tests” (LINK) for more detailed information on above.

12 weeks: Routine visit. You can typically hear the baby’s heart rate for the first time without use of ultrasound. Typically we do not do labwork at this visit.

15-20 weeks: We will do routine exams at this time and offer second trimester birth defect screening. Please see section labeled “Birth defects and 2nd trimester screening” (LINK)

18-20 weeks: At your visit that is scheduled between 18 and 20 weeks, we will perform a more detailed ultrasound. We offer an ultrasound to screen for certain anatomic defects. At this ultrasound, we look more closely at the baby’s spine, abdominal wall, heart, and kidneys. We can also typically determine the baby’s sex at this visit! If you are considering having a 4D ultrasound performed between 28 and 30 weeks, please schedule it around the time of this visit, as appointment slots fill quickly.

24-28 weeks: Routine visit with gestational diabetes screen (LINK).

28-30 weeks: This is best time to perform the 4D ultrasound. This is an optional exam, but many patients are pleased with the pictures we are able to provide. Please see section labeled “4D ultrasound” for further details of this (LINK).

32 weeks: Routine exam with CBC and syphilis (LINK—3rd trimester)

35 weeks: Routine visit with GBS screen (LINK—3rd trimester)

36-40 weeks: You will come to the office weekly. We will start doing cervical exams to see if the cervix is starting to dilate. If you are scheduling an induction, we will also schedule that around this time.

When your physician checks you, several things are being assessed:

▪ Cervical dilation—how open is the cervix. This is a number, measured in centimeters, typically between 1 and 4 (until you move into active labor).

▪ Cervical effacement—how thin is the cervix. This number is a percentage from 0-100%

▪ Fetal station—this is a measurement of how far down the baby’s head is and is a number from -4 to +4.

▪ Fetal presentation—we can assess on exam what body part is presenting, in other words, whether or not the head is down.

As an example of above, when the cervix is fully dilated and the mother is ready to begin pushing, the usual exam is 10/100%/+2.