# Pregnancy and Birth — Topic Guide > Care from preconception counselling through to birth, ultrasound scans and screening tests. Care from preconception counselling through to birth, ultrasound scans and screening tests. ## Pages on this subject ### [Preconception Counselling](https://www.muratalpay.com.tr/en/tedaviler/gebelik-oncesi-danisma/) Preconception counselling is planning the preparation for pregnancy before conceiving. Folic acid and iodine supplements, vaccination status, long-term conditions and the medicines being taken, weight, smoking and alcohol are reviewed. For some measures to be effective they need to be started months before conceiving. Changes to medicines are made with your doctor, not on your own; epilepsy medicines must never be stopped suddenly without consulting a doctor. ### [Pregnancy Care](https://www.muratalpay.com.tr/en/tedaviler/gebelik-takibi/) Antenatal care is the check-ups and tests carried out at set weeks throughout pregnancy. In a pregnancy that runs without problems, about 10 check-ups are expected for those in a first pregnancy and 7 for those who have given birth before; the booking visit is recommended before week 10. At every check-up blood pressure is measured, the urine is tested for protein and the baby's heart sounds are listened to. This schedule is based on international guidelines; national programmes differ. ### [High-Risk Pregnancy](https://www.muratalpay.com.tr/en/tedaviler/riskli-gebelik/) A higher-risk pregnancy is one in which there is something that could affect the health of the mother or the baby. This may be a condition present before pregnancy, a problem in a previous pregnancy, a condition arising in this pregnancy or one arising from the baby. The pregnancy is watched more closely; ultrasound checks become more frequent according to the level of risk. The level of risk is not fixed and is reassessed at every check-up; a reduction in the baby's movements is an important warning sign. ### [Screening Tests in Pregnancy](https://www.muratalpay.com.tr/en/tedaviler/gebelikte-tarama-testleri/) Screening ultrasounds in pregnancy are examinations that assess the baby's structures and certain risks; the two basic scans are done at weeks 11–14 and 18–22. The first confirms that the pregnancy is viable and how many babies there are, establishes the gestational age and assesses the risk of chromosomal differences and pre-eclampsia. The second examines all the baby's organ systems in detail. Findings such as the nasal bone not being seen are an indicator of risk, not a diagnosis. ### [4D Ultrasound](https://www.muratalpay.com.tr/en/tedaviler/4-boyutlu-ultrason/) Three-dimensional ultrasound is an examination that shows structures in three different planes at once; four-dimensional ultrasound does the same in motion. Its real value is in showing what two-dimensional ultrasound cannot: the structure of the womb and the baby's brain and spine. Routine screening is done with two-dimensional ultrasound. It involves no radiation; according to guidelines, ultrasound should not be performed solely to obtain a keepsake image. ### [Your Baby's Development](https://www.muratalpay.com.tr/en/tedaviler/bebegin-gelisimi/) The baby's development progresses in three periods: in the first trimester the outline of the organs is laid down, in the second the organs begin to function, and in the third the baby prepares for the outside world. Movement of the heart can generally be seen on ultrasound from weeks 5–6; movements are generally first felt at weeks 18–20. Movements do not decrease in frequency in the last months; if you notice a reduction, tell your health service without waiting. ### [Ectopic Pregnancy](https://www.muratalpay.com.tr/en/tedaviler/dis-gebelik/) An ectopic pregnancy is one in which the fertilised egg settles outside the cavity of the womb. Diagnosis combines ultrasound with the pregnancy hormone (hCG) measured in the blood 48 hours apart; this blood test shows not where the pregnancy is but how the process is progressing. Depending on the findings, expectant management (watching and waiting), drug treatment or surgery is chosen. Until the location is established, an ectopic pregnancy is not regarded as ruled out; symptoms are more important than test results. ### [NIPT (Cell-Free DNA Test)](https://www.muratalpay.com.tr/en/tedaviler/nipt/) NIPT is a **screening test, not a diagnostic test** that examines the baby's DNA fragments (mostly from the placenta) in the mother's blood. It can be done from week 10 of pregnancy and does not carry a risk of miscarriage. It is strongest for Down syndrome. A high-risk result is only final once confirmed by amniocentesis or chorionic villus sampling. ### [Pregnancy Due Date Calculator](https://www.muratalpay.com.tr/en/tedaviler/gebelik-haftasi-hesaplama/) A pregnancy week calculation takes the first day of the last menstrual period as the starting point and works out the week of pregnancy and the estimated due date. For the due date, 280 days are added to the date of the last period. Because it assumes a 28-day cycle and ovulation on day 14, the result is an estimate. Precise dating is done by ultrasound; if there is a difference, the ultrasound result is taken as the basis. ### [Ovulation Calculator](https://www.muratalpay.com.tr/en/tedaviler/yumurtlama-hesaplama/) An ovulation calculation estimates the day of ovulation and the fertile window from the first day of the last period and the cycle length. Ovulation is placed about 14 days before the next period; the fertile window begins 5 days before ovulation and ends 1 day after it. The result is an estimate, is not reliable with irregular cycles and cannot be used as a method of contraception. ### [Diagnostic Curettage](https://www.muratalpay.com.tr/en/tedaviler/tanisal-kuretaj/) Diagnostic curettage is taking a tissue sample from the lining of the womb for pathological examination (examination of the tissue in the laboratory). It is most often considered for abnormal uterine bleeding, and also when investigating fertility problems. Guidelines now put forward examining the cavity of the womb under direct vision with hysteroscopy (viewing the inside of the womb with a camera); this can be done as an outpatient without general anaesthesia. The procedure can be associated with significant pain and anxiety; you can ask for it to be stopped. ### [Abortion (Termination of Pregnancy)](https://www.muratalpay.com.tr/en/tedaviler/kurtaj/) Abortion is the ending of a pregnancy in the womb and the emptying of the womb. In Türkiye it can be carried out on request until the 10th week of pregnancy is complete; the week is confirmed by ultrasound. In the surgical method the pregnancy is removed through the neck of the womb by vacuum (gentle suction); the procedure usually takes 5–10 minutes and you go home the same day. Options include local numbing, sedation (light sleep) or general anaesthesia (being fully asleep); afterwards, cramps for a few days and bleeding that may last a few weeks are expected. ## Posts on this subject - [Nausea and vomiting in pregnancy](https://www.muratalpay.com.tr/en/blog/gebelikte-bulanti-kusma/) - [HPV in Pregnancy: Can It Pass to the Baby, and Can I Have a Normal Birth?](https://www.muratalpay.com.tr/en/blog/gebelikte-hpv-bebege-gecer-mi-normal-dogum-olur-mu/) - [Feeling faint in pregnancy](https://www.muratalpay.com.tr/en/blog/gebelikte-bayginlik-bayilma-hissi/) - [Calculating the week of pregnancy](https://www.muratalpay.com.tr/en/blog/gebelik-haftasi-hesaplama/) - [Diagnostic curettage (endometrial biopsy): what it is](https://www.muratalpay.com.tr/en/blog/tanisal-kuretaj-rahim-ici-biyopsi-nedir-op-dr-murat-alpay-antalya/) - [Is curettage always needed after a miscarriage?](https://www.muratalpay.com.tr/en/blog/dusuk-sonrasi-kuretaj-gerekir-mi-rest-kuretaj-hakkinda-bilinmesi-gerekenler/) - [Is Abortion Banned in Türkiye? Legal Time Limit, Spousal Consent and Conditions](https://www.muratalpay.com.tr/en/blog/turkiye-de-gebelik-tahliyesi-kurtaj-yasal-cerceve-ve-tibbi-surecler/) - [When Does Your Period Return After a Termination? First Period, Bleeding and Delays](https://www.muratalpay.com.tr/en/blog/kurtaj-sonrasi-adet-ne-zaman-baslar-tekrar-gebelik-mumkun-mu-antalya/) [All posts →](https://www.muratalpay.com.tr/en/blog/) --- Original page: https://www.muratalpay.com.tr/en/gebelik-ve-dogum/ Op. Dr. Murat Alpay — Specialist in Obstetrics and Gynaecology Op. Dr. Murat Alpay Practice, Tekelioğlu Cd. No:51 B Kat:2, Filo Apt., 07160 Muratpaşa / Antalya 0505 351 77 88 · Monday – Saturday 09:00 – 18:00 · Closed on Sunday *This information is for general guidance only and does not replace examination, diagnosis or treatment.*