The schedule below is based on international guidelines. National antenatal care programmes differ between countries; ask your doctor about your own plan.
The check-up schedule
| Week | What is done |
|---|---|
| Before week 10 | The booking visit (by week 14 at the latest) |
| 11–14 | First trimester ultrasound and screening test |
| 16 | Routine check-up |
| 18–21 | Detailed ultrasound |
| 25 | First pregnancy only |
| 28 | An important check-up — blood tests are repeated |
| 31 | First pregnancy only |
| 34 | Routine check-up |
| 36 | The check-up at which the birth plan is settled |
| 38 | Routine check-up |
| 40 | First pregnancy only |
| 41 | Assessment for going past the date and planning of the birth |
What is done at every check-up?
- Measuring blood pressure and testing the urine for protein — done at every visit to screen for pre-eclampsia.
- Measuring the height of the womb — measured over the abdomen with a tape and plotted on a growth chart. It is generally done at every check-up from the week 28 visit onwards.
- Listening to the baby's heart sounds.
- Asking about the baby's movements — asked at every check-up, particularly after week 28.
- Assessment of general condition, sleep pattern and complaints such as swelling (oedema).
Measuring the height of the womb is not reliable in everyone. In those with a body mass index above 35, or with a large fibroid in the womb, this measurement can be misleading; these women are followed up directly by ultrasound.
The tests requested
At the booking visit
- Blood group and antibody screening — for blood group incompatibility
- Full blood count — for anaemia. In the first three months a haemoglobin below 11 g/dL is regarded as anaemia.
- Infection screening: HIV, hepatitis B and syphilis — offered to every pregnant woman in order to prevent transmission to the baby.
- Urine culture — to detect a urinary tract infection that is causing no symptoms
- Measurement of exposure to smoking and assessment of mental health
Guidelines do not recommend routine screening in the general pregnant population for chlamydia, bacterial vaginosis, genital herpes and hepatitis C — these are requested according to the level of risk.
At weeks 11–14
By combining the measurement of the thickness at the back of the neck with two values in the mother's blood, a risk calculation for chromosomal differences is made.
In the same period, by combining the mother's risk factors, blood pressure, Doppler of the uterine arteries and a blood value, a risk calculation for pre-eclampsia can also be made.
At weeks 24–28
- Glucose tolerance test — carried out in those with risk factors (excess weight, diabetes in the family, gestational diabetes in a previous pregnancy and so on).
- The full blood count is repeated. The threshold for anaemia is different in this period: a haemoglobin below 10.5 g/dL.
- Antibody screening is repeated — in everyone, whatever their blood group.
A critical detail for Rh-negative women: this blood sample must be taken immediately before the anti-D injection is given. Getting the order wrong makes the result difficult to interpret.
At weeks 35–37
If screening is to be done, taking a group B streptococcus culture is recommended in these weeks, in order to determine the risk of transmission to the baby at birth and the need for antibiotics.
How is growth followed in the third trimester?
In the last three months the baby's growth is followed at the examination by measuring the height of the womb and plotting it on a growth chart. Ultrasound is used to complete the assessment.
Situations in which ultrasound is particularly requested:
- A plateau or a deviation from the chart in the measurement of the height of the womb
- A reduction in the baby's movements
- A newly developed condition in the mother — such as high blood pressure or bleeding
- Situations in which the measurement is not reliable — a high body mass index or a large fibroid in the womb
The follow-up plan is different in higher-risk pregnancies; see High-Risk Pregnancy.
Frequently Asked Questions
How many check-ups will I have?
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. It is recommended that the booking visit take place before week 10 (by week 14 at the latest).
What is done at every check-up?
Blood pressure is measured and the urine tested for protein (screening for pre-eclampsia), the baby's heart sounds are listened to, generally from week 28 the height of the womb is measured and plotted on a growth chart, and the baby's movements are asked about, particularly after week 28.
Is measuring the height of the womb reliable in everyone?
No. In those with a body mass index above 35 or with a large fibroid in the womb, this measurement can be misleading. These women are followed up directly by ultrasound.
Which tests are requested at the first visit?
Blood group and antibody screening, a full blood count, screening for HIV, hepatitis B and syphilis, a urine culture, measurement of exposure to smoking and assessment of mental health. Guidelines do not recommend routine screening in the general pregnant population for chlamydia, bacterial vaginosis, genital herpes and hepatitis C — these are requested according to the level of risk.
Is the glucose tolerance test done for everyone?
In the guidelines the test is carried out in those with risk factors between weeks 24 and 28: excess weight, diabetes in the family, gestational diabetes in a previous pregnancy and so on. National programmes differ; ask your doctor about your own situation.
I am Rh negative — what should be watched at week 28?
Antibody screening is repeated in this week, and there is a critical order: the blood sample must be taken immediately before the anti-D injection is given. Getting the order wrong makes the result difficult to interpret.
In which situations is an ultrasound requested in the last months?
In the last three months growth is followed at the examination by measuring the height of the womb; ultrasound is used to complete the assessment. The situations in which it is particularly requested: a plateau or deviation from the chart in the measurement, a reduction in the baby's movements, a newly developed condition in the mother (high blood pressure, bleeding), and situations in which the measurement is not reliable.
Why does the threshold for anaemia change?
Because the volume of blood increases in pregnancy, so the values naturally fall. In the first three months a haemoglobin below 11 g/dL is regarded as anaemia, while around week 28 the figure is below 10.5 g/dL. For this reason the same value is interpreted differently at different weeks.
Sources
- NICE and RCOG antenatal care guidelines — the schedule of visits, the assessments made at each check-up and the screening tests.
- British Society for Haematology (BSH) — thresholds for anaemia in pregnancy and monitoring of red cell antibodies; the order of sampling in anti-D administration.
The information on this page is based on the national and international guidelines listed above. The page is reviewed whenever those guidelines are updated.
Practice and Contact Details
The information on this page is general. Please speak to your doctor about your own situation.
- DoctorOp. Dr. Murat Alpay — Specialist in Obstetrics and Gynaecology
- AddressOp. Dr. Murat Alpay Practice, Tekelioğlu Cd. No:51 B Kat:2, Filo Apt., 07160 Muratpaşa / Antalya
- Telephone0505 351 77 88
- HoursMonday – Saturday 09:00 – 18:00 · Closed on Sunday