{"id":16213,"date":"2026-01-06T14:15:14","date_gmt":"2026-01-06T13:15:14","guid":{"rendered":"https:\/\/valintermed.com\/?p=16213"},"modified":"2026-01-06T14:15:14","modified_gmt":"2026-01-06T13:15:14","slug":"vedenie-beremennosti-po-trimestram","status":"publish","type":"post","link":"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/","title":{"rendered":"A Complete Guide to Pregnancy Care: Tests, Ultrasound, and Medical Monitoring by Trimester"},"content":{"rendered":"<div class=\"fpm_start\"><\/div>\n<p><span lang=\"EN-US\">Author&#039;s clinical commentary: doctor <a href=\"https:\/\/valintermed.com\/en\/about-us\/\">Korzhykov<\/a>, family doctor (VALINTERMED company)<\/span><\/p>\n<p>Pregnancy is a physiological condition accompanied by profound hormonal, anatomical, and metabolic changes in a woman&#039;s body. Although most pregnancies proceed without complications, this period requires systematic medical monitoring to detect potential abnormalities early, prevent complications, and ensure optimal conditions for fetal development.<\/p>\n<p>Antenatal care (pregnancy monitoring) includes a combination of clinical, laboratory, and instrumental examinations aimed at assessing the condition of the mother and fetus at different stages of gestation. Modern pregnancy management protocols are based on evidence-based medicine principles and are adapted depending on the gestational age, risk factors, and the individual characteristics of the patient.<\/p>\n<p>This material is an expanded protocol for monitoring low-risk pregnancies, structured by trimester. I have endeavored to explain simply and clearly how pregnancy care is performed in Spain. The scope of examinations may vary depending on the individual&#039;s medical history, risk factors, and the progress of the pregnancy.<\/p>\n<p>This article provides an extensive guide to pregnancy care, detailing the examinations, tests, and screenings performed in each trimester, with clinical explanations that are understandable to both healthcare professionals and patients.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-16219 size-full\" src=\"https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/consulta-medica-obstetricia-20_19_20-e1767643660773.png\" alt=\"Pregnancy management by trimester: medical monitoring, tests, and ultrasound\" width=\"1000\" height=\"757\" title=\"\" srcset=\"https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/consulta-medica-obstetricia-20_19_20-e1767643660773.png 1000w, https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/consulta-medica-obstetricia-20_19_20-e1767643660773-300x227.png 300w, https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/consulta-medica-obstetricia-20_19_20-e1767643660773-768x581.png 768w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\" \/><\/p>\n<hr \/>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_85 counter-flat ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Content<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9E%D0%B1%D1%89%D0%B8%D0%B5_%D0%BF%D1%80%D0%B8%D0%BD%D1%86%D0%B8%D0%BF%D1%8B_%D0%B2%D0%B5%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\" >General principles of pregnancy management<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9F%D0%B5%D1%80%D0%B2%D1%8B%D0%B9_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_0%E2%80%9313_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8C_%D0%B0%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7%D1%8B_%D0%A3%D0%97%D0%98_%D0%B8_%D1%80%D0%B0%D0%BD%D0%BD%D0%B8%D0%B9_%D1%81%D0%BA%D1%80%D0%B8%D0%BD%D0%B8%D0%BD%D0%B3\" >First trimester of pregnancy (0\u201313 weeks): tests, ultrasound, and early screening<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9F%D1%80%D0%B8%D0%BD%D1%86%D0%B8%D0%BF%D1%8B_%D0%BD%D0%B0%D0%B1%D0%BB%D1%8E%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_VALINTERMED\" >VALINTERMED Pregnancy Monitoring Principles<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A6%D0%B5%D0%BB%D0%B8_%D0%BD%D0%B0%D0%B1%D0%BB%D1%8E%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B2_%D0%BF%D0%B5%D1%80%D0%B2%D0%BE%D0%BC_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B5\" >Goals of first trimester monitoring<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9F%D0%B5%D1%80%D0%B2%D0%B8%D1%87%D0%BD%D1%8B%D0%B9_%D0%B2%D0%B8%D0%B7%D0%B8%D1%82_%D0%BA_%D0%B0%D0%BA%D1%83%D1%88%D0%B5%D1%80%D1%83-%D0%B3%D0%B8%D0%BD%D0%B5%D0%BA%D0%BE%D0%BB%D0%BE%D0%B3%D1%83_7%E2%80%939_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8C\" >Initial visit to the obstetrician\/gynecologist (7-9 weeks)<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9B%D0%B0%D0%B1%D0%BE%D1%80%D0%B0%D1%82%D0%BE%D1%80%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BF%D0%B5%D1%80%D0%B2%D0%BE%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0\" >Laboratory tests of the first trimester<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9A%D0%BE%D0%BC%D0%B1%D0%B8%D0%BD%D0%B8%D1%80%D0%BE%D0%B2%D0%B0%D0%BD%D0%BD%D1%8B%D0%B9_%D0%BF%D1%80%D0%B5%D0%BD%D0%B0%D1%82%D0%B0%D0%BB%D1%8C%D0%BD%D1%8B%D0%B9_%D1%81%D0%BA%D1%80%D0%B8%D0%BD%D0%B8%D0%BD%D0%B3_I_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0\" >Combined prenatal screening of the first trimester<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%92%D1%82%D0%BE%D1%80%D0%BE%D0%B9_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_14%E2%80%9328_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8C_%D0%BC%D0%BE%D1%80%D1%84%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%BE%D0%B5_%D0%A3%D0%97%D0%98_%D0%B0%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7%D1%8B_%D0%B8_%D0%BF%D1%80%D0%BE%D1%84%D0%B8%D0%BB%D0%B0%D0%BA%D1%82%D0%B8%D0%BA%D0%B0\" >Second trimester of pregnancy (14\u201328 weeks): morphological ultrasound, tests and prevention<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9A%D0%BB%D0%B8%D0%BD%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D0%B7%D0%B0%D0%B4%D0%B0%D1%87%D0%B8_%D0%B2%D1%82%D0%BE%D1%80%D0%BE%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0\" >Clinical tasks of the second trimester<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A3%D0%BB%D1%8C%D1%82%D1%80%D0%B0%D0%B7%D0%B2%D1%83%D0%BA%D0%BE%D0%B2%D0%BE%D0%B5_%D0%B8%D1%81%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D0%B5_%D0%B2%D1%82%D0%BE%D1%80%D0%BE%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0\" >Second trimester ultrasound<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9B%D0%B0%D0%B1%D0%BE%D1%80%D0%B0%D1%82%D0%BE%D1%80%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B2%D1%82%D0%BE%D1%80%D0%BE%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0\" >Laboratory tests of the second trimester<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A1%D0%BA%D1%80%D0%B8%D0%BD%D0%B8%D0%BD%D0%B3_%D0%B3%D0%B5%D1%81%D1%82%D0%B0%D1%86%D0%B8%D0%BE%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82%D0%B0\" >Screening for Gestational Diabetes<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9F%D1%80%D0%BE%D1%84%D0%B8%D0%BB%D0%B0%D0%BA%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D0%BC%D0%B5%D1%80%D0%BE%D0%BF%D1%80%D0%B8%D1%8F%D1%82%D0%B8%D1%8F_%D0%B2%D0%BE_%D0%B2%D1%82%D0%BE%D1%80%D0%BE%D0%BC_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B5\" >Preventive measures in the second trimester<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A2%D1%80%D0%B5%D1%82%D0%B8%D0%B9_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_29%E2%80%9340_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8C_%D0%BF%D0%BE%D0%B4%D0%B3%D0%BE%D1%82%D0%BE%D0%B2%D0%BA%D0%B0_%D0%BA_%D1%80%D0%BE%D0%B4%D0%B0%D0%BC_%D0%B8_%D0%BA%D0%BE%D0%BD%D1%82%D1%80%D0%BE%D0%BB%D1%8C_%D1%81%D0%BE%D1%81%D1%82%D0%BE%D1%8F%D0%BD%D0%B8%D1%8F_%D0%BF%D0%BB%D0%BE%D0%B4%D0%B0\" >Third trimester of pregnancy (29\u201340 weeks): preparation for childbirth and monitoring the condition of the fetus<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A6%D0%B5%D0%BB%D0%B8_%D0%BD%D0%B0%D0%B1%D0%BB%D1%8E%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B2_%D1%82%D1%80%D0%B5%D1%82%D1%8C%D0%B5%D0%BC_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B5\" >Goals of third trimester surveillance<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9B%D0%B0%D0%B1%D0%BE%D1%80%D0%B0%D1%82%D0%BE%D1%80%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D1%82%D1%80%D0%B5%D1%82%D1%8C%D0%B5%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0_32%E2%80%9334_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D0%B8\" >Laboratory tests for the third trimester (32\u201334 weeks)<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A3%D0%BB%D1%8C%D1%82%D1%80%D0%B0%D0%B7%D0%B2%D1%83%D0%BA%D0%BE%D0%B2%D0%BE%D0%B5_%D0%B8%D1%81%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D0%B5_%D1%82%D1%80%D0%B5%D1%82%D1%8C%D0%B5%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0_32%E2%80%9336_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8C\" >Third trimester ultrasound (32\u201336 weeks)<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A1%D0%BA%D1%80%D0%B8%D0%BD%D0%B8%D0%BD%D0%B3_%D0%BD%D0%B0_Streptococcus_agalactiae\" >Screening for Streptococcus agalactiae<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9A%D0%B0%D1%80%D0%B4%D0%B8%D0%BE%D1%82%D0%BE%D0%BA%D0%BE%D0%B3%D1%80%D0%B0%D1%84%D0%B8%D1%8F_%D0%9A%D0%A2%D0%93\" >Cardiotocography (CTG)<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%97%D0%B0%D0%BA%D0%BB%D1%8E%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\" >Conclusion<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A0%D0%B0%D1%81%D1%88%D0%B8%D1%80%D0%B5%D0%BD%D0%BD%D1%8B%D0%B9_%D1%87%D0%B5%D0%BA-%D0%BB%D0%B8%D1%81%D1%82_%D0%BD%D0%B0%D0%B1%D0%BB%D1%8E%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%BF%D0%BE_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8F%D0%BC\" >An expanded pregnancy checklist by week<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9E%D0%B1%D1%8F%D0%B7%D0%B0%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D1%8B%D0%B5_%D0%B8_%D1%80%D0%B0%D1%81%D1%88%D0%B8%D1%80%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5_%D0%BE%D0%B1%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BF%D1%80%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\" >Mandatory and extensive examinations during pregnancy<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-23\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9E%D0%B1%D1%8F%D0%B7%D0%B0%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D1%8B%D0%B5_%D0%BE%D0%B1%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Mandatory examinations<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-24\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A0%D0%B0%D1%81%D1%88%D0%B8%D1%80%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5_%D0%BE%D0%B1%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BF%D0%BE_%D0%BF%D0%BE%D0%BA%D0%B0%D0%B7%D0%B0%D0%BD%D0%B8%D1%8F%D0%BC\" >Extended examinations (as indicated)<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-25\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A7%D0%B0%D1%81%D1%82%D1%8B%D0%B5_%D0%BA%D0%BB%D0%B8%D0%BD%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%81%D0%B8%D1%82%D1%83%D0%B0%D1%86%D0%B8%D0%B8_%D0%BF%D1%80%D0%B8_%D0%B2%D0%B5%D0%B4%D0%B5%D0%BD%D0%B8%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\" >Common clinical situations during pregnancy management<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-26\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%90%D0%BD%D0%B5%D0%BC%D0%B8%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\" >Anemia in pregnant women<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-27\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A0%D0%B5%D0%B7%D1%83%D1%81-%D0%BE%D1%82%D1%80%D0%B8%D1%86%D0%B0%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C\" >Rh-negative pregnancy<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-28\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%93%D0%B5%D1%81%D1%82%D0%B0%D1%86%D0%B8%D0%BE%D0%BD%D0%BD%D1%8B%D0%B9_%D1%81%D0%B0%D1%85%D0%B0%D1%80%D0%BD%D1%8B%D0%B9_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82\" >Gestational diabetes mellitus<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-29\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%97%D0%B0%D0%B4%D0%B5%D1%80%D0%B6%D0%BA%D0%B0_%D0%B2%D0%BD%D1%83%D1%82%D1%80%D0%B8%D1%83%D1%82%D1%80%D0%BE%D0%B1%D0%BD%D0%BE%D0%B3%D0%BE_%D1%80%D0%BE%D1%81%D1%82%D0%B0_%D0%BF%D0%BB%D0%BE%D0%B4%D0%B0\" >Intrauterine growth retardation<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-30\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%98%D1%82%D0%BE%D0%B3_%D0%B8_%D1%80%D0%B5%D0%BA%D0%BE%D0%BC%D0%B5%D0%BD%D0%B4%D0%B0%D1%86%D0%B8%D0%B8_%D0%BA%D0%BB%D0%B8%D0%BD%D0%B8%D0%BA%D0%B8_VALINTERMED_%D1%80%D0%B5%D0%BA%D0%BE%D0%BC%D0%B5%D0%BD%D0%B4%D0%B0%D1%86%D0%B8%D0%B8_%D0%B4%D0%BB%D1%8F_%D0%BF%D0%B0%D1%86%D0%B8%D0%B5%D0%BD%D1%82%D0%BE%D0%BA\" >Summary and recommendations of the VALINTERMED clinic for patients<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-31\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%90%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7%D1%8B_%D0%BA%D1%80%D0%BE%D0%B2%D0%B8_%D0%BF%D1%80%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%BD%D0%BE%D1%80%D0%BC%D1%8B_%D0%B5%D0%B4%D0%B8%D0%BD%D0%B8%D1%86%D1%8B_%D0%B8%D0%B7%D0%BC%D0%B5%D1%80%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%BA%D0%BB%D0%B8%D0%BD%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%BF%D1%80%D0%B5%D1%82%D0%B0%D1%86%D0%B8%D1%8F\" >Blood tests during pregnancy: norms, units of measurement and clinical interpretation<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-32\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9A%D0%BB%D0%B8%D0%BD%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B9_%D0%BA%D0%BE%D0%BC%D0%BC%D0%B5%D0%BD%D1%82%D0%B0%D1%80%D0%B8%D0%B9_%D0%BE%D1%82_%D0%B4%D0%BE%D0%BA%D1%82%D0%BE%D1%80%D0%B0_%D0%9A%D0%BE%D1%80%D0%B6%D0%B8%D0%BA%D0%BE%D0%B2%D0%B0_%D1%81%D0%B5%D0%BC%D0%B5%D0%B9%D0%BD%D1%8B%D0%B9_%D0%B2%D1%80%D0%B0%D1%87_VALINTERMED\" >Clinical commentary from Dr. Korzhikov (family physician, VALINTERMED)<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-33\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9E%D1%81%D0%BD%D0%BE%D0%B2%D0%BD%D1%8B%D0%B5_%D0%B8%D0%B7%D0%BC%D0%B5%D0%BD%D0%B5%D0%BD%D0%B8%D1%8F_%D0%BA%D1%80%D0%BE%D0%B2%D0%B8_%D0%BF%D1%80%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\" >Main blood changes during pregnancy<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-34\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9E%D0%B1%D1%89%D0%B8%D0%B9_%D0%B0%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7_%D0%BA%D1%80%D0%BE%D0%B2%D0%B8_%D0%BF%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0%D0%BC\" >Complete blood count by trimester<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-35\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%91%D0%B8%D0%BE%D1%85%D0%B8%D0%BC%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D0%B0%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7%D1%8B_%D0%BA%D1%80%D0%BE%D0%B2%D0%B8\" >Blood biochemistry tests<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-36\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%92%D0%B8%D1%82%D0%B0%D0%BC%D0%B8%D0%BD%D1%8B_%D0%B8_%D0%BC%D0%B8%D0%BA%D1%80%D0%BE%D1%8D%D0%BB%D0%B5%D0%BC%D0%B5%D0%BD%D1%82%D1%8B_%D1%87%D1%82%D0%BE_%D0%B4%D0%B5%D0%B9%D1%81%D1%82%D0%B2%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%BE_%D0%BD%D0%B5%D0%BE%D0%B1%D1%85%D0%BE%D0%B4%D0%B8%D0%BC%D0%BE\" >Vitamins and microelements: what is really necessary<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-37\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%98%D0%BD%D1%84%D0%B5%D0%BA%D1%86%D0%B8%D0%B8_%D0%BF%D1%80%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D1%81%D0%BA%D1%80%D0%B8%D0%BD%D0%B8%D0%BD%D0%B3_%D0%B8_%D1%82%D0%B0%D0%BA%D1%82%D0%B8%D0%BA%D0%B0\" >Infections during pregnancy: screening and tactics<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-38\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#TORCH-%D0%B8%D0%BD%D1%84%D0%B5%D0%BA%D1%86%D0%B8%D0%B8\" >TORCH infections<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-39\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%98%D0%BD%D1%84%D0%B5%D0%BA%D1%86%D0%B8%D0%B8_%D0%BF%D0%B5%D1%80%D0%B5%D0%B4%D0%B0%D1%8E%D1%89%D0%B8%D0%B5%D1%81%D1%8F_%D0%BF%D0%BE%D0%BB%D0%BE%D0%B2%D1%8B%D0%BC_%D0%BF%D1%83%D1%82%D1%91%D0%BC\" >Sexually transmitted infections<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-40\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A7%D0%B0%D1%81%D1%82%D0%BE_%D0%B7%D0%B0%D0%B4%D0%B0%D0%B2%D0%B0%D0%B5%D0%BC%D1%8B%D0%B5_%D0%B2%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_FAQ\" >Frequently Asked Questions (FAQ)<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-41\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%97%D0%B0%D0%BA%D0%BB%D1%8E%D1%87%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%BE%D0%B5_%D1%81%D0%BB%D0%BE%D0%B2%D0%BE\" >Closing remarks<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-42\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%AE%D1%80%D0%B8%D0%B4%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D0%B8_%D1%8D%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D0%B0%D1%81%D0%BF%D0%B5%D0%BA%D1%82%D1%8B_%D0%B2%D0%B5%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\" >Legal and ethical aspects of pregnancy management<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-43\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%98%D0%BD%D1%84%D0%BE%D1%80%D0%BC%D0%B8%D1%80%D0%BE%D0%B2%D0%B0%D0%BD%D0%BD%D0%BE%D0%B5_%D1%81%D0%BE%D0%B3%D0%BB%D0%B0%D1%81%D0%B8%D0%B5\" >Informed consent<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-44\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9F%D1%80%D0%B0%D0%B2%D0%BE_%D0%BD%D0%B0_%D0%BE%D1%82%D0%BA%D0%B0%D0%B7\" >Right of refusal<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-45\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9E%D0%B1%D1%80%D0%B0%D0%B7_%D0%B6%D0%B8%D0%B7%D0%BD%D0%B8_%D0%B2%D0%BE_%D0%B2%D1%80%D0%B5%D0%BC%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\" >Lifestyle during pregnancy<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-46\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A4%D0%B8%D0%B7%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%B0%D0%BA%D1%82%D0%B8%D0%B2%D0%BD%D0%BE%D1%81%D1%82%D1%8C\" >Physical activity<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-47\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9F%D0%B8%D1%82%D0%B0%D0%BD%D0%B8%D0%B5\" >Nutrition<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-48\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A0%D0%B0%D0%B1%D0%BE%D1%82%D0%B0_%D0%B8_%D0%BE%D1%82%D0%B4%D1%8B%D1%85\" >Work and rest<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-49\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9F%D0%BE%D0%B4%D0%B3%D0%BE%D1%82%D0%BE%D0%B2%D0%BA%D0%B0_%D0%BA_%D1%80%D0%BE%D0%B4%D0%B0%D0%BC\" >Preparing for childbirth<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-50\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9F%D0%BE%D1%81%D0%BB%D0%B5%D0%B4%D0%BD%D0%B8%D0%B5_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\" >The last weeks of pregnancy<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-51\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9F%D0%BB%D0%B0%D0%BD_%D1%80%D0%BE%D0%B4%D0%BE%D0%B2\" >Birth plan<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-52\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9E%D0%B1%D0%B5%D0%B7%D0%B1%D0%BE%D0%BB%D0%B8%D0%B2%D0%B0%D0%BD%D0%B8%D0%B5_%D1%80%D0%BE%D0%B4%D0%BE%D0%B2\" >Pain relief during childbirth<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-53\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9F%D0%BE%D1%81%D0%BB%D0%B5%D1%80%D0%BE%D0%B4%D0%BE%D0%B2%D0%BE%D0%B9_%D0%BF%D0%B5%D1%80%D0%B8%D0%BE%D0%B4_%D0%BA%D1%80%D0%B0%D1%82%D0%BA%D0%B8%D0%B9_%D0%BE%D0%B1%D0%B7%D0%BE%D1%80\" >The Postpartum Period: A Brief Overview<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-54\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%A0%D0%B0%D0%BD%D0%BD%D0%B8%D0%B9_%D0%BF%D0%BE%D1%81%D0%BB%D0%B5%D1%80%D0%BE%D0%B4%D0%BE%D0%B2%D0%BE%D0%B9_%D0%BF%D0%B5%D1%80%D0%B8%D0%BE%D0%B4\" >Early postpartum period<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-55\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%9A%D0%BE%D0%BD%D1%82%D1%80%D0%BE%D0%BB%D1%8C%D0%BD%D0%BE%D0%B5_%D0%BF%D0%BE%D1%81%D0%B5%D1%89%D0%B5%D0%BD%D0%B8%D0%B5_%D0%B2%D1%80%D0%B0%D1%87%D0%B0\" >Follow-up visit with a doctor<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-56\" href=\"https:\/\/valintermed.com\/en\/blog\/a-complete-guide-to-pregnancy-management-including-tests-ultrasound-and-medical-monitoring-by-trimester\/#%D0%98%D1%82%D0%BE%D0%B3\" >Result<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9E%D0%B1%D1%89%D0%B8%D0%B5_%D0%BF%D1%80%D0%B8%D0%BD%D1%86%D0%B8%D0%BF%D1%8B_%D0%B2%D0%B5%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\"><\/span>General principles of pregnancy management<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Monitoring of a pregnant woman is carried out by an obstetrician-gynecologist and includes:<\/p>\n<ul>\n<li>regularly scheduled visits;<\/li>\n<li>dynamic assessment of the condition of the mother and fetus;<\/li>\n<li>laboratory and instrumental examinations within the established timeframes;<\/li>\n<li>preventive measures;<\/li>\n<li>individual adjustment of the observation plan in the presence of risk factors.<\/li>\n<\/ul>\n<p>Pregnancy is conventionally divided into three trimesters, each of which is characterized by its own diagnostic tasks:<\/p>\n<ul>\n<li><strong>First trimester (0\u201313 weeks)<\/strong> \u2014 confirmation and early assessment of pregnancy, primary screening;<\/li>\n<li><strong>Second trimester (14\u201328 weeks)<\/strong> \u2014 detailed assessment of fetal anatomy and identification of metabolic disorders;<\/li>\n<li><strong>Third trimester (29\u201340 weeks)<\/strong> \u2014 preparation for childbirth and monitoring of the fetus\u2019s condition.<\/li>\n<\/ul>\n<hr \/>\n<h2><span style=\"color: #3366ff;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-16216 size-full\" src=\"https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/mujer-embarazada-20_06_49.png\" alt=\"Pregnancy management: monitoring the condition of the mother and fetus, tests and ultrasound diagnostics\" width=\"1000\" height=\"1000\" title=\"\" srcset=\"https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/mujer-embarazada-20_06_49.png 1000w, https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/mujer-embarazada-20_06_49-300x300.png 300w, https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/mujer-embarazada-20_06_49-150x150.png 150w, https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/mujer-embarazada-20_06_49-768x768.png 768w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\" \/><\/span><\/h2>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9F%D0%B5%D1%80%D0%B2%D1%8B%D0%B9_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_0%E2%80%9313_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8C_%D0%B0%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7%D1%8B_%D0%A3%D0%97%D0%98_%D0%B8_%D1%80%D0%B0%D0%BD%D0%BD%D0%B8%D0%B9_%D1%81%D0%BA%D1%80%D0%B8%D0%BD%D0%B8%D0%BD%D0%B3\"><\/span><span style=\"color: #3366ff;\">First trimester of pregnancy<\/span> (0-13 weeks): tests, <a href=\"https:\/\/valintermed.com\/en\/body-diagnostics-disease-diagnostic-programs-in-valencia\/ultrasound-examination-of-organs-and-vessels-ultrasound-in-valencia\/\">Ultrasound<\/a> and early screening<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9F%D1%80%D0%B8%D0%BD%D1%86%D0%B8%D0%BF%D1%8B_%D0%BD%D0%B0%D0%B1%D0%BB%D1%8E%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_VALINTERMED\"><\/span>VALINTERMED Pregnancy Monitoring Principles<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li><strong>Evidence-based medicine<\/strong> and clinical appropriateness of the prescriptions.<\/li>\n<li><strong>Reasonable sufficiency<\/strong>: we assign what influences the tactics of management.<\/li>\n<li><strong>Clear explanations<\/strong>: the patient understands the purpose of each analysis and decision.<\/li>\n<li><strong>Personalization<\/strong>: the plan is adjusted if risk factors are present.<\/li>\n<\/ul>\n<p data-start=\"267\" data-end=\"878\">The first trimester of pregnancy is a key monitoring stage, as it is during this period that all fetal organs and systems are formed, and the subsequent pregnancy management strategy is formulated. <strong data-start=\"499\" data-end=\"513\">7\u20139 weeks<\/strong> A pregnant woman typically meets her obstetrician-gynecologist for the first time, who will be supporting her throughout her pregnancy. At this stage, a trusting doctor-patient relationship is established, a detailed medical and obstetric history is collected, individual risk factors are assessed, and a personalized care plan is developed.<\/p><script data-noptimize=\"\" data-wpfc-render=\"false\">\nfpm_start( \"true\" );\n<\/script>\n\n<p data-start=\"880\" data-end=\"1524\">It is during the first trimester that basic laboratory tests and ultrasound diagnostics are performed to confirm an intrauterine pregnancy, assess its viability, determine the gestational age, and identify potential abnormalities early. Early screening, including ultrasound and biochemical markers, plays a crucial role in assessing the risk of fetal chromosomal abnormalities and allows for the timely determination of the need for additional diagnostic procedures. Properly managed first trimester monitoring lays the foundation for a safe pregnancy and reduces the risk of complications later in pregnancy.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%A6%D0%B5%D0%BB%D0%B8_%D0%BD%D0%B0%D0%B1%D0%BB%D1%8E%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B2_%D0%BF%D0%B5%D1%80%D0%B2%D0%BE%D0%BC_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B5\"><\/span>Goals of first trimester monitoring<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The main tasks of the first trimester:<\/p>\n<ul>\n<li>confirmation of intrauterine pregnancy and its viability;<\/li>\n<li>clarification of the gestational age;<\/li>\n<li>identification of risk factors;<\/li>\n<li>primary laboratory and infectious screening;<\/li>\n<li>assessment of the risk of fetal chromosomal abnormalities.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9F%D0%B5%D1%80%D0%B2%D0%B8%D1%87%D0%BD%D1%8B%D0%B9_%D0%B2%D0%B8%D0%B7%D0%B8%D1%82_%D0%BA_%D0%B0%D0%BA%D1%83%D1%88%D0%B5%D1%80%D1%83-%D0%B3%D0%B8%D0%BD%D0%B5%D0%BA%D0%BE%D0%BB%D0%BE%D0%B3%D1%83_7%E2%80%939_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8C\"><\/span>Initial visit to the obstetrician\/gynecologist (7-9 weeks)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>An initial visit to the doctor is recommended between 7 and 9 weeks of pregnancy. At this stage, the following is performed:<\/p>\n<ul>\n<li>collection of anamnesis (obstetric, gynecological, somatic, hereditary);<\/li>\n<li>assessment of risk factors (age, chronic diseases, previous pregnancies);<\/li>\n<li>general and gynecological examination;<\/li>\n<li>transvaginal ultrasound examination.<\/li>\n<\/ul>\n<p><strong>Transvaginal ultrasound<\/strong> allows:<\/p>\n<ul>\n<li>confirm the presence of intrauterine pregnancy;<\/li>\n<li>visualize the embryo and cardiac activity;<\/li>\n<li>rule out ectopic pregnancy;<\/li>\n<li>clarify the gestational age according to the CRL.<\/li>\n<\/ul>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9B%D0%B0%D0%B1%D0%BE%D1%80%D0%B0%D1%82%D0%BE%D1%80%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BF%D0%B5%D1%80%D0%B2%D0%BE%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0\"><\/span>Laboratory tests of the first trimester<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p data-start=\"227\" data-end=\"804\">Laboratory tests performed in the first trimester of pregnancy are essential for assessing a woman&#039;s initial health status and early detection of factors that may affect the course of pregnancy. These tests are typically performed at <strong data-start=\"499\" data-end=\"523\">9\u201310 weeks of gestation<\/strong> and form the basic diagnostic basis for further monitoring. They help identify signs of anemia, inflammatory processes, immune system disorders, and possible infectious diseases that may be asymptomatic but pose a risk to the mother and fetus.<\/p>\n<p data-start=\"806\" data-end=\"1486\">Particular attention is paid to immunohematological testing and serological screening in the first trimester. Blood typing and Rh factor determination, as well as an indirect Coombs test, are crucial for preventing Rh incompatibility and other immune complications. Serological tests are aimed at identifying infections that are potentially dangerous for fetal development and allow for timely determination of the need for follow-up or treatment. Conducting laboratory tests early in pregnancy allows for an individualized management plan and significantly reduces the risk of complications in subsequent trimesters.<\/p>\n<p>Below is a table of the main blood tests performed in the first trimester.<\/p>\n<p><span style=\"color: #ff0000;\">\n<table id=\"tablepress-10\" class=\"tablepress tablepress-id-10\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Study<\/th><th class=\"column-2\">Indication<\/th><th class=\"column-3\">Target<\/th><th class=\"column-4\">Clinical commentary<\/th><td class=\"column-5\"><\/td><td class=\"column-6\"><\/td><td class=\"column-7\"><\/td><td class=\"column-8\"><\/td><td class=\"column-9\"><\/td>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\">General blood analysis<\/td><td class=\"column-2\">To all pregnant women<\/td><td class=\"column-3\">Detection of anemia and inflammatory changes<\/td><td class=\"column-4\">Physiological hemodilution is possible as early as the first trimester.<\/td><td class=\"column-5\"><\/td><td class=\"column-6\"><\/td><td class=\"column-7\"><\/td><td class=\"column-8\"><\/td><td class=\"column-9\"><\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">Blood type and Rh factor<\/td><td class=\"column-2\">To all pregnant women<\/td><td class=\"column-3\">Prevention of Rhesus incompatibility<\/td><td class=\"column-4\">Mandatory in the absence of documented data<\/td><td class=\"column-5\"><\/td><td class=\"column-6\"><\/td><td class=\"column-7\"><\/td><td class=\"column-8\"><\/td><td class=\"column-9\"><\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">Indirect Coombs test<\/td><td class=\"column-2\">To everyone, especially Rh(-)<\/td><td class=\"column-3\">Detection of irregular antibodies<\/td><td class=\"column-4\">Repeated dynamically with Rh-negative blood<\/td><td class=\"column-5\"><\/td><td class=\"column-6\"><\/td><td class=\"column-7\"><\/td><td class=\"column-8\"><\/td><td class=\"column-9\"><\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\">Serology of syphilis<\/td><td class=\"column-2\">To all pregnant women<\/td><td class=\"column-3\">Prevention of intrauterine infection<\/td><td class=\"column-4\">Mandatory screening<\/td><td class=\"column-5\"><\/td><td class=\"column-6\"><\/td><td class=\"column-7\"><\/td><td class=\"column-8\"><\/td><td class=\"column-9\"><\/td>\n<\/tr>\n<tr class=\"row-6\">\n\t<td class=\"column-1\">HIV<\/td><td class=\"column-2\">To all pregnant women<\/td><td class=\"column-3\">Prevention of vertical transmission<\/td><td class=\"column-4\">Conducted with informed consent<\/td><td class=\"column-5\"><\/td><td class=\"column-6\"><\/td><td class=\"column-7\"><\/td><td class=\"column-8\"><\/td><td class=\"column-9\"><\/td>\n<\/tr>\n<tr class=\"row-7\">\n\t<td class=\"column-1\">Hepatitis B (HBsAg)<\/td><td class=\"column-2\">To all pregnant women<\/td><td class=\"column-3\">Detection of carriage<\/td><td class=\"column-4\">Important for delivery tactics<\/td><td class=\"column-5\"><\/td><td class=\"column-6\"><\/td><td class=\"column-7\"><\/td><td class=\"column-8\"><\/td><td class=\"column-9\"><\/td>\n<\/tr>\n<tr class=\"row-8\">\n\t<td class=\"column-1\">Hepatitis C<\/td><td class=\"column-2\">According to the readings<\/td><td class=\"column-3\">Diagnosis of viral infection<\/td><td class=\"column-4\">More common in risk groups<\/td><td class=\"column-5\"><\/td><td class=\"column-6\"><\/td><td class=\"column-7\"><\/td><td class=\"column-8\"><\/td><td class=\"column-9\"><\/td>\n<\/tr>\n<tr class=\"row-9\">\n\t<td class=\"column-1\">Toxoplasmosis<\/td><td class=\"column-2\">In the absence of immunity<\/td><td class=\"column-3\">Determining the risk of primary infection<\/td><td class=\"column-4\">If IgG is negative, dynamic monitoring is required.<\/td><td class=\"column-5\"><\/td><td class=\"column-6\"><\/td><td class=\"column-7\"><\/td><td class=\"column-8\"><\/td><td class=\"column-9\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/span><\/p>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9A%D0%BE%D0%BC%D0%B1%D0%B8%D0%BD%D0%B8%D1%80%D0%BE%D0%B2%D0%B0%D0%BD%D0%BD%D1%8B%D0%B9_%D0%BF%D1%80%D0%B5%D0%BD%D0%B0%D1%82%D0%B0%D0%BB%D1%8C%D0%BD%D1%8B%D0%B9_%D1%81%D0%BA%D1%80%D0%B8%D0%BD%D0%B8%D0%BD%D0%B3_I_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0\"><\/span>Combined prenatal screening of the first trimester<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Combined screening is carried out at term <strong>11\u201313 weeks of pregnancy<\/strong> and includes:<\/p>\n<ul>\n<li>ultrasound examination;<\/li>\n<li>biochemical blood test;<\/li>\n<li>Mathematical calculation of individual risk.<\/li>\n<\/ul>\n<h4>Ultrasonic markers<\/h4>\n<p>During the ultrasound the following are assessed:<\/p>\n<ul>\n<li>coccygeal-parietal length (CTL);<\/li>\n<li>nuchal translucency thickness (NTT);<\/li>\n<li>presence of the nasal bone;<\/li>\n<li>heart rate.<\/li>\n<\/ul>\n<h4>Biochemical markers<\/h4>\n<ul>\n<li>free \u03b2-subunit of hCG;<\/li>\n<li>PAPP-A (pregnancy-associated plasma protein A).<\/li>\n<\/ul>\n<h4>Interpretation of results<\/h4>\n<table>\n<thead>\n<tr>\n<th>Risk level<\/th>\n<th>Tactics<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Short<\/td>\n<td>Standard observation<\/td>\n<\/tr>\n<tr>\n<td>Intermediate<\/td>\n<td>NIPT recommended<\/td>\n<\/tr>\n<tr>\n<td>High<\/td>\n<td>Invasive diagnostics (chorionic villus biopsy\/amniocentesis)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<hr \/>\n<h2><span style=\"color: #3366ff;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-16218 size-full\" src=\"https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/ecografia-embarazo-segundo-trimestre-20_16_10.png\" alt=\"ultrasound diagnostics during the second trimester\" width=\"1000\" height=\"1000\" title=\"\" srcset=\"https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/ecografia-embarazo-segundo-trimestre-20_16_10.png 1000w, https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/ecografia-embarazo-segundo-trimestre-20_16_10-300x300.png 300w, https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/ecografia-embarazo-segundo-trimestre-20_16_10-150x150.png 150w, https:\/\/valintermed.com\/wp-content\/uploads\/2026\/01\/ecografia-embarazo-segundo-trimestre-20_16_10-768x768.png 768w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\" \/><\/span><\/h2>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D1%82%D0%BE%D1%80%D0%BE%D0%B9_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_14%E2%80%9328_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8C_%D0%BC%D0%BE%D1%80%D1%84%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%BE%D0%B5_%D0%A3%D0%97%D0%98_%D0%B0%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7%D1%8B_%D0%B8_%D0%BF%D1%80%D0%BE%D1%84%D0%B8%D0%BB%D0%B0%D0%BA%D1%82%D0%B8%D0%BA%D0%B0\"><\/span><span style=\"color: #3366ff;\">Second trimester of pregnancy<\/span> (14\u201328 weeks): morphological ultrasound, tests and prevention<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p data-start=\"304\" data-end=\"985\">The second trimester of pregnancy is an important stage for in-depth assessment of fetal development and clarification of early screening results. It is during this period, as a rule, that <strong data-start=\"473\" data-end=\"492\">19 and 21 weeks<\/strong>A morphological ultrasound examination is performed, which allows for a detailed assessment of the fetus&#039;s anatomy, the identification or exclusion of most structural congenital malformations, as well as indirect markers of chromosomal abnormalities.<\/p>\n<p data-start=\"304\" data-end=\"985\">Morphological ultrasound is of particular importance for determining the risk <strong data-start=\"786\" data-end=\"804\">Down syndrome<\/strong>, since it is in the second trimester that it is possible to more accurately assess anatomical signs that either confirm a low risk or require further diagnostic clarification.<\/p>\n<p data-start=\"987\" data-end=\"1538\">In addition to ultrasound diagnostics, laboratory tests are performed in the second trimester to detect anemia and metabolic disorders in the mother, including screening for gestational diabetes. This stage is also important for preventing complications in the second half of pregnancy and planning further follow-up care.<\/p>\n<p data-start=\"987\" data-end=\"1538\">A comprehensive assessment of the mother and fetus in the second trimester allows for a high degree of reliability in confirming the normal development of pregnancy and promptly taking action if any abnormalities are detected.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9A%D0%BB%D0%B8%D0%BD%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D0%B7%D0%B0%D0%B4%D0%B0%D1%87%D0%B8_%D0%B2%D1%82%D0%BE%D1%80%D0%BE%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0\"><\/span>Clinical tasks of the second trimester<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The second trimester of pregnancy is considered the most stable period of gestation. For most women, symptoms of early toxicosis significantly diminish, general well-being improves, and active growth and differentiation of fetal organs and systems begins.<\/p>\n<p>The main tasks of medical supervision in the second trimester:<\/p>\n<ul>\n<li>detailed assessment of the anatomical development of the fetus;<\/li>\n<li>detection of congenital malformations;<\/li>\n<li>diagnosis of metabolic disorders in the mother;<\/li>\n<li>prevention of complications in the second half of pregnancy;<\/li>\n<li>dynamic assessment of fetal growth and placental condition.<\/li>\n<\/ul>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%A3%D0%BB%D1%8C%D1%82%D1%80%D0%B0%D0%B7%D0%B2%D1%83%D0%BA%D0%BE%D0%B2%D0%BE%D0%B5_%D0%B8%D1%81%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D0%B5_%D0%B2%D1%82%D0%BE%D1%80%D0%BE%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0\"><\/span>Second trimester ultrasound<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<h4>Morphological ultrasound (19\u201321 weeks)<\/h4>\n<p>Morphological ultrasound is a key stage of antenatal care. It is performed optimally between 19 and 21 weeks of pregnancy and aims to provide a detailed assessment of fetal anatomy.<\/p>\n<p>During the study, the following are sequentially assessed:<\/p>\n<ul>\n<li>central nervous system (brain, ventricles);<\/li>\n<li>face and neck area;<\/li>\n<li>spine;<\/li>\n<li>heart (four-chamber section, outflow tracts);<\/li>\n<li>chest organs;<\/li>\n<li>abdominal organs;<\/li>\n<li>kidneys and urinary tract;<\/li>\n<li>limbs;<\/li>\n<li>umbilical cord and placenta;<\/li>\n<li>amount of amniotic fluid.<\/li>\n<\/ul>\n<p>Morphological ultrasound allows us to identify most structural developmental anomalies and determine the need for further in-depth examination.<\/p>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9B%D0%B0%D0%B1%D0%BE%D1%80%D0%B0%D1%82%D0%BE%D1%80%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B2%D1%82%D0%BE%D1%80%D0%BE%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0\"><\/span>Laboratory tests of the second trimester<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The main planned analysis is carried out on time <strong>24\u201328 weeks of pregnancy<\/strong>.<\/p>\n<p><span style=\"color: #ff0000;\">\n<table id=\"tablepress-11\" class=\"tablepress tablepress-id-11\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Study<\/th><th class=\"column-2\">Indication<\/th><th class=\"column-3\">Target<\/th><th class=\"column-4\">Clinical commentary<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\">General blood analysis<\/td><td class=\"column-2\">To all pregnant women<\/td><td class=\"column-3\">Anemia control<\/td><td class=\"column-4\">The incidence of iron deficiency anemia increases in the second trimester<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">ferritin<\/td><td class=\"column-2\">According to the readings<\/td><td class=\"column-3\">Iron reserve assessment<\/td><td class=\"column-4\">Preferred over whey iron<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">Blood glucose<\/td><td class=\"column-2\">To all pregnant women<\/td><td class=\"column-3\">Carbohydrate metabolism screening<\/td><td class=\"column-4\">Held within the framework of O&#039;Sullivan<\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\">Blood biochemistry<\/td><td class=\"column-2\">According to the readings<\/td><td class=\"column-3\">Evaluation of liver and kidney function<\/td><td class=\"column-4\">Especially with a history of gestosis<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/span><\/p>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%A1%D0%BA%D1%80%D0%B8%D0%BD%D0%B8%D0%BD%D0%B3_%D0%B3%D0%B5%D1%81%D1%82%D0%B0%D1%86%D0%B8%D0%BE%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82%D0%B0\"><\/span>Screening for Gestational Diabetes<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<h4>O&#039;Sullivan test<\/h4>\n<p>The O&#039;Sullivan test is a screening method for diagnosing gestational diabetes and is performed on all pregnant women at term. <strong>24\u201328 weeks<\/strong>, in the absence of high-risk factors.<\/p>\n<p>Methodology:<\/p>\n<ul>\n<li>oral administration of a solution containing 50 g of glucose;<\/li>\n<li>measurement of venous blood glucose levels after 60 minutes.<\/li>\n<\/ul>\n<p><strong data-start=\"493\" data-end=\"532\">The following result is considered pathological:<\/strong><br data-start=\"532\" data-end=\"535\" \/><strong>Glucose: <\/strong>\u2265 <strong data-start=\"537\" data-end=\"550\">140 mg\/dL<\/strong>, which corresponds <strong data-start=\"570\" data-end=\"585\">7.8 mmol\/L<\/strong>,<br data-start=\"586\" data-end=\"589\" \/>and requires implementation <strong data-start=\"610\" data-end=\"676\">diagnostic oral glucose tolerance test (OGTT)<\/strong>.<\/p>\n<p>Comment: mg\/dL (mmol\/L) - in Spanish clinical protocols, mg\/dL is more often used for international understanding<br \/>\nIt is permissible to indicate in mmol\/l in brackets.<\/p>\n<h4>Oral glucose tolerance test (OGTT)<\/h4>\n<p>OGTT is performed in case of deviations in the O&#039;Sullivan test or in the presence of risk factors.<\/p>\n<p>The methodology includes:<\/p>\n<ul>\n<li>following a diet with sufficient carbohydrates for 3 days before the test;<\/li>\n<li>overnight fasting;<\/li>\n<li>intake of 75 g of glucose;<\/li>\n<li>blood sampling on an empty stomach, after 1 and 2 hours.<\/li>\n<\/ul>\n<p>A diagnosis of gestational diabetes is made when threshold values are exceeded at at least one measurement point.<\/p>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9F%D1%80%D0%BE%D1%84%D0%B8%D0%BB%D0%B0%D0%BA%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D0%BC%D0%B5%D1%80%D0%BE%D0%BF%D1%80%D0%B8%D1%8F%D1%82%D0%B8%D1%8F_%D0%B2%D0%BE_%D0%B2%D1%82%D0%BE%D1%80%D0%BE%D0%BC_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B5\"><\/span>Preventive measures in the second trimester<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"color: #ff0000;\">\n<table id=\"tablepress-13\" class=\"tablepress tablepress-id-13\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Event<\/th><th class=\"column-2\">Term<\/th><th class=\"column-3\">Target<\/th><th class=\"column-4\">Comment<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\">Vaccination against whooping cough<\/td><td class=\"column-2\">27\u201336 weeks<\/td><td class=\"column-3\">Prevention of neonatal whooping cough<\/td><td class=\"column-4\">Recommended for all pregnant women<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">Anti-Rhesus immunoglobulin<\/td><td class=\"column-2\">Week 28<\/td><td class=\"column-3\">Prevention of Rh sensitization<\/td><td class=\"column-4\">Only for Rh(-) pregnant women<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/span><\/p>\n<hr \/>\n<h2><\/h2>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A2%D1%80%D0%B5%D1%82%D0%B8%D0%B9_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_29%E2%80%9340_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8C_%D0%BF%D0%BE%D0%B4%D0%B3%D0%BE%D1%82%D0%BE%D0%B2%D0%BA%D0%B0_%D0%BA_%D1%80%D0%BE%D0%B4%D0%B0%D0%BC_%D0%B8_%D0%BA%D0%BE%D0%BD%D1%82%D1%80%D0%BE%D0%BB%D1%8C_%D1%81%D0%BE%D1%81%D1%82%D0%BE%D1%8F%D0%BD%D0%B8%D1%8F_%D0%BF%D0%BB%D0%BE%D0%B4%D0%B0\"><\/span><span style=\"color: #3366ff;\">Third trimester of pregnancy<\/span> (29\u201340 weeks): preparation for childbirth and monitoring of fetal condition<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p data-start=\"290\" data-end=\"778\">The third trimester of pregnancy is the final stage of antenatal care and is aimed at a comprehensive assessment of the woman&#039;s body&#039;s readiness for childbirth, as well as monitoring the condition and well-being of the fetus.<\/p>\n<p data-start=\"290\" data-end=\"778\">During this period, the main focus is on the dynamic assessment of fetal growth, placental function, the amount of amniotic fluid, and the position of the fetus, which allows for the timely detection of signs of placental insufficiency or other complications that may affect the delivery strategy.<\/p>\n<p data-start=\"780\" data-end=\"1338\">In the third trimester, laboratory tests and instrumental control methods necessary for the safe management of labor are carried out, including an assessment of the hemostasis system and the functional state of the fetus.<\/p>\n<p data-start=\"780\" data-end=\"1338\">Regular monitoring, ultrasound diagnostics, and cardiotocography help ensure the fetus is in satisfactory condition and determine the optimal time and method of delivery. Proper monitoring in the third trimester ensures maximum readiness for childbirth and helps reduce risks for both mother and unborn child.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%A6%D0%B5%D0%BB%D0%B8_%D0%BD%D0%B0%D0%B1%D0%BB%D1%8E%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B2_%D1%82%D1%80%D0%B5%D1%82%D1%8C%D0%B5%D0%BC_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B5\"><\/span>Goals of third trimester surveillance<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The third trimester is the final stage of pregnancy and requires more frequent medical monitoring.<\/p>\n<p>Main tasks:<\/p>\n<ul>\n<li>assessment of the mother&#039;s body&#039;s readiness for childbirth;<\/li>\n<li>monitoring the growth and condition of the fetus;<\/li>\n<li>identification of signs of placental insufficiency;<\/li>\n<li>prevention of intranatal complications;<\/li>\n<li>planning delivery tactics.<\/li>\n<\/ul>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9B%D0%B0%D0%B1%D0%BE%D1%80%D0%B0%D1%82%D0%BE%D1%80%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D1%82%D1%80%D0%B5%D1%82%D1%8C%D0%B5%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0_32%E2%80%9334_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D0%B8\"><\/span>Laboratory tests for the third trimester (32\u201334 weeks)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"color: #ff0000;\">\n<table id=\"tablepress-14\" class=\"tablepress tablepress-id-14\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Study<\/th><th class=\"column-2\">Indication<\/th><th class=\"column-3\">Target<\/th><th class=\"column-4\">Clinical commentary<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\">General blood analysis<\/td><td class=\"column-2\">To all pregnant women<\/td><td class=\"column-3\">Anemia and platelet control<\/td><td class=\"column-4\">Important before childbirth<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">Coagulogram<\/td><td class=\"column-2\">To all pregnant women<\/td><td class=\"column-3\">Evaluation of the hemostasis system<\/td><td class=\"column-4\">Mandatory when planning epidural anesthesia<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">Blood biochemistry<\/td><td class=\"column-2\">According to the readings<\/td><td class=\"column-3\">Diagnosis of complications<\/td><td class=\"column-4\">If preeclampsia is suspected<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/span><\/p>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%A3%D0%BB%D1%8C%D1%82%D1%80%D0%B0%D0%B7%D0%B2%D1%83%D0%BA%D0%BE%D0%B2%D0%BE%D0%B5_%D0%B8%D1%81%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D0%B5_%D1%82%D1%80%D0%B5%D1%82%D1%8C%D0%B5%D0%B3%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0_32%E2%80%9336_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8C\"><\/span>Third trimester ultrasound (32\u201336 weeks)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Ultrasound allows us to assess:<\/p>\n<ul>\n<li>estimated fetal weight;<\/li>\n<li>intrauterine growth rate;<\/li>\n<li>amount of amniotic fluid;<\/li>\n<li>localization and maturity of the placenta;<\/li>\n<li>fetal presentation.<\/li>\n<\/ul>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%A1%D0%BA%D1%80%D0%B8%D0%BD%D0%B8%D0%BD%D0%B3_%D0%BD%D0%B0_Streptococcus_agalactiae\"><\/span>Screening for Streptococcus agalactiae<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>On time <strong>35\u201337 weeks<\/strong> Vaginal-rectal culture is performed to detect group B streptococcus.<\/p>\n<p>The aim of the study is to prevent early neonatal infection. If the test is positive, intravenous antibiotics are administered during labor.<\/p>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9A%D0%B0%D1%80%D0%B4%D0%B8%D0%BE%D1%82%D0%BE%D0%BA%D0%BE%D0%B3%D1%80%D0%B0%D1%84%D0%B8%D1%8F_%D0%9A%D0%A2%D0%93\"><\/span>Cardiotocography (CTG)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Cardiotocographic examination is usually carried out with <strong>39th week of pregnancy<\/strong>.<\/p>\n<p>CTG allows to evaluate:<\/p>\n<ul>\n<li>basal fetal heart rate;<\/li>\n<li>variability;<\/li>\n<li>presence of accelerations and decelerations;<\/li>\n<li>contractile activity of the uterus.<\/li>\n<\/ul>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%97%D0%B0%D0%BA%D0%BB%D1%8E%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\"><\/span>Conclusion<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Comprehensive and consistent pregnancy monitoring in accordance with current clinical guidelines ensures a high level of safety for both mother and fetus. An individualized approach based on risk factor assessment and dynamic monitoring is key to successful pregnancy management.<\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A0%D0%B0%D1%81%D1%88%D0%B8%D1%80%D0%B5%D0%BD%D0%BD%D1%8B%D0%B9_%D1%87%D0%B5%D0%BA-%D0%BB%D0%B8%D1%81%D1%82_%D0%BD%D0%B0%D0%B1%D0%BB%D1%8E%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%BF%D0%BE_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D1%8F%D0%BC\"><\/span>An expanded pregnancy checklist by week<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Below is a systematic checklist of examinations and medical procedures performed during low-risk pregnancies. This table can be used both as a guide by patients and as a convenient clinical tool by physicians.<\/p>\n<p><span style=\"color: #ff0000;\">\n<table id=\"tablepress-15\" class=\"tablepress tablepress-id-15\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Pregnancy period<\/th><th class=\"column-2\">Survey \/ event<\/th><th class=\"column-3\">Indication<\/th><th class=\"column-4\">Target<\/th><th class=\"column-5\">Comment<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\">7\u20139 weeks<\/td><td class=\"column-2\">First visit to the obstetrician-gynecologist<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Confirmation of pregnancy<\/td><td class=\"column-5\">Formation of an individual monitoring plan<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">7\u20139 weeks<\/td><td class=\"column-2\">Transvaginal ultrasound<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Confirmation of viability<\/td><td class=\"column-5\">Exclusion of ectopic pregnancy<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">9\u201310 weeks<\/td><td class=\"column-2\">Blood tests in the first trimester<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Basic laboratory screening<\/td><td class=\"column-5\">Includes serology and immunohematology<\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\">11\u201313 weeks<\/td><td class=\"column-2\">First trimester ultrasound<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Screening for chromosomal abnormalities<\/td><td class=\"column-5\">Measuring TVP<\/td>\n<\/tr>\n<tr class=\"row-6\">\n\t<td class=\"column-1\">11\u201313 weeks<\/td><td class=\"column-2\">Combined screening<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Trisomy risk assessment<\/td><td class=\"column-5\">Combination of ultrasound and biochemistry<\/td>\n<\/tr>\n<tr class=\"row-7\">\n\t<td class=\"column-1\">&gt;10 weeks<\/td><td class=\"column-2\">NIPT<\/td><td class=\"column-3\">According to the readings<\/td><td class=\"column-4\">High-precision genetic screening<\/td><td class=\"column-5\">It is not diagnostic.<\/td>\n<\/tr>\n<tr class=\"row-8\">\n\t<td class=\"column-1\">16\u201318 weeks<\/td><td class=\"column-2\">Scheduled visit<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Condition monitoring<\/td><td class=\"column-5\">Assessment of blood pressure, weight, complaints<\/td>\n<\/tr>\n<tr class=\"row-9\">\n\t<td class=\"column-1\">Weeks 19\u201321<\/td><td class=\"column-2\">Morphological ultrasound<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Diagnosis of developmental defects<\/td><td class=\"column-5\">The key stage of observation<\/td>\n<\/tr>\n<tr class=\"row-10\">\n\t<td class=\"column-1\">24\u201328 weeks<\/td><td class=\"column-2\">Second trimester analytics<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Detection of anemia and gestational diabetes mellitus<\/td><td class=\"column-5\">Includes O&#039;Sullivan<\/td>\n<\/tr>\n<tr class=\"row-11\">\n\t<td class=\"column-1\">24\u201328 weeks<\/td><td class=\"column-2\">O&#039;Sullivan test<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Screening for GDM<\/td><td class=\"column-5\">In case of deviation - OGTT<\/td>\n<\/tr>\n<tr class=\"row-12\">\n\t<td class=\"column-1\">27\u201336 weeks<\/td><td class=\"column-2\">Vaccination against whooping cough<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Prevention of neonatal infections<\/td><td class=\"column-5\">Recommended by WHO<\/td>\n<\/tr>\n<tr class=\"row-13\">\n\t<td class=\"column-1\">28 weeks<\/td><td class=\"column-2\">Anti-D immunoglobulin<\/td><td class=\"column-3\">Rh(-)<\/td><td class=\"column-4\">Prevention of sensitization<\/td><td class=\"column-5\">Repeat after birth if necessary<\/td>\n<\/tr>\n<tr class=\"row-14\">\n\t<td class=\"column-1\">32\u201334 weeks<\/td><td class=\"column-2\">Third trimester analytics<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Preparing for childbirth<\/td><td class=\"column-5\">Includes coagulogram<\/td>\n<\/tr>\n<tr class=\"row-15\">\n\t<td class=\"column-1\">32\u201336 weeks<\/td><td class=\"column-2\">Ultrasound of the third trimester<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Fetal growth assessment<\/td><td class=\"column-5\">Placenta and amniotic fluid monitoring<\/td>\n<\/tr>\n<tr class=\"row-16\">\n\t<td class=\"column-1\">35\u201337 weeks<\/td><td class=\"column-2\">GBS screening<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Prevention of neonatal sepsis<\/td><td class=\"column-5\">Vaginal-rectal culture<\/td>\n<\/tr>\n<tr class=\"row-17\">\n\t<td class=\"column-1\">&gt;35 weeks<\/td><td class=\"column-2\">Consultation with an anesthesiologist<\/td><td class=\"column-3\">According to the readings<\/td><td class=\"column-4\">Pain management planning<\/td><td class=\"column-5\">Important in case of concomitant diseases<\/td>\n<\/tr>\n<tr class=\"row-18\">\n\t<td class=\"column-1\">\u226539 weeks<\/td><td class=\"column-2\">CTG<\/td><td class=\"column-3\">To all pregnant women<\/td><td class=\"column-4\">Monitoring fetal well-being<\/td><td class=\"column-5\">It is held regularly<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/span><\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9E%D0%B1%D1%8F%D0%B7%D0%B0%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D1%8B%D0%B5_%D0%B8_%D1%80%D0%B0%D1%81%D1%88%D0%B8%D1%80%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5_%D0%BE%D0%B1%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BF%D1%80%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\"><\/span>Mandatory and extensive examinations during pregnancy<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>For ease of understanding, all examinations can be conditionally divided into mandatory and additional (extended).<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9E%D0%B1%D1%8F%D0%B7%D0%B0%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D1%8B%D0%B5_%D0%BE%D0%B1%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Mandatory examinations<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<table>\n<thead>\n<tr>\n<th>Survey<\/th>\n<th>Reason for obligation<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>General blood tests<\/td>\n<td>Detection of anemia and inflammatory processes<\/td>\n<\/tr>\n<tr>\n<td>Determination of blood group and Rh<\/td>\n<td>Prevention of Rhesus incompatibility<\/td>\n<\/tr>\n<tr>\n<td>Serological screening<\/td>\n<td>Prevention of intrauterine infections<\/td>\n<\/tr>\n<tr>\n<td>Ultrasound by trimester<\/td>\n<td>Monitoring fetal development<\/td>\n<\/tr>\n<tr>\n<td>Screening for GDM<\/td>\n<td>Prevention of perinatal complications<\/td>\n<\/tr>\n<tr>\n<td>GBS screening<\/td>\n<td>Prevention of neonatal infection<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3><span class=\"ez-toc-section\" id=\"%D0%A0%D0%B0%D1%81%D1%88%D0%B8%D1%80%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5_%D0%BE%D0%B1%D1%81%D0%BB%D0%B5%D0%B4%D0%BE%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BF%D0%BE_%D0%BF%D0%BE%D0%BA%D0%B0%D0%B7%D0%B0%D0%BD%D0%B8%D1%8F%D0%BC\"><\/span>Extended examinations (as indicated)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<table>\n<thead>\n<tr>\n<th>Survey<\/th>\n<th>Indication<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>NIPT<\/td>\n<td>Increased risk according to screening<\/td>\n<\/tr>\n<tr>\n<td>Invasive diagnostics<\/td>\n<td>High risk of chromosomal abnormalities<\/td>\n<\/tr>\n<tr>\n<td>Advanced Biochemistry<\/td>\n<td>Somatic pathology<\/td>\n<\/tr>\n<tr>\n<td>Thyroid profile<\/td>\n<td>Thyroid diseases<\/td>\n<\/tr>\n<tr>\n<td>Vitamin D<\/td>\n<td>Deficiency\/Risk Factors<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A7%D0%B0%D1%81%D1%82%D1%8B%D0%B5_%D0%BA%D0%BB%D0%B8%D0%BD%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%81%D0%B8%D1%82%D1%83%D0%B0%D1%86%D0%B8%D0%B8_%D0%BF%D1%80%D0%B8_%D0%B2%D0%B5%D0%B4%D0%B5%D0%BD%D0%B8%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\"><\/span>Common clinical situations during pregnancy management<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"%D0%90%D0%BD%D0%B5%D0%BC%D0%B8%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\"><\/span>Anemia in pregnant women<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Iron deficiency anemia is the most common complication of pregnancy. Its early detection and treatment can reduce the risk of preterm birth, fetal growth restriction, and postpartum complications.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%A0%D0%B5%D0%B7%D1%83%D1%81-%D0%BE%D1%82%D1%80%D0%B8%D1%86%D0%B0%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C\"><\/span>Rh-negative pregnancy<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Pregnant women with Rh-negative blood require special monitoring and prophylactic administration of anti-Rh immunoglobulin to prevent alloimmunization.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%93%D0%B5%D1%81%D1%82%D0%B0%D1%86%D0%B8%D0%BE%D0%BD%D0%BD%D1%8B%D0%B9_%D1%81%D0%B0%D1%85%D0%B0%D1%80%D0%BD%D1%8B%D0%B9_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82\"><\/span>Gestational diabetes mellitus<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>GDM is associated with an increased risk of fetal macrosomia, birth trauma, and metabolic disorders in the newborn. Adequate screening and glycemic control are key elements of management.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%97%D0%B0%D0%B4%D0%B5%D1%80%D0%B6%D0%BA%D0%B0_%D0%B2%D0%BD%D1%83%D1%82%D1%80%D0%B8%D1%83%D1%82%D1%80%D0%BE%D0%B1%D0%BD%D0%BE%D0%B3%D0%BE_%D1%80%D0%BE%D1%81%D1%82%D0%B0_%D0%BF%D0%BB%D0%BE%D0%B4%D0%B0\"><\/span>Intrauterine growth retardation<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>If IGR is suspected, an in-depth ultrasound and Doppler examination is carried out with individual planning of delivery.<\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D1%82%D0%BE%D0%B3_%D0%B8_%D1%80%D0%B5%D0%BA%D0%BE%D0%BC%D0%B5%D0%BD%D0%B4%D0%B0%D1%86%D0%B8%D0%B8_%D0%BA%D0%BB%D0%B8%D0%BD%D0%B8%D0%BA%D0%B8_VALINTERMED_%D1%80%D0%B5%D0%BA%D0%BE%D0%BC%D0%B5%D0%BD%D0%B4%D0%B0%D1%86%D0%B8%D0%B8_%D0%B4%D0%BB%D1%8F_%D0%BF%D0%B0%D1%86%D0%B8%D0%B5%D0%BD%D1%82%D0%BE%D0%BA\"><\/span>Summary and recommendations of the VALINTERMED clinic for patients<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Regular visits to the doctor, recommended examinations, and adherence to medical recommendations can help ensure the safest possible pregnancy and a favorable birth outcome.<\/p>\n<p>Pregnancy is a physiological process, but systematic medical monitoring makes it safe for both the mother and the unborn child.<\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%90%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7%D1%8B_%D0%BA%D1%80%D0%BE%D0%B2%D0%B8_%D0%BF%D1%80%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%BD%D0%BE%D1%80%D0%BC%D1%8B_%D0%B5%D0%B4%D0%B8%D0%BD%D0%B8%D1%86%D1%8B_%D0%B8%D0%B7%D0%BC%D0%B5%D1%80%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%BA%D0%BB%D0%B8%D0%BD%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%BF%D1%80%D0%B5%D1%82%D0%B0%D1%86%D0%B8%D1%8F\"><\/span>Blood tests during pregnancy: norms, units of measurement and clinical interpretation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9A%D0%BB%D0%B8%D0%BD%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B9_%D0%BA%D0%BE%D0%BC%D0%BC%D0%B5%D0%BD%D1%82%D0%B0%D1%80%D0%B8%D0%B9_%D0%BE%D1%82_%D0%B4%D0%BE%D0%BA%D1%82%D0%BE%D1%80%D0%B0_%D0%9A%D0%BE%D1%80%D0%B6%D0%B8%D0%BA%D0%BE%D0%B2%D0%B0_%D1%81%D0%B5%D0%BC%D0%B5%D0%B9%D0%BD%D1%8B%D0%B9_%D0%B2%D1%80%D0%B0%D1%87_VALINTERMED\"><\/span>Clinical commentary from Dr. Korzhikov (family physician, VALINTERMED)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>In my practice, I always draw the attention of my patients to the fact that laboratory parameters during pregnancy <strong>are assessed differently than outside of pregnancy<\/strong>Minor deviations from reference values do not always indicate pathology and should be interpreted solely in the context of the gestational age, clinical picture, and dynamics of the indicators.<\/p>\n<p>Specialists must adhere to the principle of reasonable sufficiency: only those tests are prescribed that truly impact pregnancy management, and their results are explained to the patient in detail in understandable language.<\/p>\n<p>Laboratory blood tests are a key tool for assessing the health of a pregnant woman and her fetus. Physiological changes occurring in the body during pregnancy require a special approach to interpreting test results and dynamic monitoring of parameters.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9E%D1%81%D0%BD%D0%BE%D0%B2%D0%BD%D1%8B%D0%B5_%D0%B8%D0%B7%D0%BC%D0%B5%D0%BD%D0%B5%D0%BD%D0%B8%D1%8F_%D0%BA%D1%80%D0%BE%D0%B2%D0%B8_%D0%BF%D1%80%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\"><\/span>Main blood changes during pregnancy<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>During pregnancy the following are observed:<\/p>\n<ul>\n<li>physiological hemodilution due to an increase in plasma volume;<\/li>\n<li>relative decrease in hemoglobin;<\/li>\n<li>moderate leukocytosis;<\/li>\n<li>changes in the hemostasis system with a tendency towards hypercoagulation.<\/li>\n<\/ul>\n<p>These changes are normal, but it is important to distinguish physiological processes from pathological conditions.<\/p>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9E%D0%B1%D1%89%D0%B8%D0%B9_%D0%B0%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7_%D0%BA%D1%80%D0%BE%D0%B2%D0%B8_%D0%BF%D0%BE_%D1%82%D1%80%D0%B8%D0%BC%D0%B5%D1%81%D1%82%D1%80%D0%B0%D0%BC\"><\/span>Complete blood count by trimester<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"color: #ff0000;\">\n<table id=\"tablepress-16\" class=\"tablepress tablepress-id-16\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Indicator<\/th><th class=\"column-2\">1st trimester<\/th><th class=\"column-3\">Second trimester<\/th><th class=\"column-4\">Third trimester<\/th><th class=\"column-5\">Comment<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\">Hemoglobin<\/td><td class=\"column-2\">\u226511.0 g\/dL (\u2265110 g\/L)<\/td><td class=\"column-3\">\u226510.5 g\/dl (\u2265105 g\/l)<\/td><td class=\"column-4\">\u226511.0 g\/dL (\u2265110 g\/L)<\/td><td class=\"column-5\">Physiological decline in the second trimester is acceptable<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">Hematocrit<\/td><td class=\"column-2\">33\u201342 %<\/td><td class=\"column-3\">32\u201340 %<\/td><td class=\"column-4\">33\u201341 %<\/td><td class=\"column-5\">Take into account physiological hemodilution<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">Leukocytes<\/td><td class=\"column-2\">\u226412\u00d710\u2079\/l<\/td><td class=\"column-3\">\u226415\u00d710\u2079\/l<\/td><td class=\"column-4\">\u226415\u00d710\u2079\/l<\/td><td class=\"column-5\">Physiological leukocytosis of pregnancy<\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\">Platelets<\/td><td class=\"column-2\">\u2265150\u00d710\u2079\/l<\/td><td class=\"column-3\">\u2265150\u00d710\u2079\/l<\/td><td class=\"column-4\">\u2265150\u00d710\u2079\/l<\/td><td class=\"column-5\">Management of gestational thrombocytopenia<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/span><\/p>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%91%D0%B8%D0%BE%D1%85%D0%B8%D0%BC%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D0%B0%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7%D1%8B_%D0%BA%D1%80%D0%BE%D0%B2%D0%B8\"><\/span>Blood biochemistry tests<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Biochemical tests are prescribed routinely or according to indications, especially in the presence of concomitant diseases or pregnancy complications.<\/p>\n<p><span style=\"color: #ff0000;\">\n<table id=\"tablepress-17\" class=\"tablepress tablepress-id-17\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Indicator<\/th><th class=\"column-2\">Purpose of the study<\/th><th class=\"column-3\">Clinical commentary<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\">AST, ALT<\/td><td class=\"column-2\">Liver function assessment<\/td><td class=\"column-3\">U\/L (U\/L), growth requires exclusion of hepatopathy and preeclampsia<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">Creatinine<\/td><td class=\"column-2\">Kidney function<\/td><td class=\"column-3\">mg\/dL (\u00b5mol\/L); during pregnancy, values are physiologically lower<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">Uric acid<\/td><td class=\"column-2\">Risk of preeclampsia<\/td><td class=\"column-3\">mg\/dL (\u03bcmol\/L); growth requires dynamic monitoring<\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\">Albumen<\/td><td class=\"column-2\">Protein metabolism<\/td><td class=\"column-3\">g\/dL (g\/L); moderate decrease physiologically<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/span><\/p>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%92%D0%B8%D1%82%D0%B0%D0%BC%D0%B8%D0%BD%D1%8B_%D0%B8_%D0%BC%D0%B8%D0%BA%D1%80%D0%BE%D1%8D%D0%BB%D0%B5%D0%BC%D0%B5%D0%BD%D1%82%D1%8B_%D1%87%D1%82%D0%BE_%D0%B4%D0%B5%D0%B9%D1%81%D1%82%D0%B2%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%BE_%D0%BD%D0%B5%D0%BE%D0%B1%D1%85%D0%BE%D0%B4%D0%B8%D0%BC%D0%BE\"><\/span>Vitamins and microelements: what is really necessary<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>In recent years, there has been a trend toward expanded vitamin and microelement testing. However, not all of these tests are mandatory.<\/p>\n<p><span style=\"color: #ff0000;\">\n<table id=\"tablepress-18\" class=\"tablepress tablepress-id-18\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Indicator<\/th><th class=\"column-2\">When is it appointed?<\/th><th class=\"column-3\">Comment<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\">ferritin<\/td><td class=\"column-2\">Often<\/td><td class=\"column-3\">The main marker of iron reserves<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">Vitamin D<\/td><td class=\"column-2\">According to the readings<\/td><td class=\"column-3\">Not included in routine screening<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">Vitamin B12<\/td><td class=\"column-2\">For anemia<\/td><td class=\"column-3\">Important for vegetarianism<\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\">Folic acid<\/td><td class=\"column-2\">Before and in the first trimester<\/td><td class=\"column-3\">Prevention of neural tube defects<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/span><\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D0%BD%D1%84%D0%B5%D0%BA%D1%86%D0%B8%D0%B8_%D0%BF%D1%80%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D1%81%D0%BA%D1%80%D0%B8%D0%BD%D0%B8%D0%BD%D0%B3_%D0%B8_%D1%82%D0%B0%D0%BA%D1%82%D0%B8%D0%BA%D0%B0\"><\/span>Infections during pregnancy: screening and tactics<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Infectious diseases during pregnancy can pose a serious risk to the fetus, especially during primary infection.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"TORCH-%D0%B8%D0%BD%D1%84%D0%B5%D0%BA%D1%86%D0%B8%D0%B8\"><\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560528\/\" target=\"_blank\" rel=\"noopener\">TORCH<\/a>-infections<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Screening is aimed at identifying immunity to:<\/p>\n<ul>\n<li>toxoplasmosis;<\/li>\n<li>rubella;<\/li>\n<li>cytomegalovirus;<\/li>\n<li>herpes simplex virus.<\/li>\n<\/ul>\n<p>Interpretation of serological results should be performed by a physician taking into account the clinical picture and the dynamics of antibody titers.<\/p>\n<hr \/>\n<h3><span class=\"ez-toc-section\" id=\"%D0%98%D0%BD%D1%84%D0%B5%D0%BA%D1%86%D0%B8%D0%B8_%D0%BF%D0%B5%D1%80%D0%B5%D0%B4%D0%B0%D1%8E%D1%89%D0%B8%D0%B5%D1%81%D1%8F_%D0%BF%D0%BE%D0%BB%D0%BE%D0%B2%D1%8B%D0%BC_%D0%BF%D1%83%D1%82%D1%91%D0%BC\"><\/span>Sexually transmitted infections<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>All pregnant women are screened for syphilis, HIV, and viral hepatitis. Early diagnosis significantly reduces the risk of vertical transmission.<\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A7%D0%B0%D1%81%D1%82%D0%BE_%D0%B7%D0%B0%D0%B4%D0%B0%D0%B2%D0%B0%D0%B5%D0%BC%D1%8B%D0%B5_%D0%B2%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_FAQ\"><\/span>Frequently Asked Questions (FAQ)<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong>Is it necessary to take all the tests if the pregnancy is going well?<\/strong><br \/>\nYes. Many pregnancy complications can remain asymptomatic for a long time and are only detected in the laboratory.<\/p>\n<p><strong>Are frequent blood tests dangerous for a child?<\/strong><br \/>\nNo. The amount of blood collected is minimal and does not pose a risk to the mother or fetus.<\/p>\n<p><strong>Is it possible to refuse certain examinations?<\/strong><br \/>\nThe patient has the right to refuse, but the decision must be informed and made after discussion with the doctor.<\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%97%D0%B0%D0%BA%D0%BB%D1%8E%D1%87%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%BE%D0%B5_%D1%81%D0%BB%D0%BE%D0%B2%D0%BE\"><\/span>Closing remarks<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Comprehensive pregnancy care is the result of collaboration between doctor and patient. Regular monitoring, recommended examinations, and trust in medical advice can significantly reduce risks and ensure the birth of a healthy baby.<\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%AE%D1%80%D0%B8%D0%B4%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D0%B8_%D1%8D%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D0%B0%D1%81%D0%BF%D0%B5%D0%BA%D1%82%D1%8B_%D0%B2%D0%B5%D0%B4%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\"><\/span>Legal and ethical aspects of pregnancy management<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Pregnancy care is carried out within the framework of current legislation and the principles of medical ethics. The obstetrician-gynecologist is obligated to inform the patient about the purposes, methods, and possible consequences of the examinations performed.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%98%D0%BD%D1%84%D0%BE%D1%80%D0%BC%D0%B8%D1%80%D0%BE%D0%B2%D0%B0%D0%BD%D0%BD%D0%BE%D0%B5_%D1%81%D0%BE%D0%B3%D0%BB%D0%B0%D1%81%D0%B8%D0%B5\"><\/span>Informed consent<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Before invasive procedures, genetic tests, and certain types of examinations, the patient must provide informed consent. This means that the woman:<\/p>\n<ul>\n<li>receives complete and understandable information;<\/li>\n<li>understands possible risks and alternatives;<\/li>\n<li>makes a decision voluntarily.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9F%D1%80%D0%B0%D0%B2%D0%BE_%D0%BD%D0%B0_%D0%BE%D1%82%D0%BA%D0%B0%D0%B7\"><\/span>Right of refusal<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The patient has the right to refuse any examination or intervention. The doctor&#039;s responsibility is to explain the possible medical consequences of such a refusal and record it in the medical records.<\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9E%D0%B1%D1%80%D0%B0%D0%B7_%D0%B6%D0%B8%D0%B7%D0%BD%D0%B8_%D0%B2%D0%BE_%D0%B2%D1%80%D0%B5%D0%BC%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\"><\/span>Lifestyle during pregnancy<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>A pregnant woman&#039;s lifestyle directly affects the course of pregnancy and the development of the fetus.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%A4%D0%B8%D0%B7%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%B0%D0%BA%D1%82%D0%B8%D0%B2%D0%BD%D0%BE%D1%81%D1%82%D1%8C\"><\/span>Physical activity<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>In uncomplicated pregnancies, regular moderate physical activity is recommended:<\/p>\n<ul>\n<li>walking;<\/li>\n<li>swimming;<\/li>\n<li>special programs for pregnant women.<\/li>\n<\/ul>\n<p>Physical activity helps reduce the risk of gestational diabetes, excess weight gain and back pain.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9F%D0%B8%D1%82%D0%B0%D0%BD%D0%B8%D0%B5\"><\/span>Nutrition<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>A pregnant woman&#039;s diet should be balanced and varied:<\/p>\n<ul>\n<li>adequate protein intake;<\/li>\n<li>sources of iron and calcium;<\/li>\n<li>limiting simple carbohydrates.<\/li>\n<\/ul>\n<p>Strict diets and fasting are contraindicated during pregnancy.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%A0%D0%B0%D0%B1%D0%BE%D1%82%D0%B0_%D0%B8_%D0%BE%D1%82%D0%B4%D1%8B%D1%85\"><\/span>Work and rest<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Most women can continue their professional activities unless there are medical contraindications. It is important to maintain a rest regimen and avoid excessive physical and emotional stress.<\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9F%D0%BE%D0%B4%D0%B3%D0%BE%D1%82%D0%BE%D0%B2%D0%BA%D0%B0_%D0%BA_%D1%80%D0%BE%D0%B4%D0%B0%D0%BC\"><\/span>Preparing for childbirth<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9F%D0%BE%D1%81%D0%BB%D0%B5%D0%B4%D0%BD%D0%B8%D0%B5_%D0%BD%D0%B5%D0%B4%D0%B5%D0%BB%D0%B8_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8\"><\/span>The last weeks of pregnancy<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>After the 36th week of pregnancy, the main focus is on preparing for childbirth:<\/p>\n<ul>\n<li>assessment of the readiness of the birth canal;<\/li>\n<li>position and presentation of the fetus;<\/li>\n<li>choice of delivery tactics.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9F%D0%BB%D0%B0%D0%BD_%D1%80%D0%BE%D0%B4%D0%BE%D0%B2\"><\/span>Birth plan<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Creating an individual birth plan allows the patient&#039;s preferences to be taken into account, while all decisions are made with medical safety in mind.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9E%D0%B1%D0%B5%D0%B7%D0%B1%D0%BE%D0%BB%D0%B8%D0%B2%D0%B0%D0%BD%D0%B8%D0%B5_%D1%80%D0%BE%D0%B4%D0%BE%D0%B2\"><\/span>Pain relief during childbirth<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Pain relief options are discussed in advance, often with the participation of an anesthesiologist. Epidural anesthesia is the most common and effective method of pain relief.<\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9F%D0%BE%D1%81%D0%BB%D0%B5%D1%80%D0%BE%D0%B4%D0%BE%D0%B2%D0%BE%D0%B9_%D0%BF%D0%B5%D1%80%D0%B8%D0%BE%D0%B4_%D0%BA%D1%80%D0%B0%D1%82%D0%BA%D0%B8%D0%B9_%D0%BE%D0%B1%D0%B7%D0%BE%D1%80\"><\/span>The Postpartum Period: A Brief Overview<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Although the postpartum period formally extends beyond pregnancy, preparation for it begins even before childbirth.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"%D0%A0%D0%B0%D0%BD%D0%BD%D0%B8%D0%B9_%D0%BF%D0%BE%D1%81%D0%BB%D0%B5%D1%80%D0%BE%D0%B4%D0%BE%D0%B2%D0%BE%D0%B9_%D0%BF%D0%B5%D1%80%D0%B8%D0%BE%D0%B4\"><\/span>Early postpartum period<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>In the first weeks after birth the following is carried out:<\/p>\n<ul>\n<li>control of uterine involution;<\/li>\n<li>blood loss assessment;<\/li>\n<li>breastfeeding support.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"%D0%9A%D0%BE%D0%BD%D1%82%D1%80%D0%BE%D0%BB%D1%8C%D0%BD%D0%BE%D0%B5_%D0%BF%D0%BE%D1%81%D0%B5%D1%89%D0%B5%D0%BD%D0%B8%D0%B5_%D0%B2%D1%80%D0%B0%D1%87%D0%B0\"><\/span>Follow-up visit with a doctor<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>A postnatal examination is recommended 6\u20138 weeks after delivery to assess the woman\u2019s recovery.<\/p>\n<hr \/>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D1%82%D0%BE%D0%B3\"><\/span>Result<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Modern pregnancy care at the clinic is based on an individualized approach, evidence-based medicine, and a partnership between doctor and patient. Compliance with recommended monitoring stages, examinations, and the woman&#039;s informed participation in the pregnancy process are key to a favorable outcome for both mother and child.<\/p>\n<hr \/>\n<p><em>The text may be used for informational and educational purposes on the website of medical clinics with the consent of the author VALINTERMED<\/em><\/p>\n<div class=\"fpm_end\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Author&#039;s clinical commentary: Dr. Korzhikov, family physician (VALINTERMED company) Pregnancy is a physiological condition accompanied by profound hormonal, anatomical and metabolic changes<\/p>","protected":false},"author":1,"featured_media":24307,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[166],"tags":[],"class_list":["post-16213","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"_links":{"self":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/16213","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/comments?post=16213"}],"version-history":[{"count":11,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/16213\/revisions"}],"predecessor-version":[{"id":16280,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/16213\/revisions\/16280"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media\/24307"}],"wp:attachment":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media?parent=16213"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/categories?post=16213"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/tags?post=16213"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}