The pregnancy period is most crucial in determining the development of a child and the health and safety of the child. It is also a critical moment for the mother bearing the child since complications could be fatal both to the child and the mother (Van Lerberghe, Manuel, Matthews & Cathy, 2005). The events during pregnancy present interesting developments, right from the fertilization of the egg to the development of the fetus and the birth of the child. Thus, this paper seeks to understand the process of dating the pregnancy and how the delivery date is estimated. The paper also looks into the tests carried out in an expectant individual based on the stages of the pregnancy and the implication of missed tests. It emphasizes the need to develop a care plan for the expectant mother.
How to date Pregnancy
Physicians use different methods for determining the time of gestation and estimate the delivery date. Among the methods used is the dating based on last menstrual period (LMP). According to a study by Taipale and Hiilesmaa (2001), the first day of the LMP in an individual marks day one of pregnancy. The accuracy of this calculation is based on the regularity of the menstrual cycle. A challenge in using this method to date the pregnancy is mostly expressed in individuals with irregular menstrual cycles, where identification of the LMP is difficult.
According to Pereira, Dias, Baston, and Carmo (2013), another method for determining the gestation age is the ultrasound of the first trimester. The failures of using such a method are based on the patient history. They include information on the length of the menstrual cycle, birth spacing and use of contraceptives. Even so, the delivery date is estimated to be 280 days after the LMP. The number of days varies depending on the regularity of the menstrual cycle and the length of the cycles. The margin of error in this estimate lies between 10-11 days. Based on this information, the patient LMP was 12-1-12. Hence, she is likely to be 6weeks pregnant on the day of her clinical visit. Using the due date estimator, she is expected to deliver on the 31st of August or the beginning of September.
Importance of Screening
The procedure of screening during pregnancy determination presents an opportunity to identify risk factors that could be present in the mother, and that may affect the baby. The first trimester is most crucial in the development of the baby. The aim of conducting the screening tests is to enable the parents to identify potential problems and take appropriate measures in providing birth safety. According to Tharpe, Farley, and Jordan (2013), the necessary screening tests performed during the first trimester include;
Measurement of body mass index and weight
Breast and pelvic examination
Screening for hematological conditions such as blood typing, determination of rhesus factor, anemia and hemoglobinopathies
Testing on the levels of Hcg
Urine analysis to test on the Kidney performance and possibilities of diabetes or preeclampsia.
Screening for Down syndrome and other abnormalities in the chromosomes.
In regards to Leruez-Ville et al. (2013), one of the necessary tests performed during the first trimester is the screening of cytomegalovirus. The virus is known to cause hearing defects and cognitive defects. The screening of sexually transmitted diseases can also be done during this stage of pregnancy.
In regards to Group (2013), the importance of screening in providing vital information in the detection, diagnosis, and management of disease makes the process important and necessary. The implication presented in the case of a missed procedure as outlined by Schuiling and Likis (2013), may lead to the wrong preparation of childbirth and the development of diseases that could otherwise have been prevented. Missed screening test could also present a case of termination of pregnancy in order to prevent engraving danger to the mother.
Determination of a Care Plan to the Patient
According to a report by Van Lerberghe et al. (2005), the importance of providing a care plan for the expectant mother and unborn children can help in preventing deaths and the occurrence of defects and diseases in neonates. It is expected of the pregnant mother to seek appropriate medical attention during the period of pregnancy. Their participation in taking screening tests is also important in achieving the right diagnosis and prevents the spread of disease to the child.
The first step in providing care to a pregnant individual is the determination of the pregnancy, giving information on the delivery date, and dating the pregnancy. This information will help the patient accept and prepare for the birth of the child. It is important to advise the patient on the appropriate clothing to wear, foods to consider, as well as exercises to promote general health. It is also important to psychologically prepare the patient on the changes likely to occur during this period and educate them on how to deal with these changes positively.
Providing appropriate care to the expectant individual is essential. It is the responsibility of the physician, the family, and the society. The importance of the prenatal screening tests in assisting the detection and diagnosis of diseases both in the mother and the developing fetus should be emphasized and encouraged. Evidently, the determination of pregnancy dating and provision of appropriate care helps in the preparation of birth and prevention of fatal incidences.
Group, T.N.P.S.W. (2013). ACMG statement on noninvasive prenatal screening for fetal aneuploidy. Genetics in Medicine, 15(5), 395-398.
Leruez-Ville, M., Sellier, Y., Salomon, L.J., Stirnemann, J.J., Jacquemard, F., & Ville, Y. (2013). Prediction of fetal infection in cases with cytomegalovirus immunoglobulin M in the first trimester of pregnancy: a retrospective cohort. Clinical infectious diseases, 56(10), 1428-1435.
Pereira, A.P.E., Dias, M.A.B., Baston, M.H., & do Carmo Leal, M. (2013). Determining gestation age for public health care users in Brazil: comparison of methods and algorithm creation. BMC research notes, 6 (1), 1-5.
Schuiling, K. D., & Likis, F. E. (2013). Womens gynecologic health (2nd ed.). Burlington, MA: Jones and Bartlett Publishers.
Taipale, P., and Hillesmaa, V. (2001). Predicting delivery date by ultrasound and last menstrual period in early gestation. Obstetrics and Gynecology, 97(2), 189-194.
Tharpe, N. L., Farley, C., & Jordan, R. G. (2013). Clinical practice guidelines for midwifery & Womens health (4th ed.). Burlington, MA: Jones & Bartlett Publishers.
Van Lerberghe, W., Manuel, A., Matthews, Z., & Cathy, W. (2005). The world Health Report 2005-make every mother and child count. [PDF File]. <http://www.who.int/whr/2005/whr2005_en.pdf>.
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