Interactive pregnancy calendar

Start of last period

days menstrual cycle

Pregnancy week

Recommended examinations | Infections

9. - 11. Week

CLR (crown-rump length) approx. 17-60 mm

First ultrasound scan

Blood test: Blood type with Rh factor, antibody screening, rubella titre, lues (syphilis), maybe HIV test.

Chlamydia test: cervical smear test and/or urine analysis

These examinations are covered by your health insurance

Each year around 2,000 children are born in Germany, who suffer from the severe effects of toxoplasmosis in pregnancy. In the unborn child, toxoplasmosis infection can lead to mental disability and vision loss.

Most adults do not even notice an acute toxoplasmosis infection, as it causes no or only mild symptoms and as such is often left untreated. It takes only a simple laboratory test to find out whether the pregnant woman has already had a toxoplasmosis infection before her pregnancy and is therefore immune or whether her baby may be at risk due to a first time infection.

Toxoplasmosis is an infection caused by a single-celled parasite called Toxoplasma gondii. The parasites multiply within the cells of the mucous lining of a cat's intestine. The eggs are excreted in the cat faeces and can infect other mammals. Humans contract toxoplasmosis from eating raw or undercooked meat containing the most resistant form of the parasites (cysts) or by coming in contact with dirt (garden soil!) contaminated with cat faeces containing infective eggs.

About 50 percent of the adult population has had a previous toxoplasmosis infection. They have developed specific antibodies and are thus immune against further infections.

Toxoplasmosis

This examination is not covered by your health insurance

This examination is not covered by your health insurance

This examination is not covered by your health insurance

Chorionic villus sampling (CVS)

Chorionic villus sampling (CVS) is a form of prenatal diagnosis to determine chromosomal or genetic disorders and/or certain metabolic disorders in the foetus. It is not a routine test during pregnancy and should only be carried out in special cases.

During the CVS test, a small sample of cells (called chorionic villi) is taken from the placenta (afterbirth) and sent for examination. The tissue sample is taken during the early stages of pregnancy, either through the cervix (neck of the womb) or with a thin needle through the abdomen. The tissue sample is then sent to a laboratory for examination. Test results are usually available after two to three days. In addition long-term cultures are set up with the cells, with the results available after ten days to 3 weeks.

CVS can be performed from week 9 of pregnancy, earlier than amniocentesis. At 3-5%, the risk of a miscarriage is higher with CVS than with amniocentesis.

Occasionally, there may be some light bleeding after CVS, and in very rare cases, also an infection.

As we do not carry out this examination at our practice, we will refer you to a doctor who is experienced in this procedure.

12. - 14. Week

CRL (crown-rump length) approx. 45 - 90 mm
Weight - 45 g

Nuchal translucency test, first trimester screening test

The foetus is checked for abnormalities with a special ultrasound device and nuchal translucency is measured. This is the accumulation of fluid around the neck of the child. The new first-trimester test is a combination of a blood test looking at two specific hormones of pregnancy: Free beta hCG and PAPP-A (pregnancy associated plasma protein A), and a scan of the nuchal transparency of the unborn baby, both in relation to the week of pregnancy. The ultrasound scan for measuring nuchal translucency (also called the NT or nuchal fold scan) is performed between 11 weeks and 13 weeks 6 days into your pregnancy, with a CLR of 45-84 mm.

Nuchal translucency measurements are not only a strong predictor for an increased risk for Down syndrome, but indicate serious, non-chromosomal defects, such as heart defects.

A computer programme then uses the measurements from the ultrasound examination and the maternal age to calculate a risk for a genetic disease with 90% accuracy. A more specific version of this test is the imaging of the foetal profile to establish whether there is a nasal bone. First results from studies showed that at week 12-14 of pregnancy, the nasal bone was absent in foetuses with Down syndrome.

Please keep in mind: Normal screening results do not guarantee that your baby is healthy. The only way to definitely exclude genetic defects are invasive procedures such as chorionic villus sampling, or amniocentesis (removal of amniotic fluid). However they pose a higher risk for your baby.

Nuchal translucency test

This examination is not covered by your health insurance

15. - 19. Week

CRL (crown-rump length) approx. 9 - 15 cm
Weight 45 - 280 g

triple-test

The triple test includes a blood test of the expectant mother and the precise measurements of the baby by ultrasound. The blood of the expectant mother is analysed for these three hormones: alpha-fetoprotein (AFP); unconjugated estriol (E3) and beta human chorionic gonadotropin (beta-hCG). The levels of these substances together with the week of pregnancy can help doctors identify whether the unborn child is at risk for Down syndrome (trisomy 21) or spina bifida (where the spinal cord didn't form properly and nervous tissue is exposed).

The purpose of the triple test is to assess the risk of disability and to help the pregnant woman decide whether she wants amniocentesis, if she is still unsure. The triple test indicates whether in the current case the risk is higher or lower than the age-related risk.

This examination is not covered by your health insurance

Amniocentesis

Like chorionic villus sampling, amniocentesis is one of the routine tests during pregnancy. It is used to detect certain diseases or abnormalities in the foetus (e.g. where Down syndrome is suspected).

For amniocentesis, the doctor uses ultrasound (sonography) to determine the exact position of the baby in the womb and to guide a needle to a suitable injection site to remove amniotic fluid. The sonographic measurement of certain parts of the body (e.g. head, abdomen, femur) allow him to establish whether the size of the unborn child is consistent with the calculated week of pregnancy. At the selected point, he introduces a thin needle into the abdominal wall and into the amniotic sac under constant ultrasound guidance. The doctor then withdraws approximately 20 ml of fluid from the amniotic sac.

The sample is then sent to a laboratory for examination, where the cells in the sample are cultivated and propagated. These cells are cells shed by the skin, gastrointestinal tract and kidneys of the baby. Test results are usually available after approximately one to three weeks. After the procedure the patient should rest for a day.

Amniocentesis belongs to the invasive diagnostic tests. The following risks are to be considered:

  • The risk of a miscarriage: It is approx. 0.5 to 1 percent and also depends on the experience of the doctor.
  • Amniotic fluid leakage, light bleeding in the womb, injury or infection of the womb.
  • Injury of the baby from the needle.
  • Contractions of the womb: This reaction is relatively common, but usually improves quickly.

As we do not carry out this examination at our practice, we will refer you to a doctor who is experienced in this procedure.

20. - 22. Week

CRL (crown-rump length) approx. 15 - 18 cm
Weight approx. 280 - 480 g

Second ultrasound scan

Now you can feel your baby?s first movements

This examination is covered by your health insurance

Foetal abnormality screening/ high-resolution ultrasound / DEGUM II

The high-resolution ultrasound (also called differentiated ultrasound) is much more comprehensive than the ultrasound, normally performed in line with provided according to the maternity policy guidelines for this period. In addition to special devices, it requires extensive experience of the examiner. At our practice, Dr. Deiters has the DEGUM II qualification required for this examination.

In an ideal environment, with the position of the baby and the thickness of the maternal abdominal wall all playing an important role, a comprehensive ultrasound examination takes about 50 to 60 minutes. This includes a thorough examination and assessment of the foetus?s organs and limbs:

  • Measurements of the foetus will also be taken to ensure it is growing normally
  • quantity of amniotic fluid, position and appearance of the placenta
  • appearance and function of all visible organs including the heart
  • blood flow through the umbilical cord and uterine blood flow (to assess placental function and development)


What does DEGUM stand for?

This examination is not covered by your health insurance

23. - 28. Week

CRL (crown-rump length) approx. 18 - 25 cm
Size approx. 25 - 35 cm
Weight. approx. 480 - 1.200 g

Colour Doppler ultrasound

How well the foetus is provided with nutrients can be assessed by measuring the foetus's blood flow in arteries and veins. And it is also more accurate than other monitoring methods in assessing the unborn child?s overall state of health and the extent of any compensated oxygen deficiency.

By measuring the blood flow patterns in the uterine arteries, insufficient nutrient supply to the foetus (placental insufficiency) can already be recognized between weeks 20 and 24 of pregnancy; this way, preventive measures can be taken if the foetus is at risk. The assignment of pregnant women in risk groups of foetal growth restriction or gestosis (pregnancy-induced hypertension) or a low-risk group allows the monitoring tailored to the requirements of mother and child.

Colour Doppler ultrasound

This examination is not covered by your health insurance

?Baby TV? - enhanced ultrasound

Usually, normal ultrasound examinations are carried out to make sure the pregnancy is progressing normally. More comprehensive ultrasound examinations are to exclude gross structural abnormalities in non-risk pregnancies.

With an additional ultrasound we can take more time to show you what your baby looks like, or - if we can see it ? determine the gender.






?Baby TV? - enhanced ultrasound

This examination is not covered by your health insurance

Oral glucose tolerance test, OGTT

Two out of 100 women develop diabetes during pregnancy - with serious consequences for mother and child: urinary tract infections, hypertension and eclampsia occur disproportionately often, and more frequent complications during labour. There is also an increased incidence of foetal anomalies. In addition, pregnancy-related diabetes is a major cause of prenatal deaths. A simple blood test from week 25 of pregnancy will identify whether you are at risk.

  • Fasting blood glucose test
  • You drink 250ml of a glucose drink
  • Blood collection after 1 hour
  • Blood collection after 2 hours

This examination is not covered by your health insurance

Gestational diabetes

29. - 32. Week

CRL (crown-rump length) approx. 25 - 30 cm
Size approx. 35 - 40 cm
Weight. approx. 1.200-1.950g

Third ultrasound scan

blood test: checking for hepatitis B and antibodies in your blood.

Patients, whose blood is Rhesus negative, are given an injection (anti-D) to prevent any possible illness of the child in the womb. This examination is covered by your health insurance

33. - 40. Week

Colour Doppler ultrasound

In the third trimester, a special colour Doppler ultrasound is often used to identify or exclude foetal growth restriction. This allows for early detection of insufficient nutrient supply to the foetus due to placental insufficiency. This examination provides an additional level of safety on top of the usual check-ups.

The colour-coded Doppler ultrasound allows the examination of the blood flow in the large blood vessels of mother and child. This allows for better assessment of placental function and identification of any possible threat to the baby at an early stage. However, the Doppler ultrasound can only identify chronic disorders, and cannot predict acute events.

Colour Doppler ultrasound

This examination is not covered by your health insurance

Streptococci - smear

Group B streptococci are found in 10-15% of pregnant women, primarily in the genital area. Although these are normally harmless bacteria which inhabit the vaginal lining, pregnant women can infect their newborn at birth. This can lead to severe infections shortly after birth (?early onset?) or after 1-6 weeks (?late onset?). Early onset infection is associated with blood poisoning (sepsis), pneumonia, and meningitis, and may also lead to neurological damage and long-term effects. With late onset infection, there is a high risk of neonatal death, particularly in premature infants.

For these reasons, the German Society of Obstetrics and Gynaecology has made recommendations for the prevention of neonatal group B streptococcal infection.

Streptococcal infections

This examination is not covered by your health insurance

Enhanced ultrasound examination

To monitor the foetus?s position (whether the baby's head has moved down into the pelvis), assessment of placenta, amniotic fluid and foetal head size in relation to maternal pelvis. This is also a chance to check once more for any signs of a possible illness of the foetus, which has only occurred after the last regular ultrasound and has been asymptomatic in the mother.







?Baby TV? - enhanced ultrasound

This examination is not covered by your health insurance






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