| Every visit |
First visit — ALSO |
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Ask
- How she is feeling
- Physical problems — urine symptoms, STI symptoms, vaginal loss, bleeding, pain, DVT or PE symptoms
- Wellbeing — social or emotional issues, risk of family violence
- Substance use — tobacco, alcohol, caffeine, other drugs
- Baby’s movements — 18–20 or more weeks first baby, 15–16 or more weeks next babies
Check
Do
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Ask or check file notes
Check
- Height
- BMI — use pre-pregnancy weight
- U/A — midstream urine, send for MC&S even if U/A normal
- Head-to-toe exam, including vulva
- Risk factors for preeclampsia — see Hypertension in pregnancy
Take blood for
- FBC, iron studies, POC Test for Hb
- Blood group, antibody screen
- Rubella serology
- Hepatitis B serology, Hepatitis C serology
- HIV serology
- Pregnancy STI check including syphilis serology
- Diabetes tests — HbA1c and OGTT
- If known diabetes, high BP or kidney disease — UEC, LFT, TFT, B12, ACR
- If known thyroid problems — TFT, T3, T4
- Cervical screening, if due (up to 20 weeks gestation). If speculum exam not done BUT
eligible for HPV test offer lower vaginal swab (LVS)
- If history of preterm birth — LVS for MC&S for bacterial vaginosis
Do
- Offer immunisations as recommended during pregnancy, at appropriate gestation
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