Pelvic Exam
Your healthcare provider will usually
perform a pelvic examination at the first or second prenatal visit and
again in late pregnancy. In early pregnancy, it helps evaluate the size
of the uterus and determine how far along you are in pregnancy. In late
pregnancy, it reveals many things:
•the presentation of the baby—whether the baby is head first or breech
•the dilatation of the cervix—how much the cervix has opened (if at all)
•effacement—how much the cervix has thinned
•station—how low the baby is in your birth canal
•shape and size of your birth canal or pelvic bones
After a pelvic exam late in pregnancy,
your healthcare provider may tell you some numbers, such as “2 and
50%.” This means your cervix has dilated 2 centimeters and is 50%
thinned out.
Information collected during the exam is
helpful if you go to the hospital thinking you’re in labor. At the
hospital, you’ll be checked again. Knowing the measurements from your
last pelvic exam can help medical personnel determine if you are in
labor.
A pelvic exam does not tell your healthcare provider when you’ll go into labor. Labor can start at any time, regardless of the condition of your cervix.
Tests for the Woman Expecting Multiples
We know the chance of a multiple birth
increases as a woman gets older. If you are carrying more than one
baby, the number of tests you receive, and when you receive them, will
be different. Some researchers recommend if you are at least 32 years
old and your healthcare provider determines you’re carrying more than
one baby, you should have chromosome testing, such as amniocentesis or
chorionic villus sampling. Research indicates there is a slightly
higher chance of an abnormality when a woman is carrying two or more
babies.
Kay did most of the talking at her
prenatal visits. I mainly listened to this bubbly, excited first-time
mom-to-be. I don’t think her husband, Bob, said a word. They both came
for her 18-week visit, when we were doing an ultrasound. Kay had been a
little unsure about her last period, and her uterus seemed larger than
expected, so we hoped her ultrasound would help us determine if we had
the right due date. The ultrasound told us a lot—her due date was
right, but she was carrying twins! Kay was in shock; all she could do
was gasp. Bob was ecstatic—he whooped with joy. They left with Kay
shaking her head and Bob grinning from ear to ear. At her next visit,
Kay and I talked about twins and twin pregnancies.
In many cases, screening tests are the
first indication a woman is carrying more than one baby. Sometimes
these tests give an “abnormal” result. An abnormal test result does not
necessarily indicate the babies have a problem; it alerts the healthcare provider to perform follow-up tests.
Often with a multiple pregnancy, blood
tests are repeated around week 28 to check for gestational diabetes.
Tests can also reveal if the mother-to-be is anemic, which is more
common in women carrying multiples.
You may have more tests if other problems
develop. If there’s an indication of preterm labor or pre-eclampsia,
you may have amniocentesis to check lung maturity in the babies.
Premature lung disease is a serious complication for multiples who are
delivered too early.
Ultrasound at the mall can be
hazardous to you and baby because untrained technicians doing the test
on you may not use equipment correctly.
Tests to Avoid during Pregnancy
There is no known safe amount of
radiation from X-ray tests for a developing fetus. X-ray exposure may
harm the baby. Don’t have any X-rays during pregnancy unless it’s an
emergency. The medical need for an X-ray must always be weighed against
its risk to your pregnancy. Discuss the procedure with your pregnancy
healthcare provider before any X-ray is taken during pregnancy. This warning also applies to dental X-rays.
Computerized tomographic scans, also called CT scans or CAT scans,
are a specialized X-ray. The test involves the use of X-ray with
computer analysis. Many researchers believe the amount of radiation
received from a CT scan is far lower than from a regular X-ray.
However, it is probably wise to avoid even this amount of exposure, if
possible.
If you’re over 35, you may have had a
baseline mammogram, or breast X-ray, which is usually repeated every 2
years after the age of 40. If you had a mammogram before pregnancy,
you’re ahead of the game. If not, don’t have one until after baby is
born. Unless you have a good reason for undergoing the test, such as a
breast lump, don’t expose your developing baby to this type of
radiation.
With radiation exams, risk to the fetus
appears to be the greatest between 8 and 15 weeks of gestation (between
the fetal age of 6 weeks and 13 weeks). Some physicians believe the
only safe amount of radiation exposure for a fetus is no exposure.
Magnetic resonance imaging (MRI)
is a widely used diagnostic tool. No harmful effects have been reported
from its use in pregnancy, but pregnant women are advised to avoid MRI
during the first trimester of pregnancy.
