First consultation

The first consultation of the pregnancy is usually made about the second absence, except in patients with risk factors. In this consultation, first of all, a medical history should be taken, with the patient's personal and family history, a gynecological-obstetric history1 and a physical examination. It is very important to resolve possible doubts about the development of pregnancy and care during pregnancy.

The obstetric history should include the date of the last menstrual period in order to indicate the probable date of delivery.

On physical examination, blood pressure and weight should be taken for subsequent gestational monitoring. If necessary, a cytology and an examination of the genital tract should also be done.

The first analysis will be requested that includes a determination of the hemogram to assess if there is anemia, the level of platelets2 and the level of white blood cells or leukocytes. In addition, the blood group and Rh are determined to assess problems of possible incompatibilities and the need to later administer the gamma globulin or vaccine. blood coagulation should also be assessed to rule out abnormalities that could complicate a bleeding delivery. At the biochemical level, blood glucose3 is assessed and in some cases the O'Sullivan test is performed to rule out gestational diabetes. At the level of serology, antibodies against various diseases that could complicate pregnancies, both at the maternal and fetal levels, are determined, and they are syphilis, hepatitis B and C, HIV, rubella and toxoplasmosis4. This first analysis also includes a urine test to rule out inadvertent infections.

The first transvaginal ultrasound will be performed or requested to inform us of the location of the pregnancy and rule out ectopic pregnancy, the number of sacs and embryos present. The measurement of the embryo dates us exactly the gestation so it informs us if it corresponds to the weeks since the date of the last rule or there is a lag and gives us a probable date of delivery. The ultrasound also rules out the presence of gynecological pathology (ovarian cysts, fibroids5).

The patient should consult any doubts she may have and guidance on care during pregnancy should be given. It will also be determined if there is any risk factor and the pregnancy monitoring to be carried out. It will also be indicated if it is necessary to take medication and vitamin complexes according to each specific case.