Regulated consultation

| Normal or low-risk gestational control includes the first visit about the second absence. The first analysis and the first ultrasound are then performed.

Controls are monthly until the last month of pregnancy in low-risk pregnant women, at which time they are carried out biweekly and then weekly. The low-risk protocol also indicates the performance of an ultrasound per trimester plus the screening at 12 weeks and an analysis per trimester plus the screening.

At the second appointment at 12 weeks, an ultrasound is performed to determine the nuchal fold and other markers of chromosomopathy are ruled out1. Screening is then requested (if the patient so wishes) to determine the risk index for Down syndrome. This test combines the ultrasound data with the analytical data (Beta-HCG and PAAP-A), and a result is obtained in the form of a risk index, indicating the risk that this patient has in that pregnancy that the fetus is affected by syndrome Down. Depending on the result, the convenience of performing or not invasive tests to determine the fetal karyotype is assessed.

Depending on the result of the screening or the patient's risk factors, a chorion biopsy will be performed at 12 weeks or an amniocentesis at 16 weeks.

Subsequently, a high-resolution ultrasound is performed at 20 weeks and the next visit. Between 24 and 26 weeks, the second trimester analysis is carried out with the O'Sullivan test (or sugar test). It consists of an analysis with determination of the glucose level one hour after the intake of 50 g of glucose. In case of having a positive result, the glucose curve should be performed with the serial glucose determination, baseline, one, two and three hours after the ingestion of 100 g of glucose. This test is what will determine the presence or not of gestational diabetes.

In the third trimester, a last ultrasound is performed to verify adequate fetal growth and the last analysis. In the last month, vaginal and rectal cultures are also performed to detect Streptococcus Agalactiae and determine the need to administer the necessary treatment during childbirth.

After approximately 39 weeks, cardiotocographic records are also performed to rule out signs of loss of fetal well-being.