Prenatal controls are very important to monitor the development of pregnancy and to detect in time any anomaly that could appear, both in the baby and in the mother. Until today, the recommendation of the WHO (World Health Organization) was to make four medical visits throughout pregnancy, but on Monday released its new recommendations with the intention of reducing the risk of premature births and complications of pregnancy.
The organization recommends that mandatory pregnancy control visits double from four to eight. Currently, only 64% of pregnant women visit the doctor at least four times, and suggests that eight medical visits should be done ideally: the first in week 12, followed by others at 20, 26, 30, 34, 36, 38 and 40 weeks.
Many lives could be saved
According to WHO, last year 303,000 women died for reasons related to pregnancy while 2.6 million were born in childbirth and 2.7 million babies died during the first 28 days of life.
Improving the quality of prenatal care would help save many lives. Increasing controls would help prevent diseases in the mother and the baby, but it would also be a good opportunity to provide quality information to the pregnant woman about healthy lifestyle habits, pregnancy nutrition, family planning and providing support to women who may be suffering gender violence.
"Pregnancy should be a positive experience for all women and should receive care that respects their dignity," says Dr. Ian Askew, Director of Research and Reproductive Health at WHO.
Recent evidence shows that a higher frequency of prenatal check-ups by women and adolescent girls is associated with a lower chance of intrauterine fetal death. This is due to increased opportunities to detect and treat potential problems. A minimum of eight contacts for prenatal care could reduce perinatal deaths by up to 8 per 1000 births, compared to a minimum of four visits.
Eight controls in pregnancy
The first visit to the gynecologist usually takes place in the 12th week of pregnancy. It determines the probable date of delivery (FPP), the medical history is prepared and a vaginal ultrasound is performed to confirm the presence of the amniotic sac and if detected, also the fetal heartbeat.
After this first ultrasound, at least two other routine ultrasounds are performed throughout pregnancy, one in each trimester, although in some cases it may be necessary to perform some more.
Ultrasound in pregnancy is mainly used to study the growth and well-being of the baby inside the uterus. It allows, among other things, to detect malformations, evaluate the anatomical development of the fetus, its growth, its position, calculate its gestational age, hear its beats, observe the state of the placenta, amniotic fluid, estimate the baby's weight and detect abnormalities or pathologies of pregnancy.
Summary of the new WHO recommendations
Make a minimum of eight prenatal controls to reduce perinatal mortality and improve the experience of women's care.
Advise the mother about the importance of carrying a healthy eating and staying physically active during pregnancy.
Take iron supplements (30 mg to 60 mg) and folic acid 400 μg (0.4 mg) daily to prevent maternal anemia, puerperal sepsis, low birth weight and premature delivery.
Recommend the tetanus vaccination to all pregnant women, based on previous exposure to tetanus vaccination, to prevent neonatal mortality due to this disease.
Recommend at least one ultrasound before 24 weeks of gestation (early ultrasound) to estimate gestational age, improve the detection of abnormalities in the fetus and multiple pregnancies, reduce the induction of labor for prolonged pregnancies, and improve the experience of pregnancy.
Health care providers should ask all pregnant women about the consumption of alcohol and other substances as soon as possible in pregnancy and at each prenatal visit.
