Dr Ahmed Ismail

Consultant Gynaecologist & Fertility Expert

 

Maternity/Pregnancy

Care should be settled on pregnant women as for two people firstly is a pregnant woman herself secondly on the baby in uterus. The aim of such an important care is to keep women’s fully informed, fully knowledgeable about their body and their physiological changes during pregnancy as well as anatomical changes in her body during pregnancy.
The duration of Pregnancy Period is ten lunar months, nine months and ten days or 40 weeks. Pregnancy period is divided into 3 trimesters:

Gynaecology

  1. First trimester is a period between beginning of pregnancy and 12 weeks of pregnancy.
  2. Second trimester is between 12 weeks and 28 weeks of pregnancy.
  3. Third trimester is between 28 weeks and delivery of the baby.

Physiological changes in the first 12 weeks of gestation are the following:

  • Morning sickness
  • Breast changes
  • Go off certain perfumes, food.
  • Mood swings and mood changes
  • Feeling easily tired, exhausted
  • Sometimes there are no changes at all

The clinician who is looking after woman in her early pregnancy has to discuss all this changes particularly in the presence of the partner. Mr. Ismail always has a word to say to the partner “Please look and do not comment”. The main reason for partner to be present in a visit with clinician as there will be definite changes happening around him and he must be aware of them.

The changes will make him understand more about his wife and if there are changes which can cause a worry to the family or to the partner it means he should discuss it with the clinician.

Clinician should be available at all times for the patient. Pregnant women is advised Folic Acid from beginning of pregnancy and even better if they can start prior pregnancy in planned cases and should continue until six weeks gestation.

Gynaecology

Sometimes clinician decides to include with Folic Acid some blood thinning medications such as Junior Aspirin but clinician must be aware that there is only a certain situations where the patient would benefit from Junior Aspirin.

Patients often ask if they can take something for the morning sickness we as obstetricians experiencing this situations frequently and we find it more logical and appropriate to try to avoid medications if it is possible unless it is seriously required.

Most of this patients will find that the morning sickness decline and go less by 12 weeks.

Furthermore, pregnant woman should have an early scan during her pregnancy in the first trimester to ascertain the gestational again relation to the dates given by the patient from her last period.

Early scan is important to exclude multiple pregnancies. Twin pregnancy is not so rare as fertility medications increases the ability of twin pregnancy unless it is natural pregnancy. Once we know that there is a multiple pregnancy , it is appropriate to support the pregnancy with Progesterone supplement

Early scan detects any pelvic organs pathological problems such as Ovarian Cysts.

Pregnant women must be checked for any blood or other unusual discharges and to be treated accordingly.

Sexual intercourse to be avoid in case of bleeding and to be resumed with doctor advice.

Gynaecology

Queensway Clinic physiotherapy department will advise to the best course of antenatal exercise in pregnancy.

Pregnancy classified as a high risk for miscarriage often we advise against exercise, until pregnancy has passed the risk period and exercise will be introduced gently with close supervision.

Exercises useful during first trimester are breathing exercise, abdominal exercise and pelvic muscles exercise, gentle swimming recommended in healthy uncomplicated pregnancy, heavy sports should be avoided during pregnancy as a rule.

Blood Investigations during pregnancy as early as possible are mandatory.

Essential situation requires close specialist supervision:

  1. Early Pregnancy
  2. Hyperemesis Gravidarum(Vomiting in Pregnancy)
  3. Bleeding in Pregnancy
  4. Twins Pregnancy
  5. Breech Pregnancy
  6. Hypertension in Pregnancy
  7. Pregnancy Care
  8. Postnatal Care
  9. Skin Rash and Pruritis in pregnancy

 

Essential Obstetric Ultrsound

 

Scans Weeks
Early pregnancy scan 5 - 11
Viability scan & Dating scan After 7 weeks
Down syndrome screeing(Nuchal fold scan) 11+2/13+5
Triple blood test for Down syndrome 15-19
Sexing After 17
3D, 4D scan Ideally 22-32
Fetal well-being & Growth 23-40
Placental localization in case of low placenta 32 - 34
Reassurance scan 32 - 34

 

 
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