Monitoring normal pregnancy

The purpose of monitoring a normal pregnancy in the course of preventive examinations is to detect high-risk pregnancies at an early stage and thus to be able to avoid complications as far as possible.

The legislator provides clear guidelines as to which examinations are required to protect the pregnant woman and the unborn child. Both the time frame and the scope are specified.

Time frame of the examinations

Each examination should include at least the following four basic examinations:

1. Detailed anamnesis (collection of medical history and health status).
2. Gynecological examination of the vagina and cervix
3. Survey of maternal and fetal risk factors
4. Assessment of whether further examinations are necessary

In addition, some of the examinations also include special examinations depending on the progress of the pregnancy.

Special examinations

In addition, other examinations are recommended in the law gazette, but are not obligatory for receiving child care benefits.

Other recommended examinations

According to the law, ultrasound examinations are not a prerequisite for the continuation of childcare allowance in the full amount.

HI virus

HIV is tested during pregnancy to prevent transmission of the virus to the child. If the test is positive, the risk of infection can be reduced to less than 1% by highly effective combined antiretroviral therapy (cART). If the viral load is high, the child is delivered by cesarean section. Afterwards, the child receives post-exposure prophylaxis and must not be breastfed, which further reduces the risk of transmission. To ensure that all these precautions can be taken in good time, it is obligatory to take an HIV test early in pregnancy.

Blood group

Checking blood group and rhesus factor is especially important for birth. In rhesus-negative mothers with rhesus-positive children, an immune reaction can be triggered by the birth. This creates an immune memory against the rhesus factor, which can be problematic in future pregnancies. Therefore, it is important to learn about this blood value early and take the necessary precautions at birth to avoid the immune response against the rhesus factor.

Blood glucose

The oral glucose tolerance test measures blood glucose after ingestion of a sugar solution. This can detect gestational diabetes, which must be treated to avoid complications and malformations. Elevated blood glucose levels can lead to heart disease, respiratory distress syndrome and premature birth of the child.

Vaccination titer

Measurement of toxoplasmosis titers is considered proof of immune protection against toxoplasmosis. Without this protection, pregnant women must follow special precautions: Not eating raw meat, not handling litter boxes and feeding cats only canned or dry food, gardening only with gloves, washing hands carefully before each meal, and washing fruits and vegetables thoroughly before eating. These measures are taken to avoid infection with toxoplasmosis, which can cause malformations of the eyes, liver and brain during pregnancy.

Rubella titers are also done to prove immune protection. Infection during pregnancy can cause deafness, cataracts and heart defects in the child.

The physical examinations, such as measuring blood pressure and checking weight, in addition to recording the general state of health of the expectant mother, also have the purpose of detecting so-called pre-eclampsia at an early stage. This is a high blood pressure condition that is also manifested by increased water retention (edema). If left untreated, eclampsia can develop, which is characterized by epileptic seizures in the mother and entails an increased risk of growth disorders, premature birth or miscarriage. Internal examination may detect thyroid dysfunction(hypothyroidism, hyperthyroidism). These sometimes also occur in the course of pregnancy.

In a normal pregnancy, three separate ultrasound examinations are recommended at different times (see above). In the event of complications, such as bleeding or amniotic fluid leakage, additional ones may of course be required.

The midwife consultation is not mandatory, but a one-hour consultation is recommended. In this consultation, the pregnant woman usually receives information about the course of pregnancy, birth, postpartum and breastfeeding. She also receives tips on health-promoting and preventive behavior during pregnancy, the postpartum period and breastfeeding. The psychosocial environment of the pregnant woman and possible support options can also be discussed.

Further consultations during pregnancy

In addition to specific examinations, every pregnant woman is also entitled to general counseling.