AU about BPD and FL: In Mutterpass it teems with abbreviations and entry fields for all sorts of findings and investigations during pregnancy. We guide you page by page through the mother's passport so that in your pregnancy no question remains unanswered.

Mother Pass: What he is good

Mutterpass leadership

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After the first screening every expectant mother receives from her doctor or midwife - 1968 introduced and has since been updated several times - Mother through. In this examination booklet all controlled during the pregnancy and birth data and findings are recorded, including the examination findings of newborn babies and the postpartum-control findings of the mother. The Mutterpass you should always have with you and keep it even after birth. The registered data and findings are useful on the one hand for a new pregnancy, the booklet also provides space for two registered pregnancies.

Since the Mutterpass so many entered for the layman incomprehensible, we have everything explained on the subject.

Checkups during pregnancy

If you are expecting a baby, can and should you (at the expense of public health insurance) a medical follow your pregnancy, prenatal care, to complete. Type and number of tests are exactly prescribed by the Association of health insurance in the maternity guidelines. The retirement dates you can perceive with your gynecologist or midwife.

see the maternity guidelines up to the 32nd week of pregnancy tests every four weeks, then every two weeks. In the case of a transfer your gynecologist, your midwife or possibly also the doctors chosen by you maternity facility you will study every two days want. Should you feel uncomfortable between appointments, or have specific symptoms such as persistent abdominal cramps, bleeding or dizziness, please do not hesitate even to seek medical advice spontaneously, so that the cause of your troubles can be resolved.

What happens during a screening examination?

Blood tests for pregnant women

Below is an overview and explanations of the individual laid down in the maternity pass examinations. They should help you to be able to follow and assess the course of pregnancy or the individual checkups. First, it is about the investigation from the blood (serological tests). They are divided into mandatory and additional examinations.

duty investigations

Under the first provision, the doctor prepares some laboratory tests. A part of these tests are prescribed in the maternity guidelines for pregnant women. These are:

Blood / rhesus
Determining the blood type (A, B, AB or neutral) and of the Rhesus factor (presence = Rh positive or absent = Rh negative). If you do not have written proof of your blood type (for example, in an emergency card or from previous blood donations), your blood type is now determined. The mother's Rh factor is also available in combination with the father's information about whether an incompatibility between mother and child could be that jeopardizes the embryo.

Gynecologist explained: Rhesus incompatibility

Antibody screening
Simultaneously, a screening test is performed on antibodies. However, only few antibodies, for example, Rhesus antibodies importance for pregnancy. Control of the antibody screening tests will always be 24 to 28 SSW (gestation).

Rubella HI test
The rubella HI test shows if the pregnant woman is immune to the rubella virus, that whether it has the appropriate antibodies against rubella. Antibodies have you either by a previous rubella vaccination or a previous rubella infection. The rubella test is always important, unless from a previous experiment, it is clear that they already had rubella. The test is carried out as early as possible because of the risk of disease and the associated problems for the embryo in the first three months is the highest. In case of a negative test result you should avoid coming into contact with infected people.

Lues search response
Syphilis (= syphilis) -Such reaction (LSR), a test to rule out a syphilis infection. This sexually transmitted disease that is very rare today can be treated during pregnancy. If they do not, the causative agent of the disease can damage the embryo.

Hb / iron deficiency
Your gynecologist will also Hb value, the concentration of hemoglobin, the oxygen-carrying iron-containing substance in the blood determined. The'Volksmund' means the hemoglobin level with the iron value. Because the blood is diluted by the liquid increase in pregnant women, a certain decrease in the Hb's is normal. If the hemoglobin level but fall sharply, your doctor will prescribe you iron supplements and, if necessary. Cause further blood tests. The value changes in the course and is therefore checked regularly and recorded in Gravidogramm (infra).

hepatitis B
Testing for Hepatitis B (the determination of HBsAg) is also required by law, but is later carried out (until 36 weeks of pregnancy about 32) to have a current information possible before birth. If you wear the HBsAg, your child is vaccinated immediately after birth against hepatitis. Today, vaccination against hepatitis B are recommended as part of infant vaccinations.

chlamydia infection
In addition to these blood tests and a smear on a chlamydia infection (bacterial infection) of the birth canal is guaranteed by law. Since the mother's infection causes no symptoms, but can be transmitted to the newborn at birth, they must be treated in pregnancy.

Additional investigations as appropriate and upon request

The ensuing investigations are not prescribed duty investigations. However, if there is a corresponding suspicion can and does your doctor encourage these studies. If necessary. you need him to address the assumption of costs of tests to be performed on your desire.

AIDS test
An AIDS test (HIV test) may wish to - and then at the cost of health insurance - are carried out, the result is not held in the mother's passport, only the fact that a test was made.

toxoplasmosis
A study on toxoplasmosis belongs in the group of additional tests and ggfl. to pay themselves. Toxoplasma are parasites that are transmitted through the feces especially young cats or enjoy raw meat. Only the initial infection of a pregnant woman may in this case be dangerous to the child.

infectious diseases

Upon contact with other infectious diseases, e.g. Chickenpox, fifth disease or B streptococci, the doctor will consider further studies in consideration. Likewise require disorders in pregnancy, such as of the kidney or liver problems, appropriate tests to avoid complications.

Pap test
A cancer screening test (Pap test) will be arranged if required by your attending physician.

Mutterpass in children 2

Information about how earlier pregnancies are run, provide physicians with evidence to assess the current pregnancy, the possible course of birth or any risks: miscarriage (abortion), termination (abortion), vaginal delivery, cesarean section (cesarean section), vaginal surgery (eg pliers - or ventouse), gestation (the child was born too early or on time or transmitted).

It is equally important to understand really all previous pregnancies (gravida), which prematurely ended (for example, by abortion or miscarriage) must also be considered is.

If you do not want personal reasons that this statement be recorded in the maternity card, you should use the appeal by your doctor.

About medical history and advice

As part of the medical history, the doctor detects your past medical history. additionally important disease data may be captured of related family members, and other special charges that can affect the course of your pregnancy, entered. In the so-called. A catalog will be in Mutterpass z. B. A lot of women in labor (more than 4 children), first pregnancy under 18 or over 35 years, previous miscarriage or premature births, heart, circulatory or kidney disease, Rhesus incompatibility in the unborn child, bleeding during pregnancy, poor social relationships, stressful work environment as well as previous abdominal surgery listed as stressful circumstances. If you are assigned to this catalog a risk group, that is at first only that your doctor can now perform tighter provisions or additional studies. In an otherwise easily pregnancies which, however, does not have to be the case.

In addition, your doctor you will consider meaningful behaviors in pregnancy. Areas such as diet, drugs, tobacco, the workplace, sports and travel should be addressed. If you uphold a particular diet (eg as a vegetarian), you should definitely discuss this as well. can consult the doctor you too in terms of prenatal and antenatal exercises.

Calculated date of birth

Even at your first visit to the doctor will be able to tell you approximately when the "first Birthday" will be your baby. For this he needs from you the date of the first day of your last menstrual period. However, very few babies are born exactly on the expected date on the world. This depends u. a. with the individual cycle of each woman together, which can vary from 25 32 days. To calculate the date of delivery a constant cycle of 28 days, and a gestational age of 40 weeks is assumed. At a later stage, the doctor can correct the date possibly due to the pregnancy course or results of ultrasound examinations.

Here you can calculate yourself the birth date of your child: Pregnancy calculator.

Pregnancy outcome in Gravidogramm - Part 1

Each additional preventive appointment the doctor enters all results in Gravidogramm. For each appointment a row of this table is thereby completed. we explain in turn the quantity indicated there information here.

Next to the date of the examination, the doctor bears the time of pregnancy, for example, SSW 16 + 4, which is the fourth day of the 17th SSW (gestation).

  • fundus
    Then he enters the fundus, i at what height, measured at the pubic bone (pubic symphysis = S), at the navel (N), or on the ribs (Rb), with a cross finger as a unit, is the uterus. At the beginning of pregnancy, e.g. S + 4 cross finger (QF), then N + 2 QF, and still later Rb-2 QF.
  • fetal position
    In addition, the position of the baby describes what is (Breech = BEL Cephalic = SL, cross position = QL) especially towards the end of pregnancy in terms of the birth of importance. The fetal position is the earliest from the 26th SSW (gestation) is important because the child before or rotate frequently.
  • heart sounds
    The heart sounds are recorded. Either you are listening with stethoscope or the visible activity of the heart on the ultrasound provides security.
  • fetal movement
    Similarly, the fetal movements are recorded. You feel your child's first movements about 18 to 20 weeks of gestation.
  • Edema / varicose veins
    In the next two columns occurring edema, thus increasing water retention in the tissue being held as well as the appearance of varicose veins may be.
  • weight control
    The weight control is important as it also provides information about the condition of the mother and also the child. While with underweight optimal care of the child with the necessary nutrients for the development sometimes may not be enough, excessively high weight the risk of complications in pregnancy and childbirth. The normal weight increase should be between 10 and 12 kg. possibly at underweight before pregnancy a little more in previous obesity. less. The weight gain, which only slightly goes down in the first four months (2-3 kg), after which - as evenly as possible - rise steadily. It is important in any case a healthy, balanced diet.
  • Blutddruck
    The measurement of blood pressure is mainly used for detection of high blood pressure - usually is your blood pressure in pregnancy a little higher than your normal test result. deviations from "normal pressure" up or down are respected and must if necessary be treated. An increase in blood pressure may indicate the onset of disease - such as a toxemia.
  • Hb - Hemoglobin
    the iron supply of the mother (Hb / Ery) is regularly reviewed (see above blood tests) on the basis of a blood count.
  • Urinalysis
    Use the urine examination, the doctor gains a lot of information about the condition of pregnant women and particularly their urinary tract. Means of determining the values ​​of albumin, glucose, leukocytes and nitrites, infections, or changes in renal function, the risk of diabetes and urinary tract infections are detected early. If you notes for a urinary tract infection have (For example, burning during urination), part of the your doctor.
  • vaginal examination
    In a vaginal examination of the state of the cervix is ​​detected (the opening of the uterus) and cervix (length, resistance and stability of the cervix). Moreover, the vaginal secretions is to its acidity (pH) and examined under the microscope for bacteria. Both are important for the assessment of premature birth tilt.
  • risk pregnancy
    Also as part of the Gravidogramms the doctor will note special physical and mental stress or other features in the catalog B of pregnancy records that make the classification as a high-risk pregnancy is necessary (for example, a placental insufficiency).

    What did the note "risk pregnancy" to mean?

  • particularities
    Also as part of the Gravidogramms the doctor will note special physical and mental stress or other features in the catalog B of pregnancy records that make the classification as a high-risk pregnancy is necessary (for example, a placental insufficiency).

The Gravidogramm - Part 2

Furthermore, the doctor may order further examinations when indicated, which are noted in the last column of the Gravidogramms:

chorionic villus sampling
Chorionic villus sampling or Villozentese is a test of the (10th to 12th week of pregnancy) can provide information about possible chromosomal damage the unborn child at a very early stage. Either through the abdomen or the vagina, the physician removes this tissue from the placenta. After a few days already, earnings before which, however, includes a higher uncertainty than that of amniocentesis. The performance of the test is also more risky than amniocentesis.

Amniocentesis - Amniocentesis
Safer and less risky than the CVS test is amniocentesis, amniotic fluid diagnostics, which is carried out 14 to 18 weeks of gestation. It provides information about possible malformations of the fetus (ie specific genetic defects), in particular, it points to the Down syndrome (trisomy 21). Important to know that every pregnant woman has depending on age and history of an individual risk of chromosome damage their unborn. This risk should be compared with the amniocentesis.
For women who already have a child with chromosomal damage or who are over 35 years old, an amniocentesis can be considered. The waiting time for the results of the study is two to three weeks, which is a great psychological burden for each expectant mother. Recently there is a special test (FISH), which brings a preliminary result after one to two days and is used in particular is suspected.

Hormone determination of alpha-feto proteins
The determination of alpha-fetoprotein level, a hormone determination also used to detect abnormalities of the fetus. Too high a value would be indicative of formation of a gap of the spine (spina bifida). Too low a value might be a possible indication of Down syndrome (trisomy 21). For deviations up or down, the doctor will discuss further study options with you.

Triple-diagnosis: risk of Down syndrome
With the triple-diagnosis two other hormones are detected. From these values, from the age of the mother and exact gestational age, a computer is calculated to have a child with Down's syndrome individual risk. This is only a statistical value! The test, however, is a good decision making when weighing the risks and benefits of amniocentesis.

Amnioskopie - Fruchtwassserspiegelung
The Amnioskopie (amniotic fluid mirroring) can towards the end of pregnancy, if the cervix is ​​already slightly open, apply. Here, the possible discoloration of the amniotic fluid provides information about previous stress of the child. Helpful this examination method is especially when exceeding the expected birth date.

Hospitalization and heart sound documentation

Inpatient hospitalization during pregnancy, diagnosis and therapy carried out are also held here, as the records of the heart sounds of the baby and labor in the cardiotocography (CTG).

The ultrasound examinations (screening)

For the three prenatal care ultrasound examinations are provided in the maternity guidelines. Especially exciting moments for parents because they can see their child - how it moves, maybe even sucking his thumb and how fast it is growing from time to time. The organizational structure of the fetus is visible. The doctor controls the cardiac activity of the child, its location in the uterus and - on the basis of growth measurements - the timely development of the unborn child. can be measured:

  • the crown-rump length (abbreviation: SSL)
  • later the crown heel length (abbreviation: SFL)
  • the sac (abbreviation: FS)
  • from temple to temple (abbreviation: BPD for biparietal head diameter)
  • of forehead to mind (abbreviation: FOD for frontoocczipital)
  • head circumference (abbreviation: KU)
  • from belly to belly side (abbreviation: ATD for Abdomentransversal)
  • of navel to spine (abbreviation: APD for anterior-posterior)
  • waist circumference (abbreviation: AU for Abdominal)
  • the femur (abbreviation: FL for femur length) and
  • the humerus (abbreviation: HL for humerus)

The results can be entered in the appropriate standard curves. In addition, the doctor will check the amount of amniotic fluid and the seat of the placenta.

The first "screening" takes place in the ninth - rather than 32 weeks (weeks of gestation) - 12, the second in the 19 - 22 and the third in the 29th. In the second trimester of pregnancy is next to the "Basic ultrasound" Since 01.07.2013 a "extended base Ultraschallunersuchung" to select.

In the first ultrasound multiples can be detected, and whether the pregnancy is ensconced in the uterus, or a peritoneal or ectopic pregnancy is present. It is checked if everything "is intact" - whether the child's heart beats! The second ultrasound examination makes particular malformations of the fetus visible.
The general development, mainly whether the child's growth is timely, is the third investigation.
In particular problem or risk further ultrasound checks are carried out. Ultrasound examinations provide no health risk for mother and child is!

The cardio Tokographie (CTG)

From 30 weeks is part of the care routine usually the cardio Tokographie (CTG), recording the heart sound labor Schreiber. the child's heart rate and uterine activity of the mother are recorded over a period of about half an hour. So bring from now with a little more time for investigations. On suspicion of premature labor or poor care of the child (for example, by a placental insufficiency), the doctor can take action in time. When CTG during labor gives instructions on how the child's course of birth - especially the labor - coped.

What's the name of "striking CTG"?

Doppler sonography

If necessary, e.g. if the size of the child's development is delayed, the doctor may order a Doppler sonography. Using a special ultrasound device are thereby shown the flows of blood. Thus, blood flow defects of the child (in the umbilical cord or the aorta) can also determine how circulatory problems in the uterine vessels.

Final examination / Epicrisis

The Mutterpass completes be detained for eight weeks after the birth of the final examination / Epicrisis in which summarized information about the pregnancy, the birth, childbirth and gynecological examination.

One minute, five and ten minutes after birth is determined a so-called. Apgar number, an assessment of the life functions of the child after simple parameters such as respiration, heart rate, movement, skin color and muscle tone. Remember, even if your child is not full "score" receives, it can be a genius later! This is not (as perhaps some mothers accepted) the award of a "seal of approval" for the future development of the child. Explanation Needed is also the pH of the umbilical artery. It provides information about the stress of the child during birth.