When Are Which Check-ups Performed During Pregnancy Follow-up?

Pregnancy follow-up is a planned monitoring process aimed at regularly evaluating the health of the expectant mother and the baby to detect potential problems early. Every pregnancy is unique; the frequency of check-ups and the tests requested may vary depending on the mother's age, chronic illnesses, previous pregnancy history, and the course of the pregnancy. However, there are standard evaluations performed at specific weeks in an uncomplicated pregnancy. Below you will find the general outline of this schedule.

Pre-Pregnancy Counseling: The Zero Step of Follow-Up

If possible, an evaluation is recommended before planning the pregnancy. During this consultation, chronic diseases, regularly used medications, past surgeries, family history, and vaccination status are reviewed. Starting folic acid supplementation before pregnancy is known to reduce the frequency of certain congenital problems related to the baby's nervous system development. Managing conditions such as diabetes, thyroid disease, or high blood pressure before pregnancy makes follow-up easier from the start.

First Visit: Approximately Weeks 6-10

In the first examination following a missed period and a positive pregnancy test, the location of the pregnancy inside the uterus, the appearance of the gestational sac, and the presence of a heartbeat are evaluated by ultrasonography. The gestational age calculated based on the last menstrual period is confirmed with measurements taken in the first trimester, and the estimated due date is determined. This initial week confirmation is important because it forms the basis for all subsequent evaluations in the following months.

The tests usually requested at the first visit include:

• Complete blood count and blood group determination (for Rh incompatibility)
• Fasting blood glucose and thyroid function tests
• Screening for hepatitis B, hepatitis C, HIV, and syphilis
• Complete urinalysis, and urine culture if necessary
• Rubella and toxoplasma evaluation according to immunity status

Weeks 11-14: First Trimester Screening

During this period, the baby's nuchal translucency is measured by ultrasound, the nasal bone and basic structures are evaluated, and the gestational age is confirmed by crown-rump length. This measurement combined with two biochemical markers in the mother's blood is called the "combined screening test." It is important to understand that the result is not a diagnosis but a probability calculation: a result indicating increased risk does not necessarily mean there is a problem with the baby; it only suggests that further testing should be considered. Cell-free DNA testing from the mother's blood and invasive diagnostic methods are discussed and considered together with the family.

Weeks 18-23: Detailed (Second Level) Ultrasonography

This is the period when the baby's organs are examined in the greatest detail. The brain, heart, spine, kidneys, stomach, arms and legs, and facial structures are systematically evaluated; the placenta's location, amniotic fluid volume, and cervical length are measured. This examination reveals a significant portion of structural abnormalities; however, ultrasonography has natural limitations and is not expected to detect every congenital anomaly during pregnancy. The baby's position, the thickness of the mother's abdominal wall, and the amount of fluid can affect image quality.

Weeks 24-28: Glucose Tolerance Test

Gestational diabetes often does not show symptoms; therefore, screening is done with a glucose tolerance test during these weeks. When detected early and managed with diet, exercise, and medication if necessary, high blood sugar is expected to allow a smooth pregnancy. During the same period, a complete blood count is repeated to check for anemia; protective immunoglobulin administration is planned for Rh-negative pregnant women.

Weeks 28-36: Growth and Well-being Monitoring

During this period, check-ups become more frequent. Ultrasound is used to evaluate the baby's estimated weight, growth curve, amniotic fluid, and blood flow (Doppler) if needed. The mother's blood pressure and the presence of protein in the urine are reviewed at every visit; these help detect early signs of preeclampsia, also known as pregnancy-induced hypertension. From these weeks onward, tracking fetal movements becomes the mother’s most valuable monitoring tool.

From Week 36 to Delivery: Weekly Check-ups

In the final weeks, check-ups are usually weekly. The baby's position (head, breech, or transverse), estimated weight, and the condition of the cervix are assessed; if necessary, a non-stress test (NST) is performed to monitor the baby's heartbeat and uterine contractions. The mode of delivery is planned by considering the baby's position, the mother's previous birth history, health status, and the course of the pregnancy. It is helpful to know from the start that this plan may change due to new developments in the late stages of pregnancy, making the process easier to manage.

How Is the Frequency of Check-ups Determined?

The commonly followed schedule for an uncomplicated pregnancy is as follows:

• One check-up per month until the 28th week
• Check-ups every two to three weeks between weeks 28 and 36
• Weekly check-ups from week 36 until delivery

In cases such as multiple pregnancies, high blood pressure, diabetes, history of recurrent miscarriage, cervical insufficiency, or pregnancies following a cesarean section, follow-up is planned more frequently than this schedule.

Nutrition, Exercise, and Daily Life During Pregnancy

Eating for "two" is not necessary during pregnancy; what matters is not the quantity but a balanced content. A diet including vegetables, fruits, whole grains, quality protein, and dairy products is sufficient for most pregnant women. Avoiding raw or undercooked meat, unpasteurized dairy products, and poorly washed raw vegetables reduces the risk of foodborne infections. Limiting caffeine intake is recommended; smoking and alcohol are never considered safe at any stage of pregnancy.

As long as health permits, regular and moderate exercise such as walking and swimming is recommended during pregnancy; it helps reduce back and waist pain, improves sleep quality, and aids in weight control. Activities with a risk of falling or those that may cause trauma to the abdominal area should be avoided. It is important not to use over-the-counter medications, herbal products, or dietary supplements without consulting a physician; "natural" does not mean safe.

Symptoms That Require Immediate Medical Attention

• Vaginal bleeding or fluid leakage
• Severe and persistent headache, blurred vision, or floaters in the eyes
• Sudden noticeable swelling in the face, hands, or feet
• Constant abdominal pain or contractions occurring at regular intervals
• Significant decrease in fetal movements
• Fever, burning sensation during urination, or persistent vomiting

Pregnancy follow-up is not just a list of tests; it is a process where the expectant mother's questions are answered, and topics such as nutrition, exercise, work routine, and preparation for childbirth are discussed. Attending regular check-ups helps detect problems early and allows you to go through this period feeling more secure.

This article is prepared for general informational purposes and does not replace a medical examination. Please consult a physician for your complaints.