Pre-Natal Checkups and Vaccination

Infectious diseases may complicate pregnancy. It has been well publicized that an attack of German measles up to the ninth or tenth week of pregnancy may produce serious congenital malformations of the baby. If a pregnant woman has German measles or knows she has been exposed to the disease, she should consult her obstetrician immediately. Poliomyelitis is a serious complication of pregnancy, but easily averted by vaccination as directed by the doctor. Influenza vaccination, though not recommended for everybody in the population, is an important protection for the pregnant woman.

All States in this country require a serologic test for syphilis in pregnant women. This is done routinely from a blood specimen obtained at the time of pre-natal examination. People can have syphilis without knowing it. The disease can be a serious complication for the baby, or result in late miscarriage, pre­mature delivery, and even infant death. Syphilis discovered early in pregnancy can be cured readily with penicillin.

Most women have been vaccinated against smallpox, diphtheria and whooping cough, and many have acquired immunity to measles and chickenpox, by recovery from these diseases. However, it is prudent to avoid direct exposure to childhood diseases such as mumps, scarlet fever, and others. These diseases may not directly affect the fetus, but high fever may result in premature labor and termination of the pregnancy.
A physician cannot anticipate every question that may come up during the nine months of pregnancy. The intelligent patient will call her doctor at any time of the day or night when she considers it necessary. If a long trip is contemplated, the doctor should be informed. Old-wives’ tales about pregnancy still persist, and the doctor can give reassurance about worrisome questions if they are asked. The keystone of modern obstetrics is continued observation of the patient throughout pregnancy. Most of the complications of pregnancy, associated in the past with lack of medical attention, can be prevented when the patient is seen at frequent intervals.

During the first six months the patient should be seen every three to four weeks; during the seventh month, every three weeks; during the eighth month, every two weeks; and during the last month, every week.

The first visit to the physician includes a physical examination and blood-urine tests. Thereafter, visits include discussion of problems that may have come up, a review of the patient’s progress, and a brief examination. This includes examination of the abdomen, listening for the fetal heart, palpating the size of the baby, and examination of a urine specimen. During the last month of pregnancy there is usually a weekly vaginal examination to determine the “ripening” of the neck of the uterus, the position of the baby, and the proximity of onset of labor.