Prenatal care

Having the proper prenatal investigations shows that you truly value your health and the health of your baby!

Statutory health insurance covers important basic examinations intended to detect risks and help prevent damage to you and your unborn baby.

The following measures documented in the pregnancy record book form part of this prenatal care:

4th–8th week of gestation:

  • pregnancy test
  • palpation, weight & blood pressure measurements, urinalysis
  • blood test: blood group, antibodies, syphilis, rubella, haemoglobin, if necessary HIV test, chlamydia test

9th–12th week of gestation:

  • ultrasound
  • palpation, weight & blood pressure measurements, urinalysis
  • if necessary chorionic villi sampling if > 35 years of ageif you are 35 years of age or older

14th–18th week of gestation:

  • palpation, weight & blood pressure measurements
  • urinalysis, if necessary haemoglobin
  • if necessary amniocentesis, if > 35 years of age

19th–22nd week of gestation:

  • ultrasound
  • palpation, weight & blood pressure measurements
  • urinalysis, if necessary haemoglobin, tocogram

24th–28th week of gestation:

  • palpation, weight & blood pressure measurements
  • urinalysis, if necessary haemoglobin
  • blood test: Coombs test
  • tocogram

29th–32nd week of gestation:

  • ultrasound
  • palpation, weight & blood pressure measurements
  • urinalysis, if necessary haemoglobin
  • anti-D immunoglobulin injection if rh-neg
  • CTG

33rd–35th week of gestation:

  • palpation, weight & blood pressure measurements
  • urinalysis, if necessary haemoglobin
  • blood test: HBsAg
  • CTG
  • certificate of pregnancy for the insurance company

36th–38th week of gestation:

  • palpation, weight & blood pressure measurements
  • urinalysis, if necessary haemoglobin
  • CTG

39th–40th week of gestation:

  • palpation, weight & blood pressure measurements
  • urinalysis, if necessary haemoglobin
  • CTG

40th week of gestation:

  • every other day: palpation, weight measurement
  • blood pressure measurement, urinalysis

Ultrasounds: around the 10th, 20th and 30th week of gestation.

This checks the baby’s heartbeat, growth, development of organs, and the amount of amniotic fluid – however, this ultrasound should not be understood as a diagnosis of deformities, instead it merely serves as a guide.

CTG: As of the 20th week the physician or the midwife can order a test of uterine activity (tocogram) or fetal heartbeat (CTG) to detect premature labour or fetal distress.

Additionally, starting at age 35 you are entitled to an amniocentesis or chorionic villi sampling to test for chromosomal disorders.

There are no co-pays for pure prenatal care. Please note, this considerably limits the range of services, e.g. no diagnosis of infections, no consultation or investigation for pregnancy-related problems, etc.

Beyond the examinations required under the “Maternity Guidelines” there are several examinations which are medically reasonable but not covered by insurance.

We can do more for you.

To protect the health and wellbeing of you and your baby, at our gynaecological clinic we offer various services to make your prenatal care plan even more comprehensive. This allows us to provide you with even better medical care.

  • immune screening, diabetes screening, group B streptococcus screening
  • ultrasound malformation screening (integrated screening, AFP, triple screen)
  • additional ultrasounds, 3D/4D ultrasound, baby imaging
  • Doppler ultrasound to assess the baby’s vessels
  • testing for preeclampsia, premature labour, premature birth
  • acupuncture, homoeopathy

Modern prenatal care at a glance:

  • optimal addition to examinations included under statutory health insurance
  • tailored to specific needs and requests
  • a more intensive pregnancy experience and closer bond to the unborn baby

Get in touch with us. We will gladly provide information and we can choose the important tests for you together.

We offer the following elective prenatal care services:

Ultrasounds B

Sonography, or ultrasound, is the most common method used in medicine to obtain images of various body parts. Since it is also safe for sensitive tissues such as those in unborn babies, sonography is a standard part of prenatal care. During this test, not only can the fetus be seen, but different measurements can be taken and details checked which the doctor can then use to determine whether the unborn baby is developing normally.

In addition to the three routine tests, many parents also request additional ultrasounds to experience the pregnancy more intensively and create a closer bond to their unborn child. This is offered as a one-time service or with every visit.

New ultrasound equipment now provides us with 3D/ 4D technology which can show unforgettable, vivid colour images of your baby.

However, the quality of the images of your unborn child not only depends on the actual equipment, but also other factors such as the position of the baby, location of the placenta, amount of amniotic fluid or how thick the mother’s abdominal wall is.

Doppler sonography is a special examination method. It allows the doctor to obtain additional information about the direction, speed and intensity of the blood flow inside the vessels, and thus to find out how well the fetus is being supplied.

Prenatal screening

Almost every pregnant woman at one time or another wonders whether their baby is developing normally. It is a well-known fact that with every pregnancy there is a risk that the baby has, for example, a chromosomal anomaly. The most common and well-known is trisomy 21, also called down syndrome The risk of this chromosomal anomaly increases the older the mother: in women aged 25 it affects 1 out of 1300 children, in women aged 35 it is 1 out of 380, and in 40-year-olds it is 1 out of 110. Another chromosomal anomaly is trisomy 18, though it is rare.

Another developmental disorder is neural tube defect, NTD, which can manifest in the form of split spine, or so-called spina bifida. The disorder occurs in 1 out of 1200 children, regardless of the mother’s age. An early indication can be given by checking the blood for AFP; ultrasound and amniocentesis provide almost certain results.

As an alternative to invasive methods, e.g. amniocentesis and the associated risks, statistical methods were developed, firstly for pregnant women under 35 years of age and secondly for pregnant women over 35 years of age who refuse invasive diagnostic measures on principle. These include:

Testing the pregnant woman’s blood and determining the PAPP-A value, particularly when combined with the nuchal translucency, can be used to calculate the specific risk of various chromosomal anomalies or deformities. An abnormal test result therefore does not necessarily mean that the baby will have one of the anomalies listed. And conversely, a normal test result does not absolutely rule out the possibility of the child having a developmental disorder. This test does not require the removal of amniotic fluid; it does not put the baby at risk.

NT screening is a screening procedure which measures the amount of fluid between the skin and the clear tissue over the spine at the base of the neck of the unborn child in the 12th-14th week of gestation. If the nuchal translucency is elevated, the probability of different anomalies is considered higher.

Very high concentrations of AFP in the mother’s blood are considered an indication of a neural tube defect in the unborn child. The laboratory can be requested to perform this as an isolated test.

The triple test is so named because it determines three different parameters in the mother’s blood: AFP, hCG and uE3. These values and various other information are used to determine the specific risk of down syndrome and neural tube defect. This test can also determine if pregnant women under the age of 35 are at higher risk of having a child with a chromosomal anomaly.

Infection screening

Most people have already had chickenpox as a child and are therefore for the most part immune to becoming infected again. Yet almost 10% of pregnant women are not immune. In this case, chickenpox can be an acute danger for mother and baby. A simple blood test can determine whether a person is immune to chicken pox. If antibodies are detected, there typically is no cause for further action. However, if antibodies are not detected, hence the woman is not immune, the VAR vaccine is recommended if they plan on becoming pregnant.

People are usually infected orally, either due to eating raw or undercooked meat from an infected animal, or by transferring the pathogens from the hand, e.g. when gardening, etc., to the mouth. If a pregnant woman becomes infected and is not treated immediately, the risk of infection for the unborn child during the first trimester is estimated at about 20%, during the second trimester at about 30%, and during the final trimester at about 60%. However, the earlier in the pregnancy that the infection occurred, the greater the risk to the unborn child. In Central Europe, 30-60% of women of childbearing age are seronegative, i.e. unprotected. In other countries, toxoplasmosis screening has therefore been mandatory for years.

If a pregnant woman is infected with fifth disease, in about one third of cases the virus can be transmitted to the unborn child through the placenta. The virus particularly afflicts cells which produce red blood cells, ultimately destroying them. The haematopoietic cells in the liver and bone marrow are particularly affected, which can result in a major reduction in effective red blood cells and thus severe anaemia in the unborn child (in about 10% of the cases where the virus was transmitted to the unborn).

Whilst the human cytomegalovirus is harmless for healthy adults, during pregnancy the virus can be extremely dangerous and can be life-threatening to the unborn baby. A viral CMV infection is one of the most common infections which can be transmitted from mother to fetus during pregnancy. About 0.3-1% of all pregnant women become infected with the virus and in 40% of cases the infection is transmitted to the unborn child. An infection during the first or second trimester can cause deformities in the child.

This disease, which is transmitted from raw meat or raw milk products, can be life-threatening for the child.

Group B streptococci are bacteria and one of the most common causes of severe infections in the newborn. A simple, complication-free microbiological test at the end of the pregnancy can determine if the vagina or the bowels are infected with the pathogen. If Group B streptococci are detected, in most cases measures can be taken during birth to prevent the newborn from becoming infected.

Other important tests are:

An estimated 15% of all pregnant women develop a disorder of the blood sugar metabolism (so-called gestational diabetes). The risk increases the older the woman, if the woman is overweight and if there is a family history. But this common condition also affects women without these risk factors. For the pregnant woman, the condition often causes no problems, but it can cause serious complications for the mother and child. When diagnosed early, proper treatment can significantly reduce the risks.

General screening is not used. A simple test around the 24th week of gestation can detect this condition so it can be treated. The test determines the blood glucose level after fasting and after consuming glucose. It merely requires three blood samples, each taken one hour apart.

Preeclampsia is one of the most common complications during pregnancy and birth. It affects about 5% of pregnant women. The morbidity and mortality rate for mother and child is not insignificant. The clinical manifestation ranges from mild to severe. The actual causes are still not absolutely clear, however two factors in vessel development have been identified as significant biomarkers. The preeclampsia test is based on an elevation in the ratio of these biomarkers. An abnormally high ratio already indicates that there is a risk some time before the clinical manifestation. As a result, the high-risk patient should be monitored closely.

From the 14th week of gestation: This test is not part of the prenatal care guidelines.

Assurance in 5 minutes with Actim PROM

Actim Prom is a reliable test to rule out premature rupture of membranes. It determines the quality of the amniotic fluid with the help of antibodies. The sample is taken from the back of the vaginal vault, with or without a speculum. If the test is positive, the probability of a rupture of the membranes is 91%. If the result in negative, there is over 90% chance that a rupture of the membranes has not occurred. [link not working]

From the 15th week of gestation: This test is not part of the prenatal care guidelines.

Assurance in 5 minutes with Actim Partus
Three quarters of all pregnant women who experience premature labour do not deliver prematurely. Actim Partus determines who they are. If the test is negative, there is an over 92% chance that the patient will not deliver prematurely within one week of the test. This knowledge puts pregnant women at ease – particularly important for high risk pregnancies, those who experienced problems with previous pregnancies, or prior to travel. However, if the test is positive, this does not mean that a premature birth is about to occur – but there is a greater risk, which should be investigated.

From the 24th week of gestation: This test is not part of the prenatal care guidelines.

Additional prenatal care services:

e.g. flu, pertussis (whooping cough) to protect your child

for nausea, heartburn, sciatica, varicose veins, galactostasis, etc.

Acupuncture is one of the oldest medical treatments. Acupuncture performed by a skilled person has practically no side effects and is an effective alternative to so-called conventional medicine, particularly during pregnancy.

A study by the Frauenklinik Mannheim (Mannheim Women’s Clinic) proves that the procedure shortens the duration of labour for first-born children by several hours. Other proven applications in addition to nausea are headaches, back pain and sciatica. But it is also commonly used to prepare for the birth, for abnormal positions and for problems nursing.

This method of injecting customised substances in specific locations is also virtually free of side effects and can for example be helpful with smoking cessation during pregnancy. But it’s also effective for treating back pain, sleep problems, etc.

The fees for the particular services are based on the medical fee schedule (GOÄ) and can be requested at the reception. For additional services please refer to the info binder at our office. We’re happy to advise you.

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