PREGNANCY

Advice on preconception lifestyle, and on how existing conditions can affect pregnancy, is available as part of the interactive NHS care planner

Pregnancy test Checks urine for the ‘pregnancy’ hormone, human chorionic gonadotrophin (hCG). hCG is present at a low level from around 7 days after conception, and detectable by most tests from the first day of a missed period (around 2 weeks after conception). Some very sensitive tests can be used even before a period is missed, from as early as eight days after conception. A positive test result is almost certainly correct. A negative result is less reliable, and may need to be repeated after 7 days.

Preconceptual care

includes:

• Folic acid supplement
• Consideration of prescription drugs, recreational drugs, alcohol, smoking
• Advice re genetic disorders if appropriate

Antenatal care

May be midwife or consultant led; the frequency of visits increase as pregnancy advances. All pregnant women are screened for a number of conditions

Women should be advised to contact their midwife or maternity unit if they have:

• Any concerns (especially if poor or complicated obstetric history)
• Abdominal/back pains
• A show (vaginal loss) of blood, straw-coloured or dark fluids
• No movements, reduced movements or excessive movements of baby, or if
• Contractions start.

Postnatal care

Includes:

• post-natal screening for a number of conditions
• frequent monitoring of health/welfare of mother and baby.

Termination of pregnancy (TOP)

Medically directed miscarriage, achieved using pharmacological or surgical means, before the fetus is independently viable. Legal requirements The 1967 Abortion Act allows termination before 24 weeks of gestation if:

• It reduces the risk to a woman's life or
• It reduces the risk to her physical or mental health or
• It reduces the risk to physical or mental health of her existing children or
• The baby is at substantial risk of being seriously mentally or physically handicapped.

There is no upper limit on gestational time if there is:

• Risk to the mother's life
• Risk of grave, permanent injury to the mother's physical/mental health (allowing for reasonably foreseeable circumstances)
• Substantial risk that, if the child were born, it would suffer such physical or mental abnormalities as to be seriously handicapped. Such TOPs must be conducted in an NHS hospital.