It is very important to have information about every moment, developmental stages and general health status of the baby during pregnancy. For this reason, the development of the expectant mother and the baby is followed in detail during the pregnancy period. Here, ultrasonography can be shown as one of the miraculous inventions that gives information to the doctor and the expectant mother about every pregnancy from the beginning to the end of pregnancy.

Detailed ultrasound (second level ultrasound, color ultrasound) is an examination made usually between 20^th-23^rd weeks.

All organs are evaluated in detail and 80-90% of the diseases that can be seen in newborn babies can be diagnosed.

This examination can also be considered as the baby’s check-up in the mother’s womb. The examination takes an average of half an hour. The position and mobility of the baby may take a shorter or longer period compared to the subcutaneous adipose tissue of the mother.

• Multiple pregnancy births
• Abnormal adhesion of the placenta to the uterine wall
• Placenta coming ahead of the baby
• Risk of excessive bleeding
• Risk of uterine removal

The Quadruple Screening Test is one of the tests that you are screened for the baby’s Down Syndrome during pregnancy. The success of the quadruple test in detecting Down Syndrome is approximately 75%.

The quadruple test is named like this because it gives results using four parameters taken from the blood of the pregnant woman.

These are Alpha-fetoprotein (AFP), Human Chorionic Gonadotropin (HCG), Inhibin A and Estriol. The quadruple screening test should be performed between the 16th and 20th weeks of pregnancy. Ideally, it is administered between the 16th and 18th weeks.

The test also measures whether there are any disorders or problems in the brain, spinal cord and other nervous tissues in the central nervous system (nerve pathway) of the fetus, thanks to AFP.

Quadruple Screening Test is applied with the blood sample taken from the mother after ultrasonography. The blood sample is sent to the lab for examination. It may take a few days to get results.

For pregnant women, the ideal daily calorie intake is between 2,500-2,700. There should be vitamins, minerals and nutrients in the foods eaten.

In addition, protein and calcium intake is also very important. Meat, milk, cereals, fruits, and vegetables, which are the four basic food groups, should be taken every day. It is very important to consume chicken, meat, and legumes, which are protein sources, during pregnancy.

Food must be thoroughly washed before consumption. In addition, fruits that are out of its season should not be taken. Another important factor in pregnancy is fluid consumption. Completing the daily amount of fluid in the body is very beneficial for both the baby and the mother. This liquid can be obtained from water, buttermilk, fresh fruit juices and milk.

The initial period of pregnancy, i.e., the first 3 months, is the period in which pregnant women gain the least weight. The ideal weight to be gained in this process is between 1 and 2.5 kilos. In the continuation of the 3-month period, it is necessary to gain half a kilo every month. However, it should be especially noted that overweight mothers should take 250 grams per week.

If you exceed the weight gain recommended by your doctor; The probability of a cesarean delivery can increase in the range of 20% to 30%.

In addition, problems such as complaints of waist and hip pain and increased blood pressure can also occur. All these complaints are the source of a difficult birth. Less weight gain than necessary during pregnancy is an indicator of nutritional deficiency. This situation may cause growth deficiency in the baby.

The expectant mothers are among these existing risks:

• Under the age of 18 and over the age of 40
• Having a history of recurrent miscarriage
• Being underweight or overweight
• Having a consangious marriage with her husband
• Smoking or alcohol consumption above normal
• One or more of blood pressure, goiter, heart, diabetes, liver, vascular, epilepsy and thyroid diseases
• Having important previous surgeries,
• Use of drugs for any reason

Diabetes occurs in people with a predisposition due to changes in hormones during pregnancy. Diabetes is seen in 6-7% of all pregnancies according to the characteristics of the society. 90% of these are gestational, that is, diabetes that occurs during pregnancy.

The incidence is higher in mothers over the age of 35, obese, previously gave birth to portly babies or those with diabetes occurring during pregnancy, and those with a family member with diabetes.

Gestational diabetes is detected by the oral glucose tolerance test performed at 24-28 weeks of gestation. These tests are performed in every pregnancy. Diagnostic test of gestational diabetes, whose real scientific name is “Glucose Tolerance Test”, which is known as oral glucose tolerance test in pregnancy, does not harm the mother or the fetus.

Oral glucose tolerance test is done in one stage or two stages. In the 75 g glucose single stage loading test, blood values ​​are measured at the 1st and 2nd hour after sugar is drunk after 8 hours of fasting.

On the other hand, the 50 g sugar test is the test performed without hunger and the blood glucose is measured at the 1st hour and if it is high, it is the tests where the blood glucose values of 100 g at the 1st, 2nd and 3rd hours are checked. Tests that only examine pre-prandial and postprandial blood glucose are not an alternative to these tests.

In patients with gestational diabetes, the treatment is to keep blood sugar regulation at normal levels with diet and exercise. If it is not successful, insulin should be applied in the treatment. Self-monitoring of blood glucose is taught at home and medical nutrition therapy is explained.

The purpose of medical nutrition therapy is to regulate the carbohydrate, protein and fat balance in the diet of the pregnant woman. It is aimed to keep pre-prandial blood glucose below 95 mg / dl and to keep the 1st hour postprandial blood glucose below 145 and the 2nd hour postprandial blood glucose below 125.

If the targeted blood glucose levels are not reached with medical nutrition therapy and exercise, insulin therapy is recommended for the pregnant woman. After the insulin is started, the pregnant woman should continue to diet and measure blood glucose by herself.

Conditions in which amniotic fluid is pathologically less is called “oligohydramnios”. Amniotic fluid amount is below 500 milliliters or amniotic fluid index measured on ultrasound is less than 5 centimeters.

Reasons;

• Premature rupture of membranes, ie opening of the amniotic fluid sac before birth (25%)
• Congenital anomalies: (25-35%) It usually occurs in the second trimester (14-28 weeks). These are renal agenesis (absence of kidney), lower urinary tract obstructions and polycystic kidney disease.
• Chronic placental insufficiency: This is the most common cause. It is usually accompanied by growth restriction.

• Miscarriage and recurrence of the miscarriage
• Early birth
• Very weak and overweight baby birth
• Intoxication during pregnancy
• Excessive bleeding during labor
• Have had myoma surgery
• Uterine rupture
• Ectopic pregnancy

Perinatology is a branch of science that determines high risk and problematic pregnancies and deals with the diagnosis and treatment of the diseases of the baby in the womb.

The purpose of perinatology, which diagnoses negative conditions during pregnancy and applies the necessary treatment, is to plan pregnancy follow-up and necessary treatment.

Perinatology works in the fields of:

• Improving the health of expectant mothers and their babies,
• Early diagnosis of fetal abnormalities,
• Screening for chromosomal abnormalities,
• Prevention of miscarriages and stillbirths,
• Preterm birth can be determined and prevented in advance,
• Diagnosing problems that may occur in multiple pregnancies

• Detailed Fetal Ultrasonography
• Fetal Anomalies
• Fetal Echocardiography
• Fetal Heart Anomalies
• Prenatal Diagnosis
• Diagnostic Procedures in the Womb
• Pregnancy Complications
• Four-Dimensional Fetal Imaging
• Diagnosis of Genetic Diseases in the Maternal Womb
• Counseling in Risk Pregnancies
• Management of Multiple Pregnancies

If the amniotic fluid is more than normal, it is called ” Polyhydramniosis “. It is the case that the amount of liquid is more than 2000 ml or the amnios fluid index measured in ultrasound is over 24 cm. It is observed in 0.4-.3.3% of all pregnancies. It develops in 2.6% due to multiple pregnancies.

Reasons;

• Diabetes in the mother
• Congenital anomalies and genetic syndromes

Idiopathic: No cause can be found in 34% of Polyhydramniosis.

Triple screening test, also called “Triple test”, is a screening performed between the 16th and 20th weeks of pregnancy of pregnant women.

In the blood sample taken from the expectant mother, 3 different hormone measurements are made. This hormone measurement is processed by entering into a special computer program together with variables such as the age, weight, smoking or not smoking of the expectant mother and the week of pregnancy.

It is the screening of anomalies called “neural tube defects” together with chromosomal disorders such as Trisomy 21 (Down syndrome) and Trisomy 18 (Edwards Syndrome), which belong to the baby during pregnancy. Like the double test, the triple test is a screening test that scans the risky group. The success of the triple test in detecting Down syndrome is approximately 70%.

The only advantage of triple test is that it is stimulating for neural tube defect (spine closure disorder) in case of high AFP. However, since the neural tube defect is a pathology that can be detected by ultrasound and AFP can be measured alone, it is not necessary to apply triple test to patients with normal double test results.

Cervical insufficiency is the condition that the cervix is ​​not sufficient to allow the continuation of pregnancy.

In such pregnancies, as the pregnancy progresses, the cervix becomes shorter and opens, resulting in premature birth. This situation sometimes results in the fall of a feus that is too small to live for 16-20 weeks and sometimes a premature birth of a fetus that can survive in intensive care between 24-34 weeks.

Although the cause cannot be determined in general, operations that cause tissue loss in the cervix, such as cervical insufficiency conization, may be caused by causes such as abortions, congenital uterine abnormalities, and normal birth trauma, usually between 14-16 weeks.

If such a pregnancy loss has occurred once, the length of the cervix should be followed in subsequent pregnancies, and the patient should be evaluated in terms of the necessity of cervical cerclage (narrowing of the cervix by suturing the cervix).

In cases where there is dilation in the cervix, this procedure can be performed under emergency conditions. However, there is a possibility of premature birth, uterine infection and opening of the amniotic sac (water coming) after the procedure. Especially urgent procedures or procedures performed after the 20th gestational week are riskier.

Risky pregnancy covers a wide range of patients. Grouping people who are likely to have a risky pregnancy;

• Current risks of expectant mothers
• Risks from the previous pregnancy period
• Fetus and birth risks