Vatsalya Hospital Rajkot

Vatsalya Hospital – Antenatal Care Guide

Vatsalya Hospital, Rajkot

Your Complete
Pregnancy Guide

Antenatal Care — Trimester by Trimester

1st Trimester · Weeks 1–13

2nd Trimester · Weeks 14–27

3rd Trimester · Weeks 28–40

🍎

Nutrition

💊

Supplements

🔬

Investigations

💉

Vaccinations

👶

Fetal Growth

⚕️

Medications

🫐

By Week 13

~7 cm · 23 g

👶 Fetal Milestones

Heart begins beating (Wk 6) Brain & spinal cord form Limb buds appear (Wk 8) Eyes, ears, nose form All vital organs present by Wk 10 Placenta functional by Wk 12 NT scan for chromosomal screening

🔬 Investigations

Test	When	Type
Blood Group & Rh	Wk 6–8	Routine
CBC (Hb, TLC, Plt)	Wk 6–8	Routine
Blood Sugar (FBS/RBS)	Wk 6–8	Routine
TSH (Thyroid)	Wk 6–8	Routine
Urine R/M + Culture	Wk 6–8	Routine
HIV, HBsAg, VDRL	Wk 6–8	Routine
Serum Ferritin / LFT / RFT	If indicated	Special
Dating Scan (USG)	Wk 6–8	Scan
NT Scan + Double Marker	Wk 11–13+6	Scan

💊 Supplements & Medications

🟢

Folic Acid

5 mg OD · Throughout T1
Prevents neural tube defects

🔴

Iron (IFA)

60 mg elemental iron OD
Start after Wk 12

🌞

Vitamin D3

400–1000 IU daily
Or 60,000 IU monthly

🧬

Calcium

500 mg BD
Start from Wk 12

🐠

Omega-3 / DHA

200 mg DHA daily
Brain development

💊

Progesterone

200 mg vaginal/oral
If threatened abortion

🍎 Nutrition & Diet

✅ Eat More

❌ Avoid

💡 Tip: Small frequent meals every 2–3 hours help manage nausea. Ginger tea & lemon water soothe morning sickness.

💉 Vaccinations

💉

TT / Td Vaccine

1st dose at first contact if unimmunized — protects against tetanus

🛡️

COVID-19 Vaccine

Recommended after Wk 12 if not yet vaccinated

📋

Flu (Influenza) Vaccine

Any trimester — especially if flu season. Reduces pregnancy complications

⚠ Live vaccines (MMR, Varicella) are contraindicated in pregnancy.

🚨 Warning Signs — Come to Hospital Immediately

Heavy vaginal bleeding
Severe lower abdominal pain
Fever above 101°F
Persistent vomiting (unable to keep food/fluids)

Fainting or severe dizziness
No fetal heartbeat seen on scan
Watery discharge from vagina
Any chest pain or breathlessness

🍆

By Week 27

~37 cm · 900 g

👶 Fetal Milestones

Quickening felt (Wk 18–20) Hearing develops (Wk 18) Fingerprints form Eyelids open (Wk 26) Viability from Wk 24 Fetal kick counts begin (Wk 24+) Gender visible on scan Lung development ongoing

🔬 Investigations

Test	When	Type
Anomaly Scan (TIFFA)	Wk 18–20	Scan
Triple / Quadruple Marker	Wk 15–20	Special
75g OGTT (GDM screen)	Wk 24–28	Routine
CBC (repeat)	Wk 20, Wk 28	Routine
Urine R/M (repeat)	Each visit	Routine
Cervical length scan	Wk 18–24	Scan
Echocardiography (fetal)	Wk 20–24	Special
BP monitoring	Every visit	Routine
Amniocentesis	Wk 16–20	If indicated

💊 Supplements & Medications

🔴

Iron + Folic Acid

IFA tablet OD · Continue
Target Hb > 11 g/dL

🧬

Calcium

1000–1500 mg/day
Prevents preeclampsia

🌞

Vitamin D3

Continue 400–1000 IU
Bone & immune health

🐠

DHA / Omega-3

200–300 mg DHA
Brain & eye dev.

💊

Aspirin 75mg

If high risk for PIH
Start before Wk 16

🟡

Magnesium

If leg cramps present
Magnesium lactate BD

🍎 Nutrition & Diet

✅ Focus On

❌ Limit / Avoid

💡 Calorie Needs: Extra ~300 kcal/day in T2. Appetite improves — focus on nutrient density, not just quantity. Stay well hydrated (2.5–3 L fluids/day).

💉 Vaccinations

💉

TT / Td — 2nd Dose

4 weeks after 1st dose (or Wk 16–20) · Booster if last TT > 3 years

🛡️

Hepatitis B (if not immune)

3-dose series safe in pregnancy — protects baby from perinatal transmission

💊

Fetal Kick Counts (not a vaccine)

After Wk 24: Count 10 kicks within 2 hours each day. Report if reduced.

🚨 Warning Signs in T2 — Do Not Delay, Visit Immediately

No fetal movement felt after Wk 20
Persistent headache or blurred vision
Swelling of face/hands (sudden)
Leakage of fluid per vaginum

Vaginal bleeding (any amount)
BP > 140/90 mmHg on 2 readings
Burning micturition with fever (UTI)
Severe epigastric pain (preeclampsia)

🍉

By Week 40

~50 cm · 3–3.5 kg

👶 Fetal Milestones

Brain grows rapidly Lungs mature (Wk 36) Fat deposits form Head engages (Wk 36–38) Lanugo decreases Sleep-wake cycles present BPP monitoring weekly 10 kicks/2hr expected

🔬 Investigations

Test	When	Type
Growth Scan (USG)	Wk 28, 32, 36	Scan
Biophysical Profile (BPP)	Wk 36+ weekly	Scan
Doppler (umbilical / MCA)	Wk 32–36	Scan
NST (Non-Stress Test)	Wk 36+ weekly	Routine
CBC (repeat Hb)	Wk 28, 36	Routine
Repeat VDRL / HBsAg	Wk 36	Routine
GBS screening (if applicable)	Wk 35–37	Special
Urine Protein (Dipstick)	Each visit	Routine
Coagulation profile / LFT	If pre-eclampsia suspected	If indicated

💊 Supplements & Medications

🔴

Iron + Folic Acid

Continue IFA OD
Critical — blood loss at delivery

🧬

Calcium

1500 mg/day
Peak bone transfer to fetus

🌞

Vitamin D3

Continue supplement
Boosts neonatal immunity

💉

Betamethasone

2 doses IM, 24h apart
If preterm labour < Wk 34

💊

Antacids / PPI

Safe if heartburn
Omeprazole / Ranitidine

🟡

Magnesium Sulphate

If severe pre-eclampsia
Seizure prophylaxis

🍎 Nutrition & Diet

✅ Prioritise

❌ Avoid / Limit

💡 Birth Prep: Pelvic floor exercises (Kegels) daily. Start perineal massage (Wk 36+). Discuss breastfeeding, birth plan & hospital bag with your doctor.

💉 Vaccinations & Fetal Wellbeing

💉

Tdap (Pertussis Booster)

Wk 27–36 · Protects newborn from whooping cough before own vaccination

🛡️

Anti-D Immunoglobulin

Wk 28 & 34 if Rh-negative mother · Critical to prevent Rh sensitisation

📊

Fetal Wellbeing — Kick Count Chart

Count 10 movements within 2 hours. If < 10 kicks — contact hospital same day.

🏥

Pre-admission & Hospital Bag

After Wk 36: keep bag ready · Antenatal records, Aadhaar, insurance documents

🚨 Warning Signs in T3 — Emergency: Come Immediately or Call Us

Reduced / absent fetal movements
Sudden severe headache or vision changes
Vaginal bleeding (any amount)
Painful uterine contractions before Wk 37

Severe abdominal pain or rigidity
Leakage of fluid (PROM / PPROM)
BP ≥ 160/110 mmHg
Severe swelling of face, hands, feet

Contact Info

Our Doctors

Our Services

opening hours