After collecting the medical history of the patient proceed to a physical examination that starts with a check-up.
The examination of the gravida shall be performed by an obstetrician-gynecologist, dentist, otolaryngologist, ophthalmologist and, if necessary, endocrinologist, urologist, surgeon, cardiologist, etc. Should an extragenital pathology be identified in the gravida, the therapist or medical specialist gives opinion on the possibility of carrying of the pregnancy and, if necessary, performing additional tests or referring to the in-patient facility. Repeated examinations by a therapist shall be performed at the 30th and 37th-38th weeks of gestation, and by a dentist - at the 24th and 33th-34th weeks.
The dentist should not only examine, but also sanitate the oral cavity. The obstetrician-gynecologist monitors the implementation of expert recommendations at each visit to the clinic by the gravida. For example, should there be a high degree of myopia, especially complicated, one shall obtain the ophthalmologist opinion report on the management and exclusion of the second delivery period (delivery method).
Should there be any indications, a medical genetic consulting shall take place. Gravidas with a high risk of delivering children with chro-mosomopathy and hereditary pathologies, the geneticist may offer non-invasive and invasive examinations. Risk factors include:
► age of the gravida over 35;
► aggravated history (history of delivering children with a chromosomal pathology or monogenic diseases, subject to prenatal diagnosis);
► families in which one spouse is a carrier of a chromosome rearrangement or both spouses are carriers of a gene mutation;
► markers of a chromosomal pathology (e.g., collar space widening), identified by ultrasonography;