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產(chǎn)前一共要進行多少次檢查？與孕期保健的那些事兒

出處：網(wǎng)絡(luò)整理 日期：2022-06-06 08:00:58 編輯：佚名

懷胎十月，艱辛而幸福，但在懷孕過程中常會遇到各種產(chǎn)前診斷項目。這些項目到底篩查哪些疾??？產(chǎn)前診斷又有何意義？產(chǎn)前一共要進行多少次檢查？每次檢查哪些項目？今天，我們邀請市婦幼保健院十病區(qū)主任醫(yī)師、副主任彭鳳云，與準(zhǔn)媽媽們聊聊產(chǎn)前檢查與孕期保健的那些事兒。

產(chǎn)前檢查是預(yù)防

出生缺陷的重要途徑

彭主任說，產(chǎn)前檢查與孕期保健包括對孕婦進行規(guī)范的產(chǎn)前檢查、健康教育與指導(dǎo)、胎兒健康的監(jiān)護與評估、孕期營養(yǎng)及體重管理和用藥指導(dǎo)等，是降低孕產(chǎn)婦和圍產(chǎn)兒病發(fā)癥的發(fā)生率及死亡率、減少出生缺陷的重要措施。

產(chǎn)前檢查，即出生前的檢查，又稱為宮內(nèi)檢查，指在胎兒出生前采用影像學(xué)、生物化學(xué)、細胞遺傳學(xué)以及分子生物學(xué)技術(shù)，通過觀察胎兒外表結(jié)構(gòu)、分析胎兒染色體核型、檢測羊水和胎兒細胞的生化項目和基因等，判斷胎兒是否患有某種遺傳性疾病或先天畸形，并為確定保胎或終止妊娠提供依據(jù)。

規(guī)范的產(chǎn)前檢查能夠及早防治妊娠并發(fā)癥或合并癥，及時發(fā)現(xiàn)胎兒異常，評估孕婦及胎兒安危圍孕期保健，確定分娩時機和分娩方式，保障母兒安全。

產(chǎn)前檢查的時間、次數(shù)及孕周

彭主任說，產(chǎn)前檢查包括詳細詢問病史、全面體格檢查、產(chǎn)科檢查、必要的輔助檢查和健康教育指導(dǎo)。圍產(chǎn)期指產(chǎn)前、產(chǎn)時和產(chǎn)后的一段時期。

圍孕期保健_圍絕經(jīng)期綜合征的保健_女人圍絕經(jīng)期如何保健

合理的產(chǎn)前檢查時間及次數(shù)不僅能保證孕期保健的質(zhì)量，也能節(jié)省醫(yī)療衛(wèi)生資源。根據(jù)我國《孕前和孕期保健指南（2018年）》，目前推薦的產(chǎn)前檢查孕期分別是：妊娠6-13周、14-19周、20-24周、25-28周、29-32周、33-36周、37-41周（每周1次）。有高危因素者，可酌情增加次數(shù)。

第1次產(chǎn)檢

全面檢查準(zhǔn)媽媽的健康情況

第1次產(chǎn)檢在懷孕6-13周時，主要是建立妊娠期保健手冊、確定孕周、推算預(yù)產(chǎn)期、評估妊娠期高危因素、血壓、體重指數(shù)、胎心率、血常規(guī)、尿常規(guī)、血型（ABO和Rh）、空腹血糖、肝功能和腎功能、乙型肝炎病毒表面抗原、梅毒螺旋體、HIV篩查、心電圖。之前沒有做過婚檢、孕前檢查的人，還要增加地中海貧血的篩查，家里養(yǎng)寵物的人，則要增加寄生蟲檢查。

第1次產(chǎn)檢做的檢查項目相對較多，這也是為了全面檢查準(zhǔn)媽媽的健康情況。要帶上準(zhǔn)爸爸一起檢查，并且要了解你和他的直系親屬及家族成員的健康情況。

第2次產(chǎn)檢

主要是唐氏篩查

第2次產(chǎn)檢在懷孕14-19周時，主要是分析首次產(chǎn)前檢查的結(jié)果、血壓、體重、宮底高度、腹圍、胎心率、孕中期唐氏血液篩查（15—20周）。

第2次產(chǎn)檢最重要的項目是唐氏篩查，做唐氏篩查時檢查前一天晚上12點以后禁食物和水，第二天早上空腹來醫(yī)院進行檢查。另外，檢查還與月經(jīng)周期、體重、身高、準(zhǔn)確孕周、胎齡大小有關(guān)，最好在檢查前向醫(yī)生咨詢其他準(zhǔn)備工作。

第3次產(chǎn)檢

B超篩查胎兒畸形

第3次產(chǎn)檢是懷孕20-24周時，主要查血壓、體重、宮底高度、腹圍、胎心率、B超胎兒畸形篩查（18-24周）、血常規(guī)、尿常規(guī)。

第3次產(chǎn)檢項目中最重要的是B超篩查胎兒畸形，在孕期20周做超聲波檢查，主要是看胎兒外觀發(fā)育上是否有較大問題。醫(yī)生會仔細量胎兒的頭圍、腹圍、看大腿骨長度及檢視脊柱是否有先天性異常。

醫(yī)生會給孕媽咪介紹早產(chǎn)的認(rèn)識和預(yù)防，對其進行營養(yǎng)和生活方式的指導(dǎo)。

第4次產(chǎn)檢

妊娠糖尿病的篩檢

第4次產(chǎn)檢是懷孕25-28周時，主要查血壓、體重、宮底高度、腹圍、胎心率、糖耐量篩查（75g OGTT）、血常規(guī)、尿常規(guī)。

第4次常規(guī)產(chǎn)檢，最重要的項目是進行妊娠糖尿病的篩檢——糖耐量篩查，一般是在孕期第24周做。做糖耐量篩查前一天晚上8點以后不要進食，水也少喝。喝糖水的時候不要太快，不要一口喝完，要在3—5分鐘之內(nèi)喝完。喝完后最好多走動，這樣一個小時內(nèi)能量會有所消耗，會幫助降低血糖濃度。

醫(yī)生還會對孕媽媽進行早產(chǎn)的認(rèn)識和預(yù)防，營養(yǎng)和生活方式的指導(dǎo)，以及介紹妊娠期糖尿病篩查的意義。

第5次產(chǎn)檢

準(zhǔn)媽媽應(yīng)做貧血檢查

圍孕期保健_圍絕經(jīng)期綜合征的保健_女人圍絕經(jīng)期如何保健

第5次產(chǎn)檢是在懷孕29-32周時，主要查血壓、體重、宮底高度、腹圍、胎心率、產(chǎn)科B超檢查、血常規(guī)、尿常規(guī)。

這個時期貧血發(fā)生率增加，準(zhǔn)媽媽務(wù)必做貧血檢查，若發(fā)現(xiàn)貧血要在分娩前治愈。從懷孕28周開始，產(chǎn)檢變?yōu)槊績芍芤淮?，?次和第6次產(chǎn)檢都是常規(guī)項目的檢查。

醫(yī)生會對孕媽咪進行分娩方式的指導(dǎo)，提醒媽咪開始注意胎動，同時進行母乳喂養(yǎng)和新生兒護理的指導(dǎo)。

第6次產(chǎn)檢

分娩前的常規(guī)檢查

第6次檢查在懷孕33-36周時，主要查血壓、體重、宮底高度、腹圍、胎心率、血常規(guī)、尿常規(guī)。孕34周后開始，每周做一次胎心監(jiān)護。

這次產(chǎn)檢是進行常規(guī)的產(chǎn)檢項目，準(zhǔn)媽媽要注意每天都要自數(shù)胎動，發(fā)現(xiàn)異常就應(yīng)該馬上就醫(yī)。醫(yī)生還會對孕媽媽進行分娩前生活方式的指導(dǎo)，普及分娩相關(guān)知識，對新生兒疾病進行篩查，以及抑郁癥的預(yù)防。

第7至11次產(chǎn)檢

胎心監(jiān)護和超聲檢查

第7至11次產(chǎn)檢，在懷孕37-41周時，主要是血壓、體重、宮底高度、腹圍、胎心率、胎位、血常規(guī)、尿常規(guī)、胎心監(jiān)護。

這時準(zhǔn)媽媽都需要做胎心監(jiān)護了，做胎心監(jiān)護前，你應(yīng)該盡量多走動，或吃些點心，讓寶寶活動起來。你可以選擇一個舒服的姿勢進行監(jiān)護，避免平臥位。

期間，準(zhǔn)媽媽需要做一次詳細的超聲波檢查，包括胎兒雙頂徑大小、胎盤功能分級、羊水量等。醫(yī)生將憑此評估胎兒當(dāng)時的體重及發(fā)育狀況，并預(yù)估胎兒至足月生產(chǎn)時的重量。

醫(yī)生還會對你進行胎位檢查，確認(rèn)胎位以確定準(zhǔn)媽媽可以自然分娩或是手術(shù)助產(chǎn)。醫(yī)生會幫準(zhǔn)媽媽檢查骨盆等綜合情況，以決定分娩方式。

懷孕39周時，差不多到預(yù)產(chǎn)期了，此階段的產(chǎn)檢仍是以常規(guī)檢查和胎心監(jiān)護為主。不過圍孕期保健，最重要的還是準(zhǔn)媽媽養(yǎng)成每天自行檢測胎動的習(xí)慣。

孕40周，接近預(yù)產(chǎn)期，自數(shù)胎動，有產(chǎn)兆及時住院。

文/李夢琪 通訊員 張彤

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