Your First Prenatal Appointment
What Happens at the First Antenatal Visit?
The first antenatal visit, or the first visit after you find out you are pregnant, is one of the most important appointments of your pregnancy. It establishes a medical baseline, confirms your pregnancy, and allows your doctor to create a personalized care plan that is tailored to your individual needs.
Medical History
Your doctor will take a detailed history to better understand your health and pregnancy background. You will be asked for the first day of your last menstrual period (LMP). This is used to estimate the gestational age and due date. Your doctor will inquire about your past medical conditions, surgeries, and allergies, as well as current medications, supplements, or herbal products. You will also be asked about your gynecologic history, as well as any previous pregnancies and their outcomes. And finally, information about your family history of genetic conditions or congenital anomalies will be sought. This information will help identify any medical or obstetric factors that may require closer monitoring during pregnancy.
Physical Examination
During this visit, your doctor will perform a detailed physical examination to check for any underlying conditions that may have gone undetected before. These include taking your blood pressure, weight, and height, as well as physical examination of your thyroid gland, heart, lungs, breasts, and abdomen. Finally the size of your uterus will be assessed, which can be used to roughly estimate how far along you are in your pregnancy.
During this visit, a pelvic examination may be offered if clinically indicated, for example, if you have symptoms such as bleeding, pain, or abnormal discharge.
Ultrasound Examination
An early pregnancy ultrasound is commonly performed at the first antenatal visit.
This may be done abdominally or transvaginally, depending on gestational age and clinical indication. The ultrasound allows your doctor to confirm the location of the pregnancy (whether it is inside the womb), determine the number of embryos, visualize fetal cardiac activity and also to accurately date the pregnancy by measuring the size of the embryo. This information is essential for pregnancy planning. When possible, the ovaries are also evaluated to assess for cysts or other findings.
Laboratory Testing
Once pregnancy has been confirmed, as part of your antenatal risk assessment, you will be asked to do some blood tests and a urine test. The blood test includes a complete blood panel to assess for anemia and check your platelets, a blood group and Rhesus group test, screening for HIV, syphilis and hepatitis B, Rubella immunity testing as well as blood for screening for thalassemia, which is a condition that is common in South East Asia.
Urine testing is also performed to check for urinary tract infection and assess for protein and sugar in the urine, which may have health implications.
Early identification allows timely treatment and prevention of complications and may reduce mother-to-child transmission of infections.
Supplements and Counseling
During this visit, your doctor will prescribe either folate or prenatal multivitamins depending on your gestational age and your symptoms.
This visit is also an excellent opportunity to ask questions, discuss pregnancy symptoms, and clarify expectations for upcoming antenatal visits and screening tests.
References
1. American College of Obstetricians and Gynecologists. Prepregnancy counseling. ACOG Committee Opinion No. 762. Obstet Gynecol. 2019;133(1):e78–89. doi: 10.1097/AOG.0000000000003013.
2. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 175: Ultrasound in Pregnancy. Obstet Gynecol. 2016;128(6):e241–56.
3. American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 797: Prevention of Group B Streptococcal Early-Onset Disease in Newborns. Obstet Gynecol. 2020;135(2):e51–72.
4. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics. 26th ed. New York: McGraw-Hill Education; 2022.
Maternal–Fetal Medicine Specialist in Bangkok
Dr. Narisra Srikureja Firer, M.D. (Dr. Niti)
Dr. Niti is a Bangkok-based OBGYN with subspecialty training in Maternal–Fetal Medicine (MFM). She provides comprehensive care for women across all stages of life, including pregnancy care, deliveries, and general gynecological conditions.
She dedicates her time to private practice at Mission Hospital and serves as a Maternal–Fetal Medicine Consultant at a large government tertiary care center.
Read Full Biodata →
