From the Guidelines
A typical first obstetric (OB) visit usually occurs between 8-12 weeks of pregnancy and consists of several components, including an ultrasound to confirm pregnancy viability, as recommended by the most recent guidelines 1.
Key Components of the Initial OB Visit
The initial visit includes:
- A comprehensive medical history
- A physical examination, including vital signs, weight, and sometimes a pelvic exam
- Laboratory tests, such as blood type, complete blood count, infectious disease screening, and urine tests
- An ultrasound to confirm the pregnancy is in the uterus, verify gestational age, check for a heartbeat, and determine if there are multiple pregnancies
Importance of the Initial Visit
This first visit establishes a baseline for the pregnancy and allows for early identification of any risk factors that may require special attention throughout the pregnancy. The confirmation of viability through ultrasound provides important reassurance, especially for those with previous pregnancy complications or losses, as noted in the Society of Radiologists in Ultrasound consensus conference recommendations 1.
Ultrasound in the Initial Visit
The ultrasound performed at this visit is crucial for confirming the location of the pregnancy, verifying gestational age, and checking for cardiac activity, as outlined in the lexicon for first-trimester ultrasound 1. This information is essential for identifying potential complications early on and providing appropriate care.
Prenatal Care Plans
During the initial visit, the healthcare provider will also discuss prenatal care plans, including nutrition, appropriate weight gain, exercise recommendations, and potential pregnancy symptoms, as part of the evolution of prenatal care delivery guidelines in the United States 1.
From the Research
Typical Initial Obstetrics (OB) Visit
- The content of the first prenatal visit may vary, but it typically includes discussions on vitamin supplementation, laboratory testing, flu vaccinations, and cervical cancer screening 2.
- Topics such as physical examination, education about pregnancy, and screening for psychosocial risk may be discussed less often 2.
- Prenatal screening is often one of the least covered topics during the initial prenatal visit 2.
Ultrasound to Confirm Viability of Pregnancy
- Ultrasound is a commonly used diagnostic procedure in obstetrics, and it can be used to confirm viability of pregnancy 3, 4, 5.
- Routine early pregnancy ultrasound can improve the early detection of multiple pregnancies and fetal malformations 4, 6.
- It can also help with gestational dating, which may result in fewer inductions for post maturity 4, 6.
- However, the use of ultrasound during the initial prenatal visit may not be universal, and its inclusion may depend on various factors, including the presence of clinical complications or concerns about fetal growth 4, 6.