Exames no pré-natal: uma supervisão da natureza

julho 1, 2016

12-weeks-pregnant-ultrasound-pictures-1600x1236-e1418951726850-780x603

 

 

Sim, quando se descobre uma gravidez, se descobre também a necessidade de ter uma agenda cheia e intensa de compromissos, sejam para preparar para a chegada do bebê ou para supervisionar a natureza para garantir o melhor desenvolvimento para o bebê e manter a mamãe saudável e preparada para todas as fases dessa caminhada da espera.

A frequência de consultas de pré-natal será determinada pelos profissionais de saúde responsáveis pelo seu acompanhamento e também pelas particularidades da sua gestação. De acordo com o Ministério da Saúde:

  • Consultas mensais: do momento da descoberta da gestação até 28 semanas;
  • Consultas quinzenais: de 28 até 36 semanas;
  • Consultas semanais: de 36 até 41 semanas.

Durante a consulta de pré-natal, antes de solicitar os exames de laboratórios ou imagens, o profissional de saúde precisa conhecer o andamento da sua gestação. Por isso ele fará várias perguntas sobre seu estado geral, os sintomas que você apresenta, entre 18 e 20 semanas começará a te perguntar sobre os movimentos do bebê, verificará seu peso, altura do útero e circunferência abdominal, fará ausculta dos batimentos cardíacos do bebê e, finalmente, solicitará os exames laboratoriais, de imagem e outros, se necessário.

Primeiro Trimestre (1 até 12 semanas):

  • Exame de Sangue: Determinação de grupo sanguíneo e do fator Rh na tentativa de prever e evitar a Eritroblastose Fetal (incompatibilidade sanguínea entre a mãe e o feto), que é quando a mãe tem o fator Rh negativo e o feto positivo, os anticorpos dela atacam o sangue do bebê; dosar hormônios e anticorpos da tireoide; detectar possíveis doenças, como: sífilis, HIV, rubéola, toxoplasmose, hepatites A, B e C; verificar se a gestante não tem anemia; dosar os níveis de açúcar no sangue para detectar se há tendência de desenvolvimento de diabetes gestacional; pesquisar de trombofilias congênitas, essencial para prevenir o trabalho de parto prematuro e alertar para doenças hipertensivas da gestação, como pré-eclâmpsia e help síndrome, que podem causar óbito fetal; identificar a doença falciforme ou a talassemia, que são hereditárias e requerem cuidados especiais na gravidez.
  • Urina: identificam a presença de infecção urinária, que deve ser tratada ainda durante o pré-natal. Pode ser repetido nos demais trimestres para continuar a sondar uma possível infecção e também para verificar a presença de proteínas, que podem indicar tendência a desenvolver pré-eclâmpsia.
  • Fezes: Investigar a presença de parasitas no intestino que podem provocar, entre outros problemas, anemia.
  • Exame preventivo de câncer de colo de útero (Papanicolau): este exame precisa ser realizado periodicamente por todas as mulheres, de acordo com a necessidade. Procure saber se você tem a necessidade de fazê-lo durante o pré-natal.
  • Ultrassonografia: irá avaliar onde está ocorrendo essa gestação, se ela realmente está dentro do útero; qual a idade gestacional do feto, para que possa se calcular o desenvolvimento e data provável do parto; e se há mais de um bebê.

Segundo Trimestre (13 a 28 semanas):

  • Ultrassonografia Morfológica 1: realizado entre as semanas 11 e 14, avalia como está o desenvolvimento da criança e se a formação está bem, como o desenvolvimento dos membros, coração, sistema nervoso, entre outros. Mas, o principal objetivo desse exame é a medicação da espessura de um fluido entre a pela e a gordura da nuca do bebê, que aponta uma menor ou maior chance de haver anomalias, sendo a principal delas a Síndrome de Down. Este exame também irá medir o bebê, atestar sua vitalidade pela ausculta dos batimentos cardíacos e observar o ducto venoso, um vaso que pode dar aos médicos sinais de possíveis problemas cardíacos.
  • Ultrassonografia Morfológica 2: entre as semanas 20 e 24 é preciso avaliar a morfologia do bebê novamente, que além de medir o feto e estimar seu peso, irá verificar os órgãos do bebê, que, a essa altura, já se encontram formados, como rins, coração, pulmões, sistema nervoso e outros órgãos, além dos membros, e ver se tudo se desenvolveu da forma correta ou se há malformação. Na maioria dos casos, é possível visualizar o sexo da criança. Se o aparelho usado for de tecnologia 3D ou 4D, é possível até mesmo observar os traços faciais do bebê.
  • Exame de Sangue: avalia novamente a existência de sífilis e, se necessário, toxoplasmose, além do açúcar no sangue, para o qual o objetivo é avaliar novamente se há presença ou tendência de diabetes gestacional.

Terceiro Trimestre (29 a 41 semanas):

  • Ultrassonografia: feito por volta da 32ª semana para conferir se está tudo certo para o parto, se o bebê está na posição correta, por exemplo, e se ele cresceu adequadamente nesse período, além de monitorar também o volume de líquido amniótico e as condições da placenta. Pode ser realizado com tecnologia Doppler , que verifica o fluxo sanguíneo da placenta para o bebê e detecta vários problemas na gestação. O número de ultrassonografias no último trimestre de gravidez depende das necessidades de cada gestante e da conduta particular do profissional de saúde, portanto, esse exame poderá ocorrer mais de uma vez no último trimestre.
  • Exame de Sangue: na reta final da gestação, exames como o hemograma e as sorologias são repetidos, a fim de detectar a presença de hepatite B, toxoplasmose, HIV, rubéola, sífilis entre outros.
  • Triagem de estreptococo beta-hemolítico: trata-se da análise laboratorial de uma amostra de secreção vaginal e outra do reto para rastrear uma eventual infecção causada pela bactéria estreptococo do grupo B, que pode ser passada para o bebê durante o nascimento e provocar até a morte do recém-nascido. O tratamento, para os casos positivos, consiste na administração de antibióticos para a gestante no dia do parto.

Muito bem! Agora você já pode anotar na sua agenda os exames que fará para não perder nenhum detalhe do desenvolvimento do seu bebê, com a certeza de estar promovendo a ele um crescimento saudável e de se manter saudável para recebê-lo. Lembre-se: se você trabalha fora de casa, você tem direito de receber uma Declaração de Comparecimento sempre que for às consultas de pré-natal ou fizer algum exame, pois apresentando esta declaração à sua chefia, você terá a falta justificada no trabalho. Priorize sua saúde e do seu bebê!

 

Imagem Exames no Pré natal

 

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