What are women's consultations for? Rules for registration in the women's clinic. During pregnancy

Every pregnant woman in without fail need to be registered with women's consultation. It is necessary to maintain health future mother, and to avoid problems with registration in the maternity hospital and obtaining medical certificates.

Legislation Russian Federation provides free medical diagnostics and supervision of pregnant women. These activities are carried out in women's counseling centers (women's consultations). Women's consultations can work on the basis of a polyclinic or be separate institutions. In our country, they exist in both designated forms.

At the same time, antenatal clinics can work on a free and commercial basis. Free services to pregnant women are most often provided by state antenatal clinics, and commercial-based clinics, although they charge some fees, declare more high level providing medical services pregnant women.

Every woman needs to know that during pregnancy she definitely needs to register with the antenatal clinic as early as possible. The fact is that it is in women's consultations that they will be able to give advice on proper nutrition during pregnancy, to identify the features of the course of pregnancy and to prevent some of the negative phenomena that may accompany the period of pregnancy. A pregnant woman needs regular checkups medical specialists, as well as in medical consultations. Besides, birth certificates and other documents that will be needed upon admission to the maternity hospital are issued to women in antenatal clinics.

In addition to the above, antenatal clinics issue medical certificates for pregnant women, which they will need to provide at work or in any other institutions (for example, in the registry office). This is primarily about the document "certificate of pregnancy". The need for such a certificate for pregnant women is due to the fact that a pregnant woman in Russia has whole line special rights associated with labor activity as well as other aspects of life. A certificate of pregnancy can also be obtained in the examination room, however, the women's consultation draws up medical certificates on the basis of a more serious examination. I must say that a certificate of pregnancy is not the only medical document, which is issued in the antenatal clinic. In it you can get other medical certificates, listing which in this article does not make sense. However, a certificate of pregnancy is issued to every woman who has registered with the antenatal clinic.

It is desirable that the antenatal clinic, in which the pregnant woman is registered and which she will regularly visit, be located at the place of registration. First of all, this will allow the woman herself to get to the consultation faster and easier. In the same time Russian legislation does not rule out the possibility of a pregnant woman being assigned to a antenatal clinic in another district or city. Women's clinics in the Russian Federation can also provide services to women who live in other countries, but the scope of such services is limited.

Consider the features of registration in the antenatal clinic for different categories women.

If the pregnant woman is a citizen of the Russian Federation and lives in the area to which the antenatal clinic belongs, then registration will not bring any difficulties. A pregnant woman should come to the antenatal clinic, having a passport and a policy of compulsory health insurance. In rare cases, employees of antenatal clinics require you to also have a pension insurance policy with you.

In the event that a woman is registered at one address, but lives in another area (for example, with her husband at the place of his registration or in a rented apartment), she can register with the antenatal clinic of the area where she lives. True, it will be necessary to confirm that the pregnant woman is in some way connected with the area to which the antenatal clinic she has chosen belongs. We are talking about providing a consultation with documents on renting an apartment and a passport of the owner of the apartment with a residence permit. Or it can be a marriage certificate and a husband's passport with a residence permit, etc.

If before that the woman was registered in another antenatal clinic, about deregistration of the pregnant woman, and sometimes an extract from her medical record.

For women who come from other cities and have temporary registration, in addition to a passport and a compulsory medical insurance policy, you will need to present a certificate of temporary registration to the antenatal clinic. Lack of temporary registration by law does not prevent a woman from receiving medical care However, in practice this would be extremely difficult.

Everything said in the previous paragraph also applies to women who come from other countries and wish to be observed in the antenatal clinic during their stay in the Russian Federation. Note that a compulsory medical insurance policy, in its absence, is issued to all citizens on the basis of a residence permit, temporary registration or employment contract.

Even in the absence of registration, a residence permit and an insurance policy, a pregnant woman can count on free medical care in emergency cases. When the state is normalized further treatment becomes paid.

No one will argue that in any case, medical counseling plays a big role for normal flow pregnancy. Therefore, every woman should take care to be registered in a particular antenatal clinic in a timely manner.

FORMS OF MEDICAL INFORMATION:

So, you have the first doubts about the fact that you will be able to spend the next vacation only with your husband, because some very specific symptoms indicate that soon there will be three of you in the family. Where to look for confirmation of your secret hopes, if not in the antenatal clinic? What awaits you there during your first visit?

Why is women's counseling needed?

All pregnant women should attend antenatal clinics; expectant mothers who were not observed by a doctor during pregnancy are sent for childbirth to the observational departments of maternity hospitals or to specialized infectious maternity hospitals.

It is worth noting that a pregnant woman can register and attend the consultation that is closest to her home, or guided by other reasons in her choice, but regardless of the place of permanent or temporary registration. For registration in the antenatal clinic, you must provide a passport and (or) a certificate of registration at the place of stay, an insurance policy of compulsory medical insurance (if any). In the future, other documents may be needed, which the expectant mother will be informed about additionally.

When is the best time to go to the antenatal clinic?

Most often, a visit to the antenatal clinic is scheduled after the menstruation set according to the individual calendar has not occurred, but home test for the presence of pregnancy positive result. Nevertheless, there is still some uncertainty that I really want to quickly resolve. However, it is unlikely that such short term an obstetrician-gynecologist in a antenatal clinic can absolutely accurately confirm the fact of pregnancy, despite the examination. It is best to wait a couple of weeks, and then the doctor can really confirm the fact of pregnancy. Optimal time for a visit - 6-9 weeks of pregnancy, i.e. about 2-5 weeks after the date of the expected, but not onset of menstruation.

It is also not worth delaying the first visit to the consultation, because early diagnosis pregnancy will allow not only with maximum precision determine the date of birth, but also go through all necessary examinations and decide on time possible problems, spend preventive actions according to gestational age.

Where does the admission begin?

Based on the conversation with the woman who came to the reception, the obstetrician-gynecologist starts an individual card of the pregnant woman. Such cards are then laid out by the days or weeks of the appointment of the next appearance of the pregnant woman. What information is shown on the map?

General history

1. Full Name.
2. Year of birth. The age of the expectant mother is very important for the doctor, because early or late pregnancy flow differently.
3. Family status. The question of whether a woman is married or not is not a tribute to curiosity: it is important for a doctor to know mental attitude pregnant woman and the opportunity to help at home.
4. Bad habits, age and health of the husband. This point should not be surprising, because the health of the child also depends on the state of health of the future dad.
5. Professions of spouses and the specifics of their work. Harmful Conditions production, where future parents work, should be known to the doctor in order to draw the attention of the expectant mother during pregnancy to their possible negative impact.
6. Hereditary diseases suffered in childhood and in adulthood general and gynecological diseases, blood transfusions, operations (therefore, it is advisable to remember them beforehand by talking with parents). If there were hereditary diseases in the family, you may be prescribed a series of examinations at a genetic consultation. In the presence of chronic diseases the doctor will prescribe special examinations and visits to other specialists.
7. Contact with infectious patients, travel abroad, especially to countries with a tropical climate, within the last 6 months. Some infections have a long incubation period (the time when there are no manifestations of the disease yet, but the infection is already developing in the body), i.e., they do not appear immediately, so the doctor needs to know if there was contact and when, in order to check and prevent complications in time, because the infection can have its pernicious influence not only on the baby, but also on the fetus, causing fetal malformations or abortion.
8. The course and outcome of previous pregnancies and childbirth (their number, the number of abortions, preeclampsia, miscarriage of previous pregnancies, surgical interventions in childbirth birth trauma, flow postpartum period, hypoxia and fetal and newborn malformations, stillbirths). These data will allow predicting the course of this pregnancy, in a timely manner to carry out the prevention of a particular disease.
9. Features of menstrual, sexual functions. A detailed history will allow the doctor to analyze the condition of the expectant mother, to make a forecast regarding the well-being of the course of this pregnancy.

General and special obstetric objective examination

After the survey, several more medical manipulations, the data of which are entered into an individual card. It:

1. Measurements of anthropometric data (height, weight). To do this, the doctor's office has a scale and a device for measuring height. The ratio of height and weight will allow you to identify the features of proportions and approximately calculate the weight that a woman can normally add during nine months of pregnancy;
2. Measurement blood pressure. The fact is that during pregnancy, pressure can rise or fall, so it is important to know its baseline;
3. Temperature measurement. It must be borne in mind that at the beginning of pregnancy, the temperature can be slightly increased - up to 37.5 ° C, this is due to the action of pregnancy hormones. A significant increase in temperature suggests the presence of any infectious disease;
4. Determining the size of the pelvis using a special device. This is very milestone examinations. The fact is that anatomically, the bone pelvis and lining it soft tissues there is nothing but the birth canal through which the child advances before being born. Therefore, it is very important to know if the birth canal is narrow for the baby. This circumstance determines the possibility of childbirth through the birth canal;
5. A vaginal examination of the uterus and ovaries will allow the doctor to correlate the size of the uterus with the expected (by date last menstrual period) gestational age, and will also provide an opportunity to assess the condition of the vagina, cervix and ovaries. Then, by palpation (palpation) of the abdomen with special obstetric techniques, the doctor determines the condition of the anterior abdominal wall(elasticity, condition of the rectus muscles, round ligaments), the size and tone of the uterus. During the examination, the doctor will also take a smear from the vagina to determine the degree of cleanliness of the vagina (usually the laboratory examines the smear for the presence of gonococci, Trichomonas and Candida fungi that cause thrush), if necessary, can be taken special analyzes and other sexually transmitted infections.

In addition, the doctor pays attention to appearance pregnant woman: her physique, features skeletal system, mammary glands and nipples, the doctor examines the skin and visible mucous membranes.

Referrals for tests
After general and special obstetric examination The doctor will write a referral for the following tests:

1. clinical blood and urine tests;
2. blood chemistry;
3. determination of blood group and Rh factor;
4. a blood test for the presence in the body of pathogens such as syphilis (Wassermann reaction - RW), hepatitis B and C and AIDS.

at the first appointment, the pregnant woman will be referred to specialists, who will need to be visited within a few days after the visit to the antenatal clinic. This is a therapist, ophthalmologist, dentist, otolaryngologist, if necessary - an endocrinologist and other specialists (in the case when the obstetrician-gynecologist assumes the presence of any chronic diseases).

Survey results

According to the results of the examination in the antenatal clinic, special group pregnant women with increased risk complications for mother and fetus. These are women who have obstetric and gynecological diseases, for example, with miscarriage of a previous pregnancy, uterine fibroids, or extragenital diseases - these include bronchial asthma, diabetes, heart disease. Such pregnant women are under special supervision: they are recommended to visit the antenatal clinic more often than others, depending on their condition, the characteristics of the disease and other reasons.

Pregnant women of this group are examined additionally in outpatient settings or in specialized obstetric and other medical institutions. 70 days after the birth of a child, women, except those with last pregnancy or childbirth was accompanied by severe complications, they are removed from dispensary observation.

If you came to the antenatal clinic for the first time at 6-9 weeks of pregnancy, then next visit you will be assigned in 3-4 weeks. Further, in the second trimester of pregnancy, you will need to visit the doctor every 2 weeks, and in the third trimester - from 28 weeks - once every 7-10 days. If complications arise during pregnancy, then the doctor will need to come more often.