MEDICAL CENTRE
Prenatal care 1
in the hospital, where you can stay one to five days after giving birth, unless medical complications require a longer stay. If you opt for a private room, the hospital will charge a supplement which is not covered by public health insurance. • Gasthuisberg University Hospital, Obstetrics and Gynaecology Department, Herestraat 49, 3000 Leuven, + 32 16 34 47 50 • Heilig Hart Regional Hospital, Obstetrics and Gynaecology Department, Naamsestraat 105, 3000 Leuven, + 32 016 20 92 09 • MCH outpatient consultation centre, Maria-Theresiastraat 63A, 3000 Leuven, + 32 16 31 01 91
Prenatal care The Medical Centre will gladly assist you in your prenatal care. In an uncomplicated pregnancy we advise regular check-ups around 6, 12, 16, 20, 26, 32, 36 and 38 weeks, with ideally 1 preconceptional consultation. These can be performed by your family doctor, a midwife or an obstetrician.
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Social Service can help you with paperwork, health insurance, day care information, maternity leave, benefits etc. You can also consult them if you have financial difficulties. • Social Service, Van Dalecollege, Naamsestraat 80 box 5415, 3000 Leuven, + 32 16 32 44 28, www.kuleuven.be/socialservices
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Housing Service can help you find appropriate accommodation for you and your family. • Housing Service, Van Dalecollege, Naamsestraat 80 box 5415, 3000 Leuven, + 32 16 32 44 00, www.kuleuven.be/accommodation
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The doctors at the Medical Centre are familiar with your medical history and social background. They can also easily consult with the Social Service, the International Office and your university department. Furthermore, the Medical Centre provides very flexible care: you are always welcome to visit us between routine consultations if you have any questions, concerns or complaints. If you have Belgian public health insurance, with GMD and Omnio, the consultation fees are very low. • Medical Centre, Van Dalecollege, Naamsestraat 80 box 5415, 3000 Leuven, + 32 16 32 44 20, www.kuleuven.be/studentservices/health/index.htm Mon - Fri 8:30 am - 6 pm (consultations by appointment only), after hours emergency stand-by The midwives of “De Bakermat” offer pre- and postnatal medical follow-up. They organize workshops on different topics and have a large information centre. Most of their services are free of charge if you have Belgian public health insurance. They can also inform you about postnatal care at home, which includes medical assistance as well as household help during the first few days after the birth. • De Bakermat, Redingenstraat 27, 3000 Leuven, + 32 16 20 77 40, Mon - Fri 9 am-12:30 pm (walk-in information centre), consultations by appointment only The obstetricians of the local hospitals provide high quality specialist care. If the pregnancy goes well, they will see you only occasionally for ultrasounds (12, 20 and 30 weeks) and a brief medical check-up. However, if we suspect or discover any possible complications, most follow-up will be with them. Most obstetricians can be consulted in the hospital, in the MCH outpatient clinic (by doctor referral only) or in their private practice. Some charge the official fees (“geconventioneerd”), whereas others charge more, so be aware of a possible extra consultation cost in some facilities. The delivery takes place
Prenatal consultation schedule for low-risk pregnancies During each consultation you will be asked questions on your general well-being, emotional experience of the pregnancy, specific symptoms and risks. Feel free to ask or express whatever is on your mind. The doctor or midwife will also check your weight, blood pressure and urine. Some visits will consist of additional tests: n Pre-conception: Ideally you visit the doctor for a preventive consultation before getting pregnant for a thorough personal and family history, general physical examination, blood test (infections, anaemia, blood type), cervical smear, as well as useful advice, recommendations and answers to any questions you might have. You will be advised to take folic acid supplements until the third month of pregnancy. n 6 to 8 weeks: determining your due date, addressing any concerns or questions you may have, discussing your emotional experience of the pregnancy, assessing risk factors on the basis of an interview and physical examination, blood and urine test, planning pregnancy follow-up. This usually requires two consultations given the large amount of information that needs to be provided.
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11 to 14 weeks: first ultrasound (gestational age, multiple pregnancy, Down syndrome screening if desired) 14 to 16 weeks: history taking and brief physical examination, urine test 20 to 22 weeks: second ultrasound (thorough anatomical screening for major birth defects), history taking, brief physical examination and urine test 24 to 28 weeks: history taking, physical examination, blood test (screening for pregnancy diabetes, which will require you to drink a 50 g sugar solution 1 hour prior to the blood test, toxoplasmosis and irregular antibodies) 28 weeks: a preventive injection with gamma globulins for rhesus negative women 32 weeks: third ultrasound, history taking, brief physical check-up and urine test 36 weeks: history taking, brief physical check-up, urine test and GBS screening: screening for genital infections which might cause perinatal complications 38 weeks: history taking, brief physical check-up and urine test
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Postnatal care After the delivery both mother and baby will need medical check-ups. These are performed during the hospital stay and upon discharge. Mothers who wish to take their newborn home after only a short (less than five days) hospital stay can do so, if there are no complications. They will, however, need daily follow-up by a midwife who visits them at home. The baby needs a full physical examination on day 7, which can be done by your family doctor (at home or at the Medical Centre) or by a paediatrician at the hospital. The mother needs a final check-up with the obstetrician 6 weeks after the delivery.
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Toxoplasmosis is an infection which is harmless for the mother, but can cause problems for the baby when the mother is infected during pregnancy. If you have not developed immunity as a result of previous contact, you need to be careful with cats (avoid them and wash your hands after contact with them), meat (deep-frozen or well-cooked meat is safe) and all raw vegetables (wash them thoroughly). All pregnant women should avoid eating non-pasteurized dairy products, which can be contaminated with Listeria, causing miscarriages. A healthy diet consists of plenty of dairy products, fibre and vitamins (fruit and vegetables). Limit your alcohol and caffeine intake and try to avoid nicotine and drugs.
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During your pregnancy you can continue moderate physical activities, including sex and most sports. If you believe you have been exposed to any toxic agents at home or at work, mention this to your doctor. Women in risk occupations (e.g. day care centres, chemistry labs) should inform their employer about their pregnancy ASAP. Do not take any medication without consulting your doctor. Paracetamol is safe for you and your baby. Ideally folic acid should be taken one month before conception and until your 12th week of pregnancy. Any other supplements are not recommended. Flu vaccination is advisable in the second or third trimester. First trimester Down screening, which consists of an ultrasound and blood test administered between 11,5 and 13 weeks, gives an estimation of the risk of carrying a baby with certain chromosomal defects. This test is not conclusive, so any sign of trisomy 21,needs to be confirmed by an amniocentesis, which carries a 1% risk of miscarriage. The 12th week ultrasound alone offers useful information on possible other conditions as well. These tests are optional. Rhesus negative mothers can produce antibodies causing severe immune reactions when their blood comes in direct contact with the baby’s blood. This can happen during delivery (causing problems for future pregnancies) or as a result of abdominal trauma (e.g. kick, fall, car accident; causing problems for present and future pregnancies). This can be prevented with routine rhesus antibody injections at 28 weeks, upon delivery and within 48 hours after trauma. Pregnancy diabetes can affect the baby’s growth and cause distress in the baby after delivery. Mothers with pregnancy diabetes also run the risk of developing type 2 diabetes at a later age. This condition should therefore be screened for, monitored and possibly treated during pregnancy. The most accurate screening method is a glucose challenge test between 24 and 28 weeks, which requires you to drink a 50 g sugar solution 1 hour prior to the blood test. Contact your doctor when you notice any symptoms of premature labour (painful contractions), vaginal discharge, reduced foetal movements or when you have been involved in an accident. If any of these conditions result in complications, early diagnosis and treatment can often prevent further problems. The Belgian Railways offer first class seats at second class rates to women in their last four months of pregnancy. Ask your doctor for a certificate. When travelling by car, pregnant women are required by law to wear a seatbelt at all times. In case of an accident this is safer for you and for your child. You can find reliable information on www.familydoctor.org/online/famdocen/home/women/pregnancy.html or www.nhs.uk/livewell/pregnancy
Personal information
Pregnancy-related information
First and last name: _____________________________________________________ Address: ______________________________________________________________
G
P
A
LP: _________
conception: spontaneous / assisted
EDD: _________ corrected EDD: ________ multiple pregnancy: ___________________
Telephone: ____________________ Mobile phone: ____________________ risk factors: ___________________________________________________________
E-mail: _______________________ Date of birth: __________________
Place of birth: _______________________
Laboratory tests
Nationality: _____________
Routine test (date: _____________ ):
Partner’s name and telephone: ___________________________________________
Blood type: _____
______________________________________________ (married: yes n
Syphilis: _____
/ no n )
Other relevant contacts: _________________________________________________ Family doctor: _________________________________________ Midwife: ______________________________________________ Obstetrician: __________________________________________ Health Insurance:
Irregular AB: _____
Rubella: _____
Hep B:_____
Toxoplasmosis: _____
HIV:_____ Glucose challenge: _____
Follow-up Hb Toxo ferritine Irr. AB GBS other
Personal and family medical history: ______________________________________________________________________
Ultrasounds
______________________________________________________________________
1. date: _____________
week: ___________
features: _____________________
Obstetric/gynaecological history:
2. date: _____________
week: ___________
features: _____________________
______________________________________________________________________
3. date: _____________
week: ___________
features: _____________________
______________________________________________________________________
4. date: _____________
week: ___________
features: _____________________
Profession: ___________________________________ Medication: ___________________________________
Incidents, hospital referrals, complications, etc
Alcohol: none n
______________________________________________________________________
/ occasional n
Cigarettes/drugs: none n Length: ____________
/ frequent n
/ occasional n
/ frequent n
Weight: ____________
BMI: ____________
Cervical smear: _____________________________________ Possible risk factors: ________________________________________________
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
Date
Weeks
Fundus
Heartbeat/ movements
Blood pressure
Weight
Urine protein/sugar
History, clinical examination
Comments, recommendations, treatments
Doctor/ midwife
Appointment schedule (MC= Medical Centre, GHB = Gasthuisberg hospital, HHH = Heilig Hart hospital, BM = De Bakermat, MCH = GP Medical Centre) Date: _______ Time: _______ Location: _________________ Who with: ____________________
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Student Services Medical centre MPTC Naamsestraat 80 box 5415, BE-3000 LEUVEN, Belgium tel. + 32 16 32 44 20 • fax + 32 16 32 44 14
[email protected] www.kuleuven.be/studentservices/health
Student Services K.U.Leuven works for the Medical and Psychotherapeutic Centre together with the Social service associations for the students of Groep T (Inter s), the Lemmens Institute (SoVoW&K) and Vlerick Leuven Gent Management School.
