The mother pass
Introduction / General
The maternity record is a very important document that was introduced in Germany in 1961 to document preventive examinations during pregnancy.
Every pregnant woman receives this document from her gynecologist after her pregnancy has been determined.
The maternity card should be sent to the gynecologist, the midwife and the birth up to the 2nd follow-up examination (6-8 weeks after giving birth) are brought along.
In addition, is a constant carrying of the mother's passport advisable during pregnancy, since in the event of an emergency it is possible to react and help more quickly and information about the pregnancy, the child and the mother can be viewed quickly.
In terms of content, the maternity record deals with data on Mother's health (Hereditary diseases, infectious diseases, blood type, Iron content of the blood) and child development (Weight, height, position, expected due date). In addition, the maternity record can contain important information in the event of a new pregnancy and should therefore be kept after birth.
Explanation of the individual pages of the mother's passport
On the first page the Contact details of the gynecologist, the clinic where the delivery is planned, as well as the Data of the supervising midwife held. In addition, the Dates of the check-ups noted.
On the 2nd page you will find the results of all laboratory tests in the form of blood tests (serological tests) and urine tests. First of all, the mother's blood group (A, B, AB or 0) and the Rhesus factor (Rhesus positive (D positive) or Rhesus negative (D negative)) are noted there.
The rhesus factor is an important characteristic on the red blood cells (Erythrocytes), which plays an important role during pregnancy. Is the rhesus factor the Mother positive (D positive) - approx. 85% of all Europeans are positive for rhesus traits - so can no rhesus intolerance occur between mother and child, even if that Child rhesus negative (D negative) is.
However, if the mother has the trait Rhesus negative (D neg) and the child, due to inheritance from the child's father, rhesus positive (D positive) so it can too Blood group incompatibilities come between mother and child during childbirth.
Before this is due to a Blood barrier between maternal and child blood (Placental barrier) not possible.
It will maternal antibodies against that strange blood of the child educated. This is usually harmless for the first child. However, in the case of a further pregnancy lead to serious complications in the development of the child (Haemolyticus neonatorum disease).
As a preventive measure, a rhesus negative mother is so-called between the 28th and 30th week of pregnancy and up to 72 hours after birth Anti-D antibodies that prevent the body from making antibodies.
The doctor can use a Antibody screening tests, which is also documented on the 2nd page of the maternity card, to find out whether there has already been an antibody formation in the maternal blood and whether there could be a rhesus intolerance.
If the test is negative, i.e. if no antibody formation has taken place, the test will repeated in the 24th and 27th week of pregnancy. If there is renewed negativity, there is usually no rhesus intolerance between mother and child.
In addition, a vaccination against rubella recorded, as well as whether there is adequate protection against rubella, which is determined by means of a special test (Rubella Hemagglutination Inhibition Test) is carried out by the doctor.
This is very important in so far as rubella infection increases during pregnancy severe damage to the unborn child can lead. If there is insufficient protection against rubella virus, vaccination during pregnancy cannot be made up for and the only protection against infection is one Avoid contact with rubella infected people.
It is therefore very important to ensure adequate vaccination protection before pregnancy.
On the 3rd page of the maternity record, other possible sources of infection such as An infection with the bacterium Chlamydia trachomatis is recorded in the form of a urine test. The bacterium can cause inflammation of the eyes and lungs after the birth (postpartum) of the newborn. If the pregnant woman is infected with the bacterium, she must be treated with antibiotics to avoid infection of the child.
There is also a potential infection with the Syphilis (syphilis) - pathogen Treponema pallidum- noted on the 3rd page. This bacterium can from the 20th week of pregnancy can be transmitted to the unborn child and must therefore be treated with suitable antibiotics if the mother becomes ill. However, in the mother's passport only one test carried out and no test result noted.
In addition, the result of a test carried out on a Hepatitis B. Infection on the basis of an antigen test (HBs antigen) noted about the maternal blood. Infection of the mother with hepatitis B can occur life-threatening consequences for the newborn carry with them. In the case of an existing infection with hepatitis B, the child must be vaccinated against the virus immediately after birth.
In addition, the presence of a HIV infection by the advice of the doctor or the request of the pregnant woman, as well as the test for one Toxoplasmosis-Antibodies are carried out.
On the 4th page you will find information about previous pregnancies, such as. Abortions (Abrupt), Miscarriages (Abortion) or Fallopian tubes- or Ectopic pregnancies (Ectopic pregnancies) noted.
In addition, the birth process (Spontaneous birth, Caesarean section (Caesarean section), vaginal births (suction cup / forceps birth (Forceps)), duration of pregnancy) and possible complications from previous pregnancies described. In this way, possible high-risk pregnancies can be better estimated.
In addition, on the 4th page the Date of birth, weight and gender of previously born children documented.
The 5th page describes information requested by a doctor (anamnesis) and the findings of the first preventive medical examination.This concerns, for example, familial illnesses with special attention to diabetes mellitus, high blood pressure (hypertension), malformations, genetic and mental illnesses, own previous illnesses, allergies, the use of medication, the social and professional situation as well as previous pregnancies ( Number of pregnancies (Gravida) or births (number of births (Para), premature births, delivery complications).
The gynecologist can after a medical interview (anamnese) pregnancy as one High risk pregnancy classify.
Furthermore, the Advice to pregnant women in terms of a balanced nutrition, Luxury foods, Taking medication, Sports, job, to travel, Birth preparation courses and Pregnancy gymnastics such as possible risks during pregnancy documented. Also will educate you about one possible HIV test and the Dental health as well as one that took place Cancer screening test noted.
On the one hand, the 6th page contains information about special features in the course of pregnancy (e.g. medication, maternal illnesses, special pregnancy illnesses, abnormalities in relation to the amniotic fluid and bleeding), and on the other hand, the date of the expected delivery.
The date of the last one plays a role in calculating the exact date Menstrual bleeding, of the safe due date (Conception), as well as that Date of pregnancy determination and in which Week of pregnancy the woman was at the time played an important role. The approximately calculated delivery date can then possibly be more precisely determined and adjusted in the course of the pregnancy.
The calculation is based on the so-called Naegele rule in the following way: Due date (ET) = first day of the last menstrual period + 7 days - 3 months + 1 year
Pages 7 and 8
On pages 7 and 8 there is the so-called gravidogram. These are pregnancy records, which give the midwife and doctor a good overview of the course of pregnancy. All test results of the preventive examinations are noted in this table.
This is the respective week of pregnancy (Week of pregnancy), the Location of the upper edge of the uterus (Fundus stand), the Position of the child (so in Breech position (BEL), cranial position (SL) or transverse position (QL)), the childlike Heart sounds (detected via ultrasound (US) or that CTG (Cardiotocography)), the Child movement, Water retention (Edema) or Varicose veins (Varicosis) the woman who current weight of the pregnant woman, the Blood pressure readings, the Concentration of the carrier molecule for oxygen (Man), Urine tests (on protein, sugar, blood, nitrite) and the result of the Examination of the vagina (vaginal exam). There are also entries over possible complications, height and weight of the child, and medication possible.
On the 9th page you can Treatment methods and drugs possible diseases as well as an overview of any inpatient hospital stays documented during pregnancy. In addition, the childlike heart action and the Uterine activity, which are determined by a cardiotocography (CTG) from the 28th week of pregnancy every 2 weeks.
Pages 10 and 11
The findings of the Ultrasound examinations during pregnancy (3 check-up appointments: 1) 9-12 weeks, 2) 19-22 weeks, 3) 29-32 weeks) represent the main content of pages 10 and 11. In the ultrasound (Sonography) can childlike growth patterns, such as Organ systems or Organ malformations, the Amniotic fluid volume, the Size of the child (Head, torso, legs), the Cardiac activity, as well as the Movement and position of the child being represented.
If complications or abnormalities are suspected, such as malformations, premature labor, bleeding or a shortening of the cervix (Cervical insufficiency), additional conditions (Indications) for further ultrasound check-ups.
On the 13th page is the Child's growth process documented on the basis of a curve. Here the Crown-rump length (SSL), as well as the Head diameter from temple to temple (BPD) and the Belly diameter from rib to rib (ATD) entered. A comparison between the child's growth values and the age-dependent normal curve as well as the time course are observed.
On page 14, as on page 12, further ultrasound examinations for abnormal (pathological) Describe anomalies.
On the 15th page, the Final examination (Epicrise) documented after the birth of the child. This page is divided into 3 sections. Here flow first Information about pregnancy, the medical check-ups that have taken place, such as the social situation the woman one.
Second is the Birth including date of birth, SSW, Gender of the child, Child position, Child size and Headgear such as any conspicuous malformations and the Umbilical artery pH detained after birth.
Furthermore, the Birth form and the APGAR scorewhich is the initial examination of the child (A = breathing, P = pulse / heart rate, G = basic tone (muscle tone), A = appearance (skin / skin color), R = reflex triggering) immediately after birth, after 5 and 10 minutes.
In the third part, the Women's health in the puerperium written down.
The last page of the maternity record contains the examination results of the second postnatal examination of the woman 6-8 weeks after delivery.