Antenatal Care in Pokhara: Your Complete Pregnancy Check-Up Schedule

Antenatal care (ANC) — also called prenatal care — is the systematic health monitoring of a pregnant woman and her developing baby throughout pregnancy. It is not just a series of visits; it is a structured process designed to detect problems early, prevent complications, prepare women for labor, and improve outcomes for both mother and newborn.

In Nepal, inadequate or delayed antenatal care remains a significant contributor to maternal and neonatal mortality, particularly in districts outside Kathmandu. At A&B International Hospital in Pokhara, structured antenatal care follows the WHO-recommended model adapted to the Nepal Ministry of Health protocol — with all essential tests, measurements, and counseling sessions provided in one place.

What Does Antenatal Care Include at A&B International Hospital?

Antenatal care at A&B is a structured program that includes clinical examination, laboratory investigations, ultrasound at key gestational ages, nutritional counseling, and birth planning — delivered across a schedule of visits from first trimester to delivery.

At each visit, the minimum clinical assessment includes:

• Blood pressure measurement
• Weight and BMI monitoring
• Fundal height measurement (from 20 weeks) — monitors fetal growth
• Fetal heart rate auscultation
• Urine analysis for protein and glucose
• Symptom review — swelling, headache, bleeding, fetal movement

Additional investigations are scheduled at specific gestational ages as described below.

When Should a Pregnant Woman Have Her First Antenatal Appointment?

The first antenatal appointment should be scheduled as soon as pregnancy is confirmed — ideally before 10 weeks of gestation. Early booking allows dating ultrasound to confirm gestational age accurately, first-trimester screening tests, and early detection of risk factors.

Women who present late in the first trimester (after 12 weeks) can still begin antenatal care, but the benefits of early first-trimester screening for chromosomal conditions and maternal blood tests are reduced.

A&B International Hospital accepts first ANC appointments from the point of a positive pregnancy test. Same-week appointments are typically available.

What Is the Recommended Antenatal Visit Schedule?

The recommended antenatal care schedule follows a tiered approach — more frequent in the third trimester when complications are more likely, and spaced appropriately in earlier trimesters when the pregnancy is stable.

First trimester (Weeks 4–13):

• Visit 1 (ideally by 10 weeks):
• Confirmation of pregnancy and gestational age
• Full medical, surgical, and obstetric history
• Blood tests: blood group and Rh factor, CBC, blood glucose, VDRL, HIV, hepatitis B surface antigen, urine culture
• BMI and blood pressure baseline
• First-trimester ultrasound (8–12 weeks): confirms viability, dates the pregnancy, screens for multiple pregnancy
• Nuchal translucency screening (11–13 weeks): screens for Down syndrome and other chromosomal conditions
• Folic acid and iron supplementation initiated
• Nutritional and lifestyle counseling

Second trimester (Weeks 14–27):

• Visit 2 (14–16 weeks):
• Blood pressure, weight, urine check
• Review first-trimester test results
• Glucose tolerance test (if high risk for gestational diabetes)
• Anatomy ultrasound arranged (18–22 weeks)

• Visit 3 (18–22 weeks — anomaly scan):
• Detailed fetal anatomy ultrasound — checks fetal organ development, placental position, amniotic fluid
• Fundal height measurement begins
• Discussion of findings with the gynecology team

• Visit 4 (24–28 weeks):
• Glucose tolerance test (GTT): oral glucose challenge to screen for gestational diabetes
• CBC repeat to detect anemia
• Blood pressure monitoring (pre-eclampsia screening)
• Iron and calcium supplementation review

Third trimester (Weeks 28–40):

• Visit 5 (28–30 weeks):
• Fetal growth scan if indicated
• Rh antibody screening for Rh-negative mothers
• Anti-D injection for Rh-negative mothers at 28 weeks
• Presentation of baby (head-down or breech begins to matter)

• Visit 6 (32–34 weeks):
• Fetal position assessment
• Pre-eclampsia screening (blood pressure, urine protein)
• Fetal movement monitoring instructions
• Birth plan discussion

• Visit 7 (36 weeks):
• Final presentation check (if breech, discuss options including external cephalic version or planned C-section)
• Birth readiness assessment
• Neonatal care discussion

• Visit 8 (38–40 weeks):
• Final pre-delivery assessment
• Cervical examination if indicated
• Finalize delivery plan
• Admission instructions

What Tests Are Done During Antenatal Care?

Antenatal testing follows a schedule based on gestational risk. The tests performed at A&B include the following across the pregnancy:

Blood tests:

• Blood group and Rh typing (every pregnancy, first visit)
• Complete blood count (CBC) — screens for anemia, which is very common in Nepal
• Blood glucose (fasting and postprandial or GTT at 24–28 weeks) — screens for gestational diabetes
• VDRL/RPR — syphilis screening
• HIV testing — critical for prevention of mother-to-child transmission
• Hepatitis B surface antigen — determines need for neonatal prophylaxis
• Thyroid function (TSH) — in women with symptoms or history of thyroid disease

Urine tests:

• Dipstick urinalysis at every visit: protein (pre-eclampsia marker), glucose (gestational diabetes), infection
• Urine culture at first visit — detects asymptomatic bacteriuria, which can cause preterm labor if untreated

Ultrasound schedule:

• 8–12 weeks: Dating and viability
• 11–13 weeks: Nuchal translucency (Down syndrome screening)
• 18–22 weeks: Anatomy scan (detailed fetal organ survey, placental position)
• 28–32 weeks: Growth scan if clinically indicated
• 36 weeks: Position and placental grading

What Should Pregnant Women in Nepal Eat and Avoid?

Nutrition in pregnancy is critical in the Nepali context, where anemia, calcium deficiency, and iodine deficiency are common.

Eat more of:

• Iron-rich foods: dark leafy vegetables (spinach, fenugreek), lentils, liver, beans — to combat iron-deficiency anemia
• Calcium-rich foods: dairy products, sesame seeds, dark green vegetables — for fetal bone development
• Protein: lentils, eggs, fish, chicken, milk — for fetal tissue development
• Iodized salt: iodine is essential for fetal brain development
• Folic acid sources: leafy vegetables, legumes — plus a daily folic acid supplement (400–800 mcg) throughout the first trimester

Avoid:

• Raw or undercooked meat and eggs — risk of Listeria and Salmonella
• Unpasteurized milk and soft cheese
• High-mercury fish (swordfish, king mackerel, shark)
• Alcohol — no safe level in pregnancy
• Excessive caffeine — limit to 200 mg/day (approximately one cup of tea)
• Papaya (especially unripe) — traditionally avoided; unripe papaya may stimulate uterine contractions

What Are the Danger Signs During Pregnancy That Require Immediate Care?

Every pregnant woman should know these warning signs that indicate possible serious complications requiring immediate assessment at A&B:

• Vaginal bleeding at any stage of pregnancy
• Severe headache or visual disturbances (blurred vision, spots) — may indicate pre-eclampsia
• Severe abdominal pain — may indicate abruption, ectopic pregnancy (first trimester), or labor
• Swelling of the face, hands, or feet that is sudden or severe
• Decreased or absent fetal movement after 28 weeks (the baby should move at least 10 times in 12 hours)
• Fever with rigors — risk of malaria, urinary tract infection, or other serious infection in pregnancy
• Leaking of fluid from the vagina before 37 weeks — premature rupture of membranes requires immediate assessment
• Convulsions — eclampsia is a medical emergency

Does ECHS Cover Antenatal Care at A&B Hospital Pokhara?

Yes. ECHS-eligible women (ex-servicemen’s spouses and dependents) receive cashless coverage for antenatal care at A&B International Hospital, including consultation visits, blood tests, ultrasound, and supplementation within ECHS guidelines.

ECHS cardholders should register at A&B at their first antenatal visit and bring supporting documentation. The hospital’s team assists with any pre-authorization requirements.

Start Your Antenatal Care at A&B International Hospital Pokhara

Early booking leads to better pregnancy outcomes. A&B International Hospital provides structured, evidence-based antenatal care in Pokhara — with all blood tests, ultrasound coordination, and birth planning under one roof.

A&B International Hospital

Pokhara-02, Bindhyaabasini

Phone: +977 061-412512

Website: abinthospital.com

Book your first antenatal appointment as soon as your pregnancy is confirmed. ECHS cashless coverage available. 24/7 maternity emergency services on site.