HEDI - Maternity Record (Mutterpass) Pages 7 and 8: Gravidogram

The gravidogram chart is a structured overview of the course of your pregnancy. Your gynaecologist or midwife will note down important results from all of your check-ups on this double page. This helps them keep a good overview. The first two columns of the gravidogram chart record the dates of your check-ups as well as the week of gestation. This number can be updated again in the third column. A correction may be necessary, for example, after an ultrasound examination. Healthcare providers can then better assess how far the pregnancy has really progressed.

Distance between the uterus and the pubic bone

The fourth column contains information on the fundal height. The word fundus refers to the upper part of the uterus. The fundal position refers to the distance between the edge of the uterus and the pubic bone, the navel and the costal margin (the lower border of the front of the rib cage). From around the 16th week of pregnancy, the edge of the uterus can be felt about a hand's breadth below the navel. The fundal position continues to increase throughout the pregnancy. From around the 24th week of pregnancy, your midwife or doctor can even feel it from the outside at your navel. In the third trimester from about the 36th week, you can even feel it under your ribs. The closer your due date gets, the lower the edge of the uterus sinks again.

How is the baby sitting in the womb?

Determining the fetal position is important so that the birth is as risk-free as possible. The doctor or midwife determines the fetal position at your check-ups. They use abbreviations to note the result in the fifth column of the gravidogram chart. SL stands for the German for cephalic presentation. This means that the child's head is down. In Germany, BEL denotes that the baby is breech, meaning it is positioned with its bottom downwards. QL is the abbreviation for shoulder presentation in German. Then the baby's head and bottom are both on the side so it is lying perpendicular to the mother.

Fetal heartbeat and movements

The sixth column of the gravidogram chart is where health care providers can note whether they were able to detect a fetal heartbeat. They then write a ‘+’ and note what tools they used to make the measurement. ‘US’ stands for ‘ultrasound measurement’. ‘CTG’ is the abbreviation for ‘cardiotocography’. If you can feel the baby move, the examiner will also document this with a ‘+’. Most pregnant people feel the baby move for the first time between the 17th and 20th weeks of pregnancy.

Fluid retention and varicose veins

The seventh and eighth columns of the gravidogram chart are about your health. If you are experiencing fluid retention, the person doing your exam will make a note of it. The technical term for fluid retention in your body’s tissues is edema. Varicose veins are referred to as Varikosis. Varicose veins and edema are common during pregnancy and are usually not dangerous. Still, you should bring any symptoms to the attention of your medical care providers. This is the only way to avoid unnecessary risks.

Weight

Your doctor or midwife also regularly uses the ninth column to note your current weight. This is important because extreme weight gain can be harmful to you and the fetus. The cause of insufficient weight gain must also be clarified.

Blood pressure and haemoglobin

Your blood pressure is measured regularly and entered in the tenth column of the gravidogram chart. It normally drops a little below the usual value during pregnancy. Blood pressure that is too low starts at values below 100/70, while an increased high blood pressure starts at 140/90. The eleventh column is also about blood. There you will find the abbreviation Hb. It stands for haemoglobin. This is the red blood pigment that carries oxygen. If your red blood cell count is too low, your doctor or midwife will recommend taking iron supplements. An adequate oxygen supply is important when you’re pregnant.

Urinalysis

Results from regular urine tests are documented under the heading Sedimente in column twelve. This is important because unusual values can indicate diseases or other problems. White blood cells in the urine, for example, indicate inflammation or infection. If there is nitrite in your urine, you may be suffering from a urinary tract infection, and if your blood sugar is elevated, gestational diabetes could be to blame.

Further check-ups, screenings and measurements

Your doctor or midwife will carry out a series of vaginal examinations, especially during the first and second trimesters. They will examine your vagina and abdomen. In the last trimester of pregnancy, vaginal exams are no longer done at every check-up. They will check whether your cervix is closed, whether your cervix is shortened and whether you may have a vaginal infection. These checks are important because irregularities may indicate that a miscarriage is possible. The last two columns of the gravidogram chart are used to enter what types of pregnancy risks should be kept in mind. It is also noted which additional tests and therapies were carried out.