Routine Antenatal Care Schedule & Screening in Victoria
Evidence-based routine antenatal care schedule in Victoria aligned with RANZCOG: trimester screening, NIPT, morphology scan, GDM, and maternal vaccines.
First Trimester Care (Conception to 13+6 Weeks)
Early presentation to your GP establishes the foundation for a healthy pregnancy:
- Baseline Pathology: Full blood examination, blood group and antibody screen, rubella immunity, hepatitis B, hepatitis C, HIV, syphilis serology, midstream urine culture, and ferritin.
- Periconceptional Supplementation: Folic acid (500 mcg daily, or 5 mg daily if high-risk for neural tube defects) and Iodine (150 mcg daily) to support neural tube closure and foetal thyroid development.
- Aneuploidy & Carrier Screening: Non-Invasive Prenatal Testing (NIPT / cell-free foetal DNA from maternal blood) from 10 weeks offers >99% sensitivity for Trisomy 21 (Down syndrome), Trisomy 18, and Trisomy 13. Three-gene carrier screening (cystic fibrosis, spinal muscular atrophy, fragile X syndrome) is offered to all couples.
- Dating Ultrasound (7–9 weeks): Confirms intrauterine location, foetal cardiac activity, and accurate gestational age.
Second Trimester Care (14 to 27+6 Weeks)
The second trimester focuses on anatomical development and maternal metabolic monitoring:
- Anatomy Ultrasound (18–20 weeks): A detailed structural survey evaluating the brain, spine, heart chambers, facial profile, abdominal wall, kidneys, limbs, and cervical length.
- Gestational Diabetes Mellitus (GDM) Screening (24–28 weeks): A fasting 75g 2-hour Oral Glucose Tolerance Test (OGTT). Early diagnosis and dietary/insulin management prevents foetal macrosomia and birth complications.
- Full Blood Examination & Antibody Rescreen: Evaluating for physiological anaemia of pregnancy and atypical maternal antibodies.
Third Trimester Care (28 Weeks to Birth)
Visits increase to fortnightly from 28 to 36 weeks, and weekly from 36 weeks until delivery:
- Foetal Growth & Wellbeing: Serial symphysis-fundal height (SFH) measurements, foetal heart auscultation, and assessing foetal lie and presentation.
- Blood Pressure & Pre-Eclampsia Surveillance: Routine urinalysis for proteinuria and screening for symptoms of pre-eclampsia (headaches, visual disturbances, epigastric pain).
- Group B Streptococcus (GBS) Screening (35–37 weeks): Low vaginal-perineal swab. If positive, intrapartum intravenous antibiotic prophylaxis (IV penicillin/ampicillin) during labour prevents neonatal early-onset GBS sepsis.
Archival Document Available: You can also access Dr Tseng's original reference sheet as a printable PDF.
Download Original PDF