Why should a pregnant woman apply for an exchange card?
Why does a woman carrying a child need a special document that she must carry with her from the 30th week? It contains very valuable information about her health and the progress of her pregnancy. This helps the doctor monitor all the changes that occur at different stages of pregnancy, prescribe medications, and draw conclusions about the need for hospital treatment.
Based on the data recorded in the card, a forecast will be made regarding possible problems during delivery. All this will help obstetricians choose the right delivery strategy. After the birth of the child, notes are also made on the card about how the woman’s recovery is going in the postpartum period.
After discharge from the maternity hospital, the card is transferred to the children's clinic, where the child will continue to be served. That is, the exchange card is a valuable document that contains all the data about the course and completion of the “interesting situation.”
What if there is no exchange card?
They will not be able to refuse admission to the maternity hospital. But you understand: the less doctors know about the progress of pregnancy, the condition of the fetus and the risks, the greater the likelihood that in the event of a critical situation they will not be able to provide you with quality medical care. And even more so – to prevent the development of complications. So timely registration is, first of all, your concern for the future baby, his and your own health.
By the way, if you are being seen in a private clinic, you are also required to create and eventually issue an exchange card in an officially approved form.
And don’t forget – the exchange card is kept throughout your pregnancy. Its presence is required when visiting a gynecologist, specialized specialists, as well as when entering the maternity hospital.
Important! If you want to bear a healthy child, it is in your interests to register for pregnancy no later than 12 weeks. This way you minimize risks, and the knowledge that everything is under the doctor’s control will give you confidence and peace of mind. Without an exchange card, you will not be taken to the maternity hospital that you choose yourself, but will be sent to the nearest medical facility, to the observation department - for unexamined women.
What does this document look like and when is it issued?
This name is given on a special form. It has a standard form, so all pregnant women in all antenatal clinics receive the same document. It is started at the first visit to the doctor, when a woman comes to register. Specialists from different medical institutions make their marks in this document: antenatal clinic (private obstetric clinic), maternity hospital. Doctors who advise the pregnant woman also make notes on this form.
According to Order No. 50 of February 10, 2003, the doctor must issue the card to a pregnant woman no earlier than 22-24 weeks. In fact, they can give it away right away. If the card is in the patient’s hands, then it should be taken with you every time you visit the doctor. After 24 weeks (when congenital defects are diagnosed and artificial termination of pregnancy becomes impossible), but no later than 30 weeks, the woman will be given a card. It should be handled with care; It is better to place it in a waterproof folder or file.
The doctor will add information to this document and paste in the ultrasound results until the end of pregnancy. The card must always be carried with you along with documents that confirm the woman’s identity, since childbirth can begin at any time.
For those who are interested in what a pregnant woman’s exchange card looks like, a photo of such a form will help to get a complete picture of it. Briefly, it can be described as follows: outwardly, it looks like a black and white brochure, has a soft cover, on which advertising announcements regarding pregnancy and childbirth are sometimes printed.
This form contains columns where personal data is entered, as well as tables and graphs. At the end of the card there are recommendations for future parents (how to behave during pregnancy and during childbirth, how to handle a newborn).
When and who issues an exchange card?
Such a card is created from the moment a pregnant woman first contacts an obstetrician-gynecologist; it is initially kept in the antenatal clinic. And they give it to you at 32 weeks of pregnancy. From now on, it is better for the expectant mother to constantly take the exchange card with her in case of unforeseen circumstances. If you suddenly feel unwell on the street, end up in the hospital by ambulance, or go into premature labor, the likelihood that you will be brought to the clinic where you are being observed is not very small. After all, in such a situation, every minute counts! With an exchange card, it is much easier and faster for the doctors who will assist you to find the best treatment options.
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Important! To receive an exchange card, you need a passport!
Who fills out the document and in what order?
Only medical workers have the right to enter any data into a pregnant woman’s card. All fields must be completed. Deleting information is not permitted. Additional information placed on the pages or cover of the card by the sponsors who print the forms is for informational purposes only.
During the initial examination and registration, the gynecologist who is seeing the pregnant woman personally enters information into the first part of the card (about passport data and previous diseases). At subsequent visits, he records in detail all complaints, weigh-ins and test results, as well as any prescribed medications.
If a pregnant woman is admitted to a “pathology”, then she takes the card with her. Hospital doctors familiarize themselves with its contents and make notes about what medications were prescribed, procedures and studies performed on the woman in the department.
If a pregnant woman was admitted to the maternity hospital with contractions, and she does not have an exchange card, then she will be admitted to the observation department, since it will be considered that she has not been examined and has no information about herself. Women with signs of infectious infection are also placed there (even if they have an exchange card).
The section containing information about the birth and the woman in labor is filled out in the maternity hospital. The new mother will receive this part of the card in her hands to be sent to her antenatal clinic. The gynecologist of this medical institution will leave notes in the document about the early postpartum period and the well-being of the new mother.
The block dedicated to the newborn will be filled out by a neonatologist at the maternity hospital who conducted the first examination of the baby after his birth. The completed part will be given to the mother upon discharge home so that she can give it to the pediatrician.
Appearance
Depending on the conditions and capabilities of clinics and outpatient clinics, antenatal clinics, the document may have different covers, shape, design, but in essence it has standard features:
- looks like a brochure or book - with soft paper sheets;
- in black and white colors;
- contains columns and tables for recording indicators and personal data;
- is divided into two parts - for records of the antenatal clinic and for entering data in the maternity hospital.
In practice, the sheets of the card are not enough to accommodate all the tests, examinations and appointments of the pregnant woman, so additional sheets, inserts and documents are pasted into the “exchange”, which is why it becomes very voluminous by the end of the waiting period.
In some institutions, the “exchange” looks like an advertising brochure, since thematic advertisements are placed on the cover.
Content
In 2020, the bypass map consists of 6-8 pages of its own.
The title page of the card includes the personal data of the expectant mother in labor:
- Name;
- Date of Birth;
- place of registration;
- name of the medical institution;
- weight and height of the woman at the time of registration;
- pelvic girth;
- the day the baby first moves in the womb;
- expected day of birth.
- general information about pregnancy - sequence, presence or absence of abortions and miscarriages, gestational age, etc.;
Next comes the analysis section, where the numerical and symbolic values of the studies and observations are indicated. There is a table with the woman’s main indicators, which change during different waiting periods, so as appointments progress, new data is entered - about blood pressure, weight, hemoglobin level, and the result of a urine test.
Also included here are data from examinations of venous blood, ultrasound in various trimesters and other values:
- position of the child; normal is the longitudinal position, pathology is transverse or oblique;
- presentation - refers to the part of the child’s body that is closest to the birth canal; for normal delivery the head must be present; early detection of the baby’s pelvic presentation will eliminate all the dangers of this situation with the help of surgical intervention;
- fetal heartbeat - at each appointment, the gynecologist “listens” to the baby’s heartbeat; also in the third trimester, the woman undergoes a CTG examination;
- Tests for infectious diseases are required - syphilis, HIV, hepatitis B and C.
The results of stool tests for worm eggs and vaginal smears for viruses and infections are also recorded here.
The third section contains the results of the hospital - “bypass” of doctors:
- therapist;
- ophthalmologist;
- endocrinologist;
- dentist;
- otolaryngologist.
An important block of the document is a record of the issuance of a certificate of incapacity for work - given after 30 weeks to receive maternity pay.
Next comes the part of the card that is filled out in the maternity hospital. Here the title page with general information about the woman in labor is duplicated, and then the columns about the features of the past birth are filled in:
- presence or absence of surgical intervention;
- use of anesthesia;
- postpartum treatment;
- dates of admission and discharge.
Then data is entered into the section about the child - information is provided about his condition at birth, diagnoses, treatment, condition at discharge, and vaccinations.
Exchange card and dispensary book for a pregnant woman - what are the differences?
The exchange card in some consultations is called differently - “dispensary book”, “mother’s passport”, “maternal passport”. Essentially, this is one and the same document, which is drawn up according to a single standard. If there are differences between them, then, for the most part, they are external: design, color, size.
Both the card and the dispensary book will be accepted in the maternity hospital, since they contain the same information inside, and for doctors it does not matter what the pregnant woman’s card looks like from the outside.
Is the exchange card only issued at 30 weeks?
They definitely didn’t give me one when registering (2 years ago, Moscow).
But not at 30 either. Somewhere in between. For specialists (ENT, ophthalmologist, dentist, therapist, ECG) they issued some kind of bypass sheet, then the gynecologist copied everything in exchange.
It’s better to have it in your hands, of course, the sooner the better. In case of sudden hospitalization. Although the gynecology and maternity hospital will accept you without it, they may take repeated tests (wasted time).
When registered at 12 weeks.
From 27-28 weeks, you should note the baby’s movements in it. She should be in her arms. Go to the appearance with her.
I went through 2 pregnancies, didn’t make a single mark on it, and in general I’m hearing for the first time O_o
There simply isn't enough space
