Monitoring of Pregnancy and Medical Examinations During Pregnancy, Ministry of Health
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Monitoring of Pregnancy and Medical Examinations During Pregnancy

Regular monitoring of pregnancy allows early detection of health problems that could arise during pregnancy, and their treatment, thus increasing the chance for a normal pregnancy and the birth of a healthy baby.
The information below relates to examinations recommending during pregnancy for women who have no risk factors. As needed, changes are possible in the framework of the monitoring and the scope of the examinations recommended for you. The monitoring of women with a high-risk pregnancy will be performed in the HMOs (kupot cholim).
The information detailed below is not intended to provide all the information pertaining to pregnancy and examination during pregnancy, and it does not constitute a substitute for individual medical consultation.

  • At your first meeting with the physician before or during the pregnancy, it is desirable to attend with your partner. At this meeting, the physician will collect medical information about you and your extended family, and will determine which examinations, treatments and consultations etc. should be performed before and during the pregnancy.
  • It is desirable that the management and coordination of the monitoring of the pregnancy be performed by one party. Multiple care providers do not ensure optimal treatment, and can even make monitoring and treatment more difficult.
  • The table below details the examinations recommended during pregnancy, the time of their execution and their objectives. The examinations are arranged by age of pregnancy in weeks, or by trimester. Most of the examinations are offered routinely, to every pregnant woman and in every pregnancy. Some of the examinations are intended for the early detection of defects in the fetus, and you must decide whether you wish to perform these examinations. You might be advised to perform additional examinations, in accordance with your own individual profile and with the course of your pregnancy.
  • Some of the examinations detailed are included in the Health Basket, and are provided in the framework of Tipat Halav Mother and Infant Care Centers or the HMOs (kupot cholim); and some of them are not in the basket, but are recommended by the Ministry of Health and professional medical associations. Also, as per the judgment of the treating physician, there may be additional examinations. The examinations that are not included in the Health Basket can be performed privately, by payment, or are sometimes partially covered by supplementary insurance of the HMOs or private insurance. Prior to performing the examinations that you wish to undergo, it is desirable to check your eligibility at the HMO that insures you. 
    It is to be noted that the table does not show all possible examinations, and that in the framework of private and public medicine, there is an ever increasing availability of various examinations that can be performed during pregnancy, including examinations for which there is no recommendation by professional medical associations. These examinations do not appear in the table.
  • The list of examinations is updated from time to time. It is therefore recommended to obtain updates from the medical staff.

It is important to emphasize that the decision as to whether perform each of the examinations is your own.

Examinations are recommended by week of pregnancy (the table does not include all possible examinations).
* The examinations marked with an asterisk (*) are recommended for every woman by the professional associations and the Ministry of Health.

​Time Performed Examination​ Purpose of the Examination​ Payment for the Examination​ Remarks​
Prior to the pregnancy or as early as possible during the pregnancy​ ​* Blood test to identify carriers of hereditary diseases. ​Identification of couples at increased risk for giving birth to offspring with hereditary disease. As needed, additional tests will be performed to diagnose the embryo’s/fetus’ condition. ​Some of the examinations are included in the basket. Check your eligibility for the funding of the remaining examinations with your HMO. ​At each pregnancy, be updated to find out whether additional examinations have been added to the list of those recommended. A leaflet about this can be obtained at the center.
​Immediately after the first visit at the center, preferably by Week 12 ​* Blood test for blood count, blood and Rh type, fasting sugar; syphilis antibodies, and urine test for general and for culture ​Detection of blood deficiency, thalassemia carrier, incompatibility of partner’s blood type, gestational diabetes and occult infection in urine. ​The tests are included in the basket and can be performed at the HMO. ​If you are Rh-negative, a test for Rh antibodies will be performed. Additional tests will be performed as per medical judgment.
​Week 6 - 12 ​*Ultrasound ​Determination of the age of the pregnancy, its normality and the number of embryos/fetuses. ​The examination is included in the basket, and is performed at institutes determined by the HMOs.
​Week 10 - 12 Chorionic villus sampling test ​Testing of the embryo’s/fetus’ chromosomes, and diagnosis of genetic diseases of the embryo/fetus. ​By recommendation of a clinical geneticist. The test is included in the basket.
Eligibility will be granted only to patients who underwent the process without private funding, whether full or partial, whether by themselves or by a party on their behalf (including an insuring party or the HMOs’ complementary insurance).
​Week 11+0 - 13+6 ​* First trimester screening, including:
1. Nuchal translucency determined on ultrasound examination;
2‏. Blood test for PAPP-A and for free beta HCG
​Early detection of various defects and early determination of the level of risk for Down syndrome in the fetus. ​These screening tests are not in the basket. Check your eligibility for funding of the test with the HMO. In a multiple pregnancy, the translucency test is included in the basket. ​If the result indicates elevated risk for a defect - seek genetic counseling.
​Week 13 - 17 ​Early ultrasound fetal anatomy survey ​Detection of congenital defects or abnormalities in fetal anatomy. ​The test is not in the basket. ​This examination does not replace the survey in Week 19-25.
​Week 16 - 20 ​* Second trimester screening: Triple Screen Test (fetoprotein, HCG, estriol). Or second trimester screening: Quad Screen (Triple Screen Test + inhibin) ​Determination of the level of risk for Down syndrome and/or for severe defects of the brain and the neural tube, of the abdominal wall and others. ​The test is included in the basket, with partial participation of the pregnant woman.
The Quad Screen is not in the basket. Check your eligibility for funding of the test with the HMO.
​The tests are not performed after Week 20, and it is important to perform them on time and before this Week.
The Quad Screen is more sensitive than the Triple Screen Test in determining the level of risk for Down syndrome.
​Week 16 and beyond ​Amniotic fluid test ​Testing of the fetus’ chromosomes, and diagnosis of genetic diseases of the fetus. ​The test is included in the basket for women aged over 35 at the beginning of the pregnancy, or by recommendation of a geneticist at any age. Eligibility will be granted only to patients who underwent the process without private funding, whether full or partial, whether by themselves or by a party on their behalf (including an insuring party or the HMOs’ complementary insurance).
​Week 19 - 25, recommended in Week 20 - 23 ​* Ultrasound examination for a “basic” fetal anatomy survey. Or ultrasound examination for a “comprehensive” fetal anatomy survey ​Detection of congenital defects or abnormalities in fetal anatomy. The examination is routinely performed in every pregnancy. ​The basic examination is included in the basket. The more comprehensive fetal anatomy survey can be performed privately and by payment. Check your eligibility with the HMO. ​The comprehensive examination provides more details and information about the fetus, but does not include all the organs of the fetus.
​During the second or third trimester of the pregnancy ​Ultrasound examination directed to the examination of a specific organ or focused on a specific clinical situation ​Provision of answer to a defined and focused question regarding a defect in the fetus or a medical condition of the mother or fetus. ​The test is included in the basket in the presence of a medical indication and by recommendation of a physician.
​Week 24 - 28 ​* Blood count, glucose tolerance test. Rh antibodies (as needed) ​Diagnosis of anemia, suspected gestational diabetes. ​These tests are included in the basket. ​Rh antibodies will be tested for in Rh-negative women.
​Third trimester ​Ultrasound examination during the third trimester. ​Monitoring of fetal growth and diagnosis of fetal position. ​The test is included in the basket in the presence of a medical indication and by recommendation of a physician. ​Recommended for all women by the Israel Society of Obstetrics.
​After the expected date of delivery ​* Monitoring by a physician includes examination with ultrasound and electronic fetal monitor ​To verify the normality of the continued pregnancy. ​These tests are included in the basket. ​The tests are usually performed every 2-3 days, at the HMO or at hospital, as per the HMO’s guidelines.
 
For your information:
  • The decision to perform examinations connected to the detection of defects, including Down syndrome, is a personal one and is not based only on medical considerations. It is desirable to consult with the medical staff before performing the examinations, and to read the booklet at Tipat Halav.
  • First and second trimester screening tests provide an indication only of the level of risk for an embryo/fetus with Down syndrome or another chromosomal problem.
  • For final diagnosis of Down syndrome or another chromosomal problem, an invasive test needs to be performed: chorionic villus sampling test or amniotic fluid test. The recommendation of the Ministry of Health and of the medical associations is to consider performing an invasive test only after screening tests have been performed. Women who have no medical indications for chorionic villus sampling test or for amniotic fluid test, or who have not performed screening tests, may perform amniotic fluid test or chorionic villus sampling test by private funding.
  • Women who were aged 35 or over when they became pregnant, or who have a medical indication following genetic counseling, are entitled to a chorionic villus sampling test or an amniotic fluid test with funding from the Ministry of Health, at institutes approved by the Ministry. Eligibility will be granted only to patients who underwent the process without private funding, whether full or partial, whether by themselves or by a party on their behalf (including an insuring party or the HMOs’ complementary insurance).
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