According to the WHO and Indian guidelines, at how many weeks of gestation should the first antenatal care visit ideally occur?

Explanation

## Timing of First Antenatal Care Visit **Key Point:** The first antenatal care (ANC) visit should occur as early as possible in pregnancy, ideally before 12 weeks of gestation (first trimester). ### Rationale 1. **Early detection of risk factors** — Allows identification of maternal medical conditions, obstetric history, and lifestyle factors that may affect pregnancy. 2. **Baseline investigations** — Blood pressure, weight, urine analysis, and blood tests (ABO/Rh typing, infectious disease screening) are performed. 3. **Dating of pregnancy** — Accurate gestational age assessment is most reliable in the first trimester (±3–5 days accuracy). 4. **Counselling and education** — Early engagement enables nutrition, hygiene, and danger sign education. ### WHO and Indian Guidelines - **WHO recommendation:** First contact before 12 weeks of gestation. - **Indian NRHM/RCH guidelines:** First ANC visit should be within the first trimester. - **Subsequent visits:** Minimum 4 ANC visits recommended (one per trimester + one in the third trimester). **High-Yield:** Early first visit (before 12 weeks) is the gold standard for optimal maternal and fetal outcomes; delays increase risk of missed complications. **Clinical Pearl:** In resource-limited settings, even if the first visit is delayed, it should not be deferred — late first visits still provide value for risk assessment and baseline investigations.