Routine testing is required at regular intervals during pregnancy. The routine testing is listed here, please ask your doctor if you have any questions about any of the specific tests. Testing may be different for women with different risk factors, this is meant only as a general guide.
One of the most common tests done during pregnancy is an ultrasound exam (sonogram). Ultrasound scanning involves the use of a handheld probe, called a transducer, which sends out sound waves of very high frequency but very low power. These sound waves bounce off structures and are reflected back to provide a picture of the baby or pelvic structures.
There are many reasons your doctor might order a sonogram during your pregnancy. In our practice, a sonogram is frequently ordered between 18-20 weeks to be done at another facility, where they will evaluate fetal anatomy, including heart, brain, and spine. Other information, such as placental location, amount of amniotic fluid, and fetal activity can also be assessed. Many, but not all, birth defects may be seen on ultrasound. At present there are no known risks to the baby or the mother from an ultrasound exam.
Please remember that ultrasound is a medical diagnostic test, and is ordered for reasons of medical necessity. Ultrasound is not recommended for entertainment purposes.
Generally done at the first prenatal visit, the first lab work includes a blood type, screen for antibodies, screen for several STDs (HIV, syphilis, gonorrhea, chlamydia, Hepatitis B), a rubella titer, a complete blood count to screen for anemia, and a urine culture.
A note re: HIV testing. Routine HIV testing for pregnancy was implemented in January 1996 (House Bill 1345) and requires that all women be tested at their first prenatal visit and again in the third trimester. You have the option of refusing testing or being referred to facility where you can be tested anonymously. We strongly encourage you to be tested, as treatment of HIV positive mothers can dramatically reduce the risk of babies becoming infected with HIV during pregnancy or delivery.
At the beginning of the third trimester (between 24-28 weeks), all women are screened for gestational diabetes. In some instances, depending on your history, you may be screened earlier in pregnancy. The screening is done with a two hour glucose tolerance test. This test consists of coming in on an empty stomach and having a
fasting blood glucose level drawn. A concentrated sugar beverage is then consumed, and repeat glucose levels are drawn 1 and 2 hours after consuming the drink.
Your blood type is determined with the first prenatal labs at your first OB visit. If you are Rh negative and your partner is Rh positive, or you do not know your partner’s blood type, then your baby may be Rh positive. If that occurs, then there is a risk that blood cells from the Rh positive baby can enter your system and cause an immune response, prompting your body to make antibodies against your baby’s blood. This can cause severe problems in future pregnancies, including severe and even fatal fetal anemia.
If you are Rh negative, you will be given a Rhogam shot at around 28 weeks, and also at any time we think there may be a risk of bleeding from the baby’s system to yours. This is repeated after delivery, if the baby’s blood type is confirmed to be Rh positive. In almost all cases, this Rhogam shot will prevent your body from making antibodies against future pregnancies.
At the time of your diabetes screening, you will also have a repeat complete blood count, as many women may not develop anemia until late in pregnancy. If you demonstrate anemia at this time, you may be asked to start an iron supplement, to help prepare your body for the blood loss that accompanies childbirth.
Around 35-37 weeks of pregnancy, a vaginal/rectal culture for Group B Strep (GBS) bacteria will be obtained. The bacteria are normally harmless for you and are common colonizers of the lower intestine. However, if the bacteria is present around the vaginal area at the time of delivery, it can cause an infection in the baby, such as pneumonia or sepsis. If you test positive for GBS, you will receive antibiotics during labor to help reduce the baby’s risk of infection.