Confirm the pregnancy.,
Get a transvaginal ultrasound.,
Schedule a thorough exam.,
Determine your blood type.,
Complete a first trimester screening.,
Conduct a urine screen.,
Screen for the Zika virus.,
Check for gestational diabetes.,
Have a fetal ultrasound during the second trimester screening.,
Be prepared for blood testing.,
Have an amniocentesis performed.,
Have routine urine testing.,
Submit to testing for group B Streptococcus (GBS).,
Conduct a kick count.,
Conduct a nonstress test.,
Consider a biophysical profile.,
Understand that you have the right to refuse a test.,
Talk with your healthcare provider.,
Consider genetic counseling.
One of the main purposes of the first doctor’s visit is to confirm that you are actually pregnant. This is done through urine pregnancy test taken in the office. If there is a concern for miscarriage or ectopic pregnancy, then you may need to have a blood test.
Don’t take this personally. The doctor is not doing the test because they don’t believe you. They simply want to make sure that you didn’t get a false positive (a positive test when you actually aren’t pregnant) or that you haven’t miscarried early on in the pregnancy, as this is relatively common. Many women have miscarriages without even realizing they were pregnant.;
, During a transvaginal ultrasound, the doctor will insert a probe into your vagina. The purpose of this testing is to: confirm the pregnancy, determine whether or not multiple embryos are present, find the baby’s heartbeat, determine the cause of any bleeding (if you are experiencing it), and to detect an ectopic pregnancy, which occurs when the fertilized egg has attached itself somewhere outside the uterus.This test should not be painful, though if you are stressed or tense during the exam, you might experience some discomfort. You might also experience some light spotting (bleeding) after the exam. This is nothing to worry about as it is usually caused by a few broken cervical blood vessels. The color of the spotting (if it occurs) is usually light brown or pinkish. If the blood is bright red and you are also experiencing cramping in the lower abdomen you should contact your doctor right away.
, When you find out you’re pregnant, you will need to schedule a visit with a doctor or certified nurse-midwife a thorough examination. During this exam you will have your height, weight, blood pressure, and pulse measured. Your doctor will ask many questions about family history of both you and your partner, as well as general questions about lifestyle (diet, medication use, activity level, etc.).You will likely also have a gynaecological exam which includes a breast exam, a pap smear, and blood test to determine blood type, complete blood count, and for specific STIs.
At this point, your doctor may also suggest additional tests to check for health problems based on your risk factors, such as anemia or an inherited diseases you may not be aware of.
, You will need to have your blood drawn so that your doctor can determine your blood type. If the father of the baby has a positive blood type while you have a negative one it is possible that your baby will have an Rh positive blood type. While this usually doesn’t affect a first pregnancy, it can lead to complications in later pregnancies because the mother’s blood may create antibodies that will attack the growing fetus if they have a blood type that is Rh positive (this is called Rh disease).For example, if you have O- type blood and the baby’s father has A+ type blood, your baby may have a positive blood type as well. If this is the case, your doctor will give you two injections: one around 28 weeks of pregnancy and another within 72 hours of giving birth. This injection is called Rh immune-globulin and acts as a vaccine that will prevent your body from making antibodies against your new baby or any future babies you might conceive.
If you don’t know the father’s blood type and cannot find out for whatever reason, don’t worry. Your doctor may take steps to prevent any complications as a precautionary measure.
, A first trimester screening is a comprehensive check that usually involves a test of the mother’s blood and an ultrasound. The purpose of this test is to screen for potential chromosomal disabilities such as Down syndrome (also called trisomy 21) as well as trisomy 13, 18, spina bifida, and neural tube defects.This test will usually be done between 11 and 14 weeks. Your doctor will use information about you, such as your age and the results of the blood test to determine the likelihood that your baby will suffer from chromosomal abnormalities.
The test measures a protein in your blood known as AFP that is only present during pregnancy. Abnormal levels of this protein can indicate physical defects, chromosomal defects, or tubal defects, but it can also indicate a miscalculated due date or that the mother is pregnant with multiple babies.
If the results come back abnormal, your doctor may investigate further by recommending an ultrasound to see whether or not there are any physical defects, or they may recommend that you have an amniocentesis performed.
It is important to be aware, though, that this testing is optional. While this test does successfully detect 85% of abnormalities, it also has a 5% false positive rate. This means that in 5% of cases, the test will detect abnormalities that aren’t present.Remember that genetic testing is only a screening tool, not a diagnostic tool. If the results are abnormal it does not necessarily imply that something is wrong with the baby. It may also indicate that you are pregnant with twins or that your doctor has miscalculated the due date, for example.
, Your doctor will also have you pee in a cup so that they can test your urine for high protein levels, which may indicate kidney problems. Urine tests can also be used to check for preeclampsia, a potentially life-threatening condition, which is usually characterized by high-blood pressure and high protein levels in the urine.Urine tests are yet another way to check for gestational diabetes.
A urine test may also be used to make sure that there are no bacteria in the body that could cause harm to you or the fetus.
Note that you will likely have your urine tested at every visit for the duration of the pregnancy.
, Zika is a virus that is spread through the bite of an infected mosquito.Recently, there have been outbreaks of the Zika virus in certain parts of the world. A link between exposure to the virus and several birth-related complications, especially microcephaly, has been identified. Microcephaly is a birth defect which results in an abnormally small head, and can result in many different mental deficiencies.If you have recently travelled to any country in the Caribbean, Central America, the Pacific Islands, or South America you should inform your doctor whether or not you think you were exposed to the virus.There is a screening test for the virus that you may be able to get as part of your early prenatal screening.
, Based on your body mass index (BMI) or family history, your doctor may wish to perform a test to check for gestational diabetes during the first trimester of pregnancy; however, if your BMI is normal and you don’t have any family history of diabetes, then this test will normally be performed in the second trimester, usually between weeks 24 and 28.The test involves drinking a glucose solution and then testing your blood sugar levels about an hour later. If you have higher than normal blood sugar, this does not necessarily indicate that you have gestational diabetes. However, your doctor will likely do follow-up testing to determine whether or not you do.
Gestational diabetes often disappears after you give birth, but you will need to be aware that you are at higher risk for developing type 2 diabetes if you developed gestational diabetes, so it is important to monitor your blood sugar and eat a healthy diet., For many soon-to-be parents this is the best part of prenatal testing. A fetal ultrasound allows the sonographer to have a look at the growing baby’s anatomy. For the parents, it gives them a chance to actually see their baby before they are born. If you want them to, the doctor may also be able to tell you the sex of the baby.During this exam, the sonographer will be measuring and examining several things. Things they will be looking at include: the shape and size of your baby’s head, signs of a cleft palate, spine and skin deformities, the heart to make sure it is not developing abnormally, the abdominal wall (which is a common place for defects to occur), the kidneys to make sure there are two of them, as well as fingers and toes (though they won’t be able to count them). They will also be looking at your uterus and the location of the placenta to make sure it is not covering your cervix., A blood test may be performed as a follow up to testing from the first trimester, checking your levels of AFP. Testing for genetic disorders can usually be confirmed if testing is done during both the first and second trimester., If you have an increased risk of chromosomal abnormalities, you will likely be offered an amniocentesis. This involves taking a sample of amniotic fluid using a needle inserted into the abdomen. The fluid is then tested to diagnose genetic or chromosomal abnormalities.It may sound scary and some patients do report some cramping during the procedure, but it is a relatively painless procedure. If you do have an amniocentesis performed, you will need to rest for the next 24 hours.
, Fortunately, the number of tests performed usually drops in the third and final trimester as long as both mother and baby are deemed to be healthy, and there are no other complications. Urine testing, however, will continue to monitor the protein levels and to detect any unusual bacteria., Testing for GBS, a bacteria that is normally present in the intestines, is standard between 35 to 37 weeks. If GBS infects your baby, it can cause serious illness. The test involves taking swabs from the anal and genital regions to test for traces of the bacteria.If you test positive for the bacterium, you will likely be given antibiotics during labor to protect your baby.
, If you don’t feel your baby moving, are past your due date, carrying more than one baby, or have chronic health conditions, your doctor may ask you to measure the amount of time it takes your baby to move ten times while lying on your side.The best time to do this test is directly after eating as this is when babies tend to be most active. If the baby does not kick at least 10 times in two hours or if the number of moves seems to be decreasing, your doctor may order additional testing.
, If you have risk factors such as chronic health conditions or are carrying multiples, this test may be conducted more than once beginning at 32 weeks (possibly earlier). A strap will be placed around your abdomen to monitor the baby’s heartbeat. The test usually takes anywhere from 20 – 40 minutes.
A baby whose heart rate doesn’t rise when he moves may simply be sleeping. Your doctor will try to wake the baby using a buzzer placed on the belly. If the problem persists, further testing will be done.
, If your baby is overdue or if you’ve had many complications throughout your pregnancy, your healthcare provider may want to complete a biophysical profile. The test involves an ultrasound combined with the nonstress test, and helps the doctor to determine whether your baby may benefit from being delivered as soon as possible.For example, if your level of amniotic fluid is low, your doctor may wish to deliver the baby as soon as possible.
, There are many different prenatal screening tests that you can have done. Some are routine and some are not. Regardless of whether or not they are routine it is important to remember that as the parent of your unborn child, you have the right to refuse any test that you are uncomfortable with.This is not to suggest that you should refuse testing. The point here is to make clear that you are able to make these decisions without feeling forced.
, If you feel unsure about whether or not you want to submit to a particular prenatal test, feel free to voice your concerns with your healthcare provider. Ask them to explain the benefits and risks of the test you are concerned about, and ask them what the consequence of not having the test done might be.
Remember that different healthcare providers might have different ideas about what is a good and not good reason to have a test. If you trust your doctor, there is no reason to doubt them, but do keep in mind that they are human, and they cannot predict the outcome of any test with 100% accuracy.
, Genetic counseling should preferably take place before conception, if indicated by family history. The purpose of genetic counseling is to determine the probability of your baby having a congenital defect, the risks to your baby, the treatments available, the prenatal tests available and the possible courses of action to help with your decision-making.You should not be told what to do. All tests are voluntary and the counselor may suggest different options, but the decision will be yours.
Understanding how diseases can be inherited and the implications of dominant, recessive and x-linked genes provide helpful background information.