Routine Testing – It is standard of care to obtain the following tests on the first visit for your pregnancy:
- CBC – A complete blood count is done to determine the ability to carry oxygen and nutrients through the body and to the fetus. This is repeated when the glucose challenge test is performed, and sometimes at around 36 weeks if you were anemic on an earlier visit.
- Rubella Titer – This test is done to determine your immunity status to Rubella (the German Measles). If the test shows non-immunity, the imunnization will be offered at the time of delivery.
- Hepatitis B – This test determines whether you have been exposed to Hepatitis B, or are a carrier.
- Blood Type and Rh, Antibody Screen – If you are Rh negative and the father of the baby is Rh positive, there is the possibility the baby could inherit the father’s blood type. This could cause a problem during this or future pregnancies. Fortunately, we can prevent this in most cases by giving you an injection of Rhogam which prevents your immune system from responding to the baby’s Rh positive blood cells. If you are Rh positive, there is nothing to worry about.
- Syphilis – Ohio state law mandates the testing for this sexually transmitted disease.
- Pap Smear – This test detects cancerous and pre-cancerous changes in the cervix (the opening to the womb, located at the top of the vagina).
- Gonorrhea and Chlamydia Cultures – These sexually transmitted diseases can cause complications in the newborn. Both infections are easily treated during pregnancy.
- HIV – An HIV (AIDS) test will be offered at your first visit. It is your choice if you would like to have this test performed. If you are infected, you can transmit the virus to the baby. With medications and pregnancy management, we can decrease the likelihood of transmitting the virus to the baby. We can perform this test any time during the pregnancy.
The following tests are offered later in the pregnancy:
- Penta Screen – This blood test combines the results of five laboratory values to predict the risk of a fetus with a neural tube defect, such a Spina Bifida, the risk of Down Syndrome, and Trisomy 18, a syndrome of several chromosomal birth defects. The values include alpha-fetoprotein (AFP), unconjugated esteriol (uE3), Human Chorionic Gonadotropin (hCG), inhibin A, and invasive trophoblast antigen (ITA). Results are reported as a ratio, such as 1:200 or 1:50,000. This test is done between 15 and 20 weeks and is offered to all pregnant women. The results are combined with your age, race, weight, due date and number of fetuses to help your doctor interpret the results. It is your choice if you would like to have this test.
- Amniocentesis – Women who are 35 years or older during pregnancy have a greater risk than younger women of giving birth to a baby with a chromosomal defect such as Down Syndrome. Amniocentesis is offered for this age group because the risk of miscarriage from the procedure equals or is less than the risk of chromosomal birth defects. (Approximately 1:270 at the age of 35). It is generally performed during the 14th to 16th week of pregnancy. Using ultrasound as a guide, a needle is placed through the abdomen into the uterus to collect amniotic fluid for testing. Cells obtained are cultured in a laboratory for evaluation of the chromosomes. Results of the studies are available in about two weeks. In addition, the fluid is tested for the level of alpha-fetoprotein to detect a neural tube defect such as Spina Bifida.
- Chorionic Villi Sampling (CVS) – This test is offered to the same age group as amniocentesis, but is performed earlier in the pregnancy, usually between the 10th and 12th week. A small sample of cells is taken from the placenta where it is attached to the wall of the uterus, rather than from amniotic fluid. Chromosomal birth defects, such as Down’s Syndrome, can be detected. Results of the chromosomal studies are available in approximately two weeks. The risk of miscarriage is about the same as with an amniocentesis and there is an additional risk of limb deformities with this test. The CVS is performed too early to detect neural tube defects. An alpha-fetoprotein blood test (AFP) can be performed between 15 and 20 weeks.
- Glucose Challenge Test (GCT) – This is a screening to test for gestational diabetes. It is performed on all pregnant patients between the 24th and 30th week of pregnancy on those who are not already known to be diabetic.
- Ultrasound or Sonogram – A sonogram uses specially directed sound waves. This painless procedure can give information concerning the age of the baby, the position, the possibility of multiple gestation, and some major birth defects. Minor birth defects are usually not seen on routine ultrasound screens. Ideally this test is done between 18 and 20 weeks to allow for confirmation of the due date and adequate evaluation of the fetus.
- Non-Stress Test (NST) – This test may be recommended after 32 weeks for a variety of reasons, including:
- Multiple gestation
- Maternal smoking
- High blood pressure
- A perceived decrease in fetal movement
- Age (older than 35 or a teenager)
- Diabetes or gestational diabetes
An external fetal monitor is placed on your abdomen. The baby’s heart rate is evaluated with relation to its movements. This test generally takes from 20 to 30 minutes and predicts the baby’s well-being inside the uterus.
- Bio-physical Profile (BPP) -This test is also utilized to evaluate fetal-placental function. Using ultrasound parameters, fetal well-being can be evaluated.