Testing that can be expected throughout your pregnancy is sometimes confusing and overwhelming. This can be the case particularly if the tests are simply ordered for you but not thoroughly discussed. What are all those tests? What are the risks, benefits, and alternatives? This post will hopefully give you some insight into some of the tests that are offered, and why.
Tests performed at each prenatal visit
There are two simple and critical tests done at nearly every prenatal visit. They can communicate a lot about the state of your health and your baby’s health to your care provider: your blood pressure is taken and your urine is tested. Monitoring these two things alone can go a long way toward ensuring mom and baby’s safety.
A urine test is used to assess bladder or kidney infections, diabetes, dehydration and preeclampsia by screening for levels of sugars, proteins, ketones and bacteria. High levels of sugars may suggest gestational diabetes, which may develop around the 20th week of pregnancy. Higher levels of protein may suggest a possible urinary tract infection or kidney disease. Preeclampsia may be a concern if higher levels or protein are found later in pregnancy, combined with high blood pressure.
Your blood pressure can tell your provider about several things that are happening with your pregnancy. It is normal for a woman’s blood pressure to rise slightly as the pregnancy progresses because her blood volume rises. Blood pressure monitoring is important to monitor because it is a primary symptom of pre-eclampsia.
What about all the rest of those tests that they have you do? Glucose test? Amniocentesis? Blood tests? What are they looking for?
Here is a quick list of some of the standard prenatal tests that are performed in pregnancy:
This is sometimes done early in pregnancy, then repeated at the 6 week postpartum. It’s purpose in pregnancy is the same as any other time that the test is performed. Pap smears are performed to look for abnormal cell growth on the cervix that would indicate cancer.
Gonorrhea culture (GC): The GC is also run at the same time as the pap spear. The presence of gonorrhea in the vagina or in the cervix can seriously infect the baby’s eyes during delivery. This is what the eye drops administered after delivery are for, whether or not mothers have a positive GC. Gonorrhea is often asymptomatic, so as a result, every woman is tested.
This is what your provider is generally watching when they get your blood tested:
A.) Complete blood count (CBC) to check for anemia, or iron deficiency. Hemoglobin (HGB) values should be above 11.0 and the hematocrit (HCT) should be 33 or more. This test is usually repeated between the 28 and the 32 weeks of pregnancy.
B.) Blood samples are also drawn to type your blood and rhesus group (Rh factor), which will be either positive or negative. If the mom’s Rh is negative, the baby’s father should be tested also.
C.) Antibody test to check your immunity to infectious diseases: rubella, measles, cytomegalo virus, toxoplasmosis, hepatitis, and AIDS.
D.) RPR is the test for syphilis.
E.) Afp Screening. This is a blood test to detect neural tube defects only. This includes, anencephaly, microcephaly, hydrocephaly and spina bifida.
This test is usually recommended between 15-17 weeks. Most women over 35 are advised of their options regarding genetic screening. Amniocentesis can identify down syndrome, trisomy 18, and other chromosomal defects. Amniocentesis is performed by inserting a needle through the abdomen into the amniotic sac in order to withdraw a sample of amniotic fluid. It is a common procedure, but it carries several risks, rh sensitization, infection, leaking amniotic fluid, and in a small number of cases, miscarriage.
Glucose Tolerance Test:
This test is done between 26-28 weeks to rule out gestational diabetes. Protocols vary for this test, but it usually involves fasting, drinking glucola (a very sweet, sugary drink), then checking blood sugars after the test. There is very little evidence to support the Glucose Test, yet it is almost universally recommended for all women in pregnancy. Some argue that the test is very unnatural, and that not all women will respond predictably to the test.
Ultrasounds can be performed for many reasons. In early pregnancy, ultrasounds can be performed to check the gestational age of the baby and establish a due date. Around 18-22 weeks, ultrasound can reveal the sex of the baby. Many physicians are now requiring late term ultrasounds to measure the baby’s growth, though these are very inaccurate measurements.
What you should know about prenatal testing
Before taking or refusing any test, ask your provider, “How will the results of this test change your plan of care for me?”
For instance, if you choose to opt out of the glucose test, will that leave your provider anxious and wanting to induce earlier? Or if you choose to have amniocentesis, and the test comes back with a positive for down syndrome, will the provider recommend termination? If your decision to have the baby will not be affected by the results of the test in any way, is there a reason to have it done?
Much prenatal testing is done to simply monitor the health of you and your baby. However if for any reason you feel that a particular test or screen is not right for you, you always have the right to opt out of any test.
Being aware puts you in the fulfilling position of taking responsibility for your care. The more active you are in your personal care, the more empowering the whole pregnancy experience becomes.
Pap Smear: http://www.healthline.com/health/pap-smear
Gonorrhea culture: http://www.healthline.com/health/pregnancy/infections-screening-gonorrhea
Blood tests: http://americanpregnancy.org/prenatal-testing/blood-test/
Glucose test: http://evidencebasedbirth.com/gestational-diabetes-and-the-glucola-test/