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| What Types of tests are going to be performed during the pregnancy? |
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Routine Testing – we do the following tests during your first visit: |
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- Rubella Titer – we do this test to determine your immunity status to Rubella (German Measles). If the test shows non-immunity, the immunization will be offered to you when you deliver.
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- CBC - A complete blood count is done to determine your body’s ability to carry oxygen and nutrients through it to your baby. This is repeated when we do the glucose challenge test (see below) and sometimes at around 36 weeks if we find you are anemic on an earlier visit.
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- 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 which could cause a problem during this or future pregnancies. Fortunately, we can prevent this in most cases by giving you an injection of Rhogam - this 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.
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- Hepatitis B - This test determines whether you have Hepatitis B, or if you are a carrier. If you are a carrier, your baby will need to be vaccinated at birth.
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- HIV – we recommend HIV testing to all pregnant women. If you are infected, you can transmit the virus to the baby. We can decrease the chances of this happening with medications and pregnancy management, which is why we like to perform this test. The test can be performed at any time during your pregnancy if you decide not to have it at your first visit.
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- Syphilis - state law requires the testing for this sexually transmitted disease.
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- 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).
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The following tests are offered later in the pregnancy: |
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- Quadruple Screen Test - This blood test combines the results of four laboratory values, alpha-fetoprotein (AFP), estriol, Beta Human Choriogonadotropin (BHCG), and inhibin A to predict the chance that your baby has a chromosomal abnormality such as Down Syndrome or Trisomy 18 while also providing valuable information as to whether or not the spinal cord was inadequately developed leading to a neural tube defect (such as Spina Bifida). 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. It is your choice if you would like to have this test. This is a screening tool that if abnormal would lead to the recommendation for ultrasound and/or amniocentesis.
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- 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 (the most well-known is Down's Syndrome). Amniocentesis is offered at this age 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). We generally perform this test between the 14th an 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.
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- Chorionic Villi Sampling (CVS) - This test is offered to the same age group as amniocentesis, but is performed earlier in the pregnancy (10 to 12 weeks). 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 but there is an additional risk of limb deformities with this test. The CVS is performed too early to detect neural tube defects. A separate blood test (AFP) can be performed between 15 and 20 weeks.
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- Glucose Challenge Test (GCT) - This screening test is performed on all pregnant patients (who are not already known to be diabetic) between the 24th and 30th week of pregnancy as a screening test for gestational diabetes (diabetes during pregnancy). If your score is elevated, a nurse will call you to arrange for a 3 hour glucose tolerance test, a definitive test for gestational diabetes.
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- Ultrasound or Sonogram - A sonogram is an image of the developing fetus produced using 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.
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| Non-Stress Test - 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. This test may be recommended for a variety of reasons, including: |
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- Multiple gestation
- Maternal smoking
- High blood pressure
- A perceived decrease in fetal movement
- Age (older than 35 or a teenager)
- Diabetes or gestational diabetes
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