You have just peed on a stick (or two or twenty) and gotten that life-changing news that you are pregnant. Rest assured…this is just the first test in a long line of pregnancy screenings and diagnostics.
First of all, let’s understand the difference here: screening tests gauge risk factors for certain issues whereas diagnostic tests are just that…they confirm or deny the presence of those issues. Many of the tests early in pregnancy are the less invasive screenings. If those results warrant further investigation, you will be sent for the usually more invasive diagnostic tests.
I know this is overwhelming. You are probably still trying to wrap your head around the fact that your body is growing a new human being and here you are being thrown right into the tornado of decisions that come with parenthood. Which tests are required and which are optional and how do you navigate through it all?
Here’s the good news…as with EVERYTHING in life (including during your pregnancy, labor and birth)…you ALWAYS have options! To help you wade through it all, we are breaking down the most common pregnancy tests by trimester; including the what, why and when for each one.
Initial Blood Work - Several vials of blood will be drawn at your first visit. Your practitioner is looking at several things here. Let’s take them one at a time.
Urine Sample – this will be the first of many. A urine sample should be collected at every visit throughout your pregnancy. It is a simple, non-invasive screening for Pregnancy Induced Hypertension (protein will be present in the urine sample) and Gestational Diabetes (sugar will be present in the urine). It is also a diagnostic test for urinary tract infections.
Blood Pressure – at some point in your first trimester, your practitioner will start taking your blood pressure at the start of every appointment. This is to monitor you for hypotension (low blood pressure) or hypertension (high blood pressure).
Ultrasound – this initial ultrasound is used to help confirm your estimated due date (EDD) and the presence of twins or higher multiples. This is one of those tests you can choose to decline if you wish as it does not really affect any course of treatment.
First Trimester Screen – is a group of three tests, usually done on the same day, performed between 11 and 14 weeks gestation. This is a screening…diagnostic testing such as chorionic villus sampling (CVS) will be recommended if results are abnormal. The three tests are:
Second Trimester Screening – this is a group of three or four tests that are, again, screening for chromosomal abnormalities. Most of the time, only Mamas who had abnormal results in the First Trimester Screening will have this group of tests done. If abnormal results are seen in both the First and Second Trimester Screenings, an amniocentesis is usually recommended as a diagnostic test.
Anatomy Ultrasound – this ultrasound is usually performed around 20 weeks gestation. The technician can check all vital organs and body structures as well as check the location of the placenta (to rule out, or diagnose, placenta previa) and level of amniotic fluid. Since you are past 16 weeks here, you can also find out the sex of your baby…if you choose.
Follow Up Blood Work – this is a repeat CBC, usually done between 24 and 28 weeks, and will be compared to the initial results.
Urine Sample and Blood Pressure checks will continue.
Glucose Challenge – this is a one hour test that screens for gestational diabetes. It is usually done between 24 and 28 weeks. You will have a blood draw, drink some cool-aid on steroids (glucose) and have a second blood draw one hour later. If you “fail” this test – your level is higher than normal – you will go in for a more intensive three-hour challenge.
Let’s clear something up first…unless you have had issues in the earlier parts of your pregnancy, ultrasounds are NOT routine procedures in the third trimester. Many Mamas are surprised by this. Although you can request or deny one at any time, they are not without risk and I encourage you to research the pros and cons of ultrasounds. Ok...on with the other tests.
Urine Sample and Blood Pressure checks will continue.
Follow Up Blood Work – you guessed it, another CBC here. In addition, many practitioners will repeat STI tests (syphilis, gonorrhea and chlamydia).
GBS – otherwise known as Group B Streptococcus – is a type of bacteria that has been known to cause infection and serious complications for newborns, although this is rare. Between 35 and 37 weeks your practitioner will take a cotton swab and collect cells from your vagina. These cells will be cultured and will tell your practitioner if this bacteria is present. If it is not, you are good to go. If it is, you will be administered intermittent IV antibiotics throughout your labor and delivery as a preventative measure for baby.
Non-Stress Test (NST) – is a non-invasive way to confirm that baby is doing well. It is an out-patient test, although it may require a trip to the labor and deliver unit depending on the setup of your birth place. Using electronic fetal monitors, the practitioner will track uterus activity (contractions if they are present) and baby’s heart rate simultaneously. This “tracing” will confirm how baby is responding to contractions and if any interventions may be warranted.
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