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Prenatal Exams, Tests, and Procedures

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What Will My Doctor Look for During Prenatal Exams? | What Routine Tests and Procedures Can I Expect to Have? | What Additional Tests Might Be Ordered? | What Tests Are Given to Women With High Risk Factors?

Rerun image During your pregnancy, you will experience a variety of exams, tests, and procedures. Some of the tests are routine for all pregnant women. Others are optional or may be recommended by your doctor in certain situations or if there are complications.

You should keep all appointments with your doctor so that problems can be detected as soon as possible. If any problems or potential problems are identified, your doctor can plan for your care as necessary. During each visit, your doctor will ask about any symptoms or problems you may be having, particularly:

  • Bleeding
  • Contractions
  • Leakage of fluid
  • Regular movement of your baby once you start feeling your baby moving
  • Headaches
  • Swelling of your hands or feet

What Will My Doctor Look for During Prenatal Exams?

Your doctor will look for and ask about signs and symptoms at the various stages of pregnancy including:

  • Symptoms of early pregnancy, such as morning sickness, breast enlargement and tenderness, and frequent urination
  • An embryo, viewed with ultrasound
  • Enlarged uterus
  • Enlarged abdomen
  • Fetal heartbeat
  • Movement of the baby
  • Changes in your vagina, cervix, and skin

What Routine Tests and Procedures Can I Expect to Have?

You will probably have the following routine tests and procedures:

  • Pelvic exam, to determine the size of your pelvis and uterus
  • Pap smear, very early in the pregnancy
  • Weight measurement and blood pressure (at each visit)
  • Determination of gestational age and due date
  • Urine tests to check for protein, sugar, and bacteria
  • Assessment of the size and position of the fetus
  • Blood tests to check for anemia, diabetes, blood type, Rh factor, rubella antibodies, syphilis, hepatitis, HIV, and other sexually transmitted diseases
  • Exam of your lower legs and ankles for swelling

The Centers for Disease Control and Prevention recommends vaginal/rectal culture for Group B streptococcus (at 35-37 weeks of pregnancy) to prevent infection of the baby during labor and delivery.

Women with certain medical conditions have a higher risk of having problems during pregnancy and, therefore, may need additional regular prenatal testing like ultrasounds. Examples include women with high blood pressure, diabetes, kidney disease, heart disease, multiple pregnancies (two or more fetuses), too much or too little amniotic fluid, or post-term pregnancy.

What Additional Tests Might Be Ordered?

Additional tests may be done if your doctor thinks they are medically necessary. It may be done if your baby has a high risk of certain genetic issues or if you have had some complications in your pregnancy. Examples of additional tests include:

  • Triple/quadruple blood screen test—This test gives more information about risk of birth defects and includes tests for alpha-fetoprotein, conjugated estradiol, and human chorionic gonadotrophin, as well as Inhibin A in the quadruple screen. If the results are positive, this screening test may be supplemented by an ultrasound or other tests to look for abnormalities.
  • Nonstress tests—These tests check changes in the baby’s heart rate as it moves.
  • Ultrasound—The ultrasound is used for dating of pregnancy or detecting abnormalities.
  • Genetic testing—Preconceptional or prenatal gene carrier screening is recommended for genetic diseases in individuals are at higher risk of these conditions. Examples of people that may need this testing include persons of Eastern European Jewish descent.
  • Amniocentesis —This test is used for detecting chromosomal abnormalities and birth defects.
  • Chorionic villus sampling (CVS) —CVS is used for detecting chromosomal abnormalities and birth defects.

What Tests Are Given to Women With High Risk Factors?

If you have high risk factors for pregnancy complications, you may have additional tests and procedures. Examples include:

  • Amniocentesis to determine fetal lung development
  • Blood tests to assess clotting and liver function
  • Biophysical profile—to check fetal health with ultrasound and a non-stress test
  • Rh antibody screening—repeated at 28-30 weeks if you are Rh negative
  • Stress tests to check your baby's health during uterine contractions
  • Vaginal "culture" for fetal fibrinectin—a screening test for likelihood of premature labor
RESOURCES:

American Congress of Obstetricians and Gynecologists

http://www.acog.org/

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada

http://www.sogc.org/

References:

First Prenatal Checkup. March of Dimes website. Available at: http://www.marchofdimes.com/pregnancy/prenatalcare_firstvisit.html. Accessed December 20, 2012.

First-trimester screening for aneuploidy [committee opinion]. American College of Obstetricians and Gynecologists. 2004 July;296.

Later Prenatal Checkups. March of Dimes website. Available at: http://www.marchofdimes.com/pregnancy/prenatalcare_visits.html. Updated May 2011. Accessed December 20, 2012.

Prenatal Care and Tests. United States Department of Health and Human Services Womens Health website. Available at: http://womenshealth.gov/pregnancy/you-are-pregnant/prenatal-care-tests.html. Updated September 27, 2010. Accessed December 20, 2012.

Prenatal and preconceptional carrier screening for genetic diseases in individuals of Eastern European Jewish descent [committee opinion]. American College of Obstetricians and Gynecologists. 2004;298.

Screening and monitoring during pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated November 28, 2012. Accessed December 20, 2012.

Ultrasonography in pregnancy [practice bulletin]. American College of Obstetricians and Gynecologists. 2004 Dec;58.

Last reviewed December 2012 by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


 
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