What to expect: tests during pregnancy 

Many patients come to me when they first find out they’re pregnant and ask, “Do I have to take all the tests?” As part of routine prenatal care, several lab tests are suggested for all women, which can find conditions that can increase the risk of complications for mom and baby. So the answer to that question is no, you don’t have to do anything but, I highly recommend it. Life as a parent is all about planning, and taking the various prenatal tests your doctor recommends is part of that responsible planning process.

Now, there may not be as many suggested tests as you think, and there is one test that many moms are actually excited about – the ultrasound. This allows families to see their baby on the screen for the first time. But let’s start from the beginning.

First trimester: Pap smear and other urine and blood tests

I’ll be honest with you. Your first doctor’s visit after finding out you’re pregnant will involve some poking, prodding and a bit of fluids. But it’s nothing you can’t handle. Your Ob/Gyn will give you a full physical, which can include a breast and pelvic exam (yes, that means a Pap smear), a weight assessment, and blood pressure check. And to double check – or maybe triple, quadruple check for some surprised moms – you may be asked to take a urine test to confirm your pregnancy, which will also test for any irregularities like infection. Your blood will also be drawn for a laundry list of things like your blood type, anemia, STDs, immunity to measles and chickenpox.

Remember when I told you that you’ll have to get your blood pressure checked and a urine test in the first trimester? Expect to do this every single time you see your doctor during your pregnancy. This precaution helps us monitor any conditions that may be of concern such as gestational diabetes or preeclampsia.

Second trimester: Ultrasound and screening and diagnostic tests

An ultrasound is usually performed around 20 weeks into a woman’s pregnancy. You can expect that the doctor will tell you if the placenta is healthy and baby is growing properly in the uterus. Sometimes this test can also be done earlier to determine how far along you are in your pregnancy, also known as the gestational age. But at the 20 week mark, you get to the fun parts, such as hearing the baby’s heart beat and seeing the baby’s shape; you may even catch a glimpse of some of the somersaults they’ve been doing in your belly. This is also when you can learn the gender of your baby if you wish. So what should you expect? Your doctor will apply a gel on your abdomen and rub a device called a transducer, which sends high frequency sound waves into the body, allowing you to see your baby on screen. The ultrasound is safe for you and your baby and does not use radiation.

Then there are a number of other tests that the doctor may recommend you do, depending on several factors including your age, family history, and interest in knowing your chance to have a baby with a genetic condition. One of these tests is non-invasive; it is a simple DNA blood test that screens for chromosome conditions, such as Down syndrome, and delivers fewer false positive results compared to what can be expected from traditional tests. This is a screening test that can be performed in any age or risk category. When you take this test, keep in mind that these are screening tests so any abnormal results should be followed by a conversation with your doctor to discuss options for a diagnostic test, like amniocentesis.

The last stretch: Just a few more tests

Because you’re in the final lap – although, I understand this may seem like miles on an uphill road – doctors want to make sure they’re fully aware of your condition and your baby’s condition before or on the big day. There are a few more tests women usually have to take:

• Fetal heart rate monitoring can be done any time after week 20 and simply checks to see if the baby is healthy. Expect to get this checked during labor and delivery.
• Non-stress test is called this because no stress is placed on the fetus for this test. This test is most often conducted after 32 weeks in women who are high risk, or after your due date. A fetal monitor is strapped to your abdomen to measure the baby’s heart rate as it moves.
• Group B streptococcus tests for a type of bacteria that can exist in the female reproductive tract without causing symptoms. About 30 percent of women can have this. If not caught and treated at the time of labor and delivery, there may be serious consequences for the baby, including infections like meningitis, pneumonia, and sepsis. Testing is simple and involves taking a sample from the vagina and the rectum with a cotton swab at 35-36 weeks gestation.

The number of tests may seem like a lot, and how they’re conducted can be confusing. But if you’re going to take anything away from this post, it’s that you have every right to ask your doctor questions about these tests and you should expect to get all the information you need before doing any of them. Don’t be afraid to ask.

Dr. Shannon Huff is an obstetrician-gynecologist in Arden, North Carolina and is a member of the Ariosa Diagnostics Speaker’s Bureau.