Labs are done at your first OB visit. Always included are the following:
CBC (complete blood count)-with this we are testing whether you are anemic and assuring that you have a normal platelet count.
Hepatitis B surface antigen-test for the virus Hepatitis B
RPR-test for syphilis
Blood type
RH type (this is the plus or minus sign with the blood type)
Antibody screen-test to see if you have made antibodies against types of blood proteins
Rubella-a test to see if you are immune to rubella
HIV-test to see if you have the HIV
Urine Cullture-test for urinary tract infection which is common in pregnancy and does not always have symptoms
Sometimes we test for thyroid disease with a TSH if symptoms are present or you have a history of thyroid disease.
Genetic testing falls into 2 categories; One category is testing your chromosomes to see if you carry any genetic traits that could led to disease. The other category is testing to see if your baby may carry any risk for chromosome issues. Your will be referred to Maternal Fetal Medicine and their genetic counselors to discuss all of your options for both of these categories.
The following video gives an idea of the testing available and how it is done.
Click here for video about genetic testing
An ultrasound is done at about 20 weeks as by this stage we can evaluate for anatomic abnormalities. In the ultrasound we can evaluate the following systems:
brain
heart
kidneys
stomach
spine
bladder
limbs
placenta
amniotic fluid
The ultrasound is an excellent screening tool but it is not perfect. We can assure you that with a normal ultrasound we feel there is a low chance of a major anatomic abnormality but remember that nothing is guaranteed. Often we do find small abnormalities, please refer to the ultrasound section to explain more about this as appropriate.
We check for diabetes and recheck for anemia. There is more than one way to screen for diabetes. We will give you the necessary paperwork and instructions for all. There is a one phase or a two phase approach. For the one phaseyou will come in fasting. They will draw your blood. You’ll drink a beverage with a measured amount of glucose. They will then draw your blood at 1 and 2 hours after drinking the beverage. If all the these numbers fall within normal, you do not have gestational diabetes. If one of the numbers falls higher than the normal, you are diagnosed with gestational diabetes. With the 2 phase approach, we will give you the glucose drink at a previous appointment. Before your appointment, you will drink the glucose drink. Do not eat or drink anything after you drink the glucose. The goal of this test is for the lab to be drawing your blood 1 hour after you drink the glucose. The lab will only be drawing your blood once. If this level is high, we send you for a second test before to determine if you have diabetes. This test is the 3 hour test. It is similar to the 1 phase approach except you have an extra blood draw at the 3 hour mark. If 2 or more of these values are abnormal, you are diagnosed with diabetes.Your provider may recommend that if you have had diabetes in a prior pregnancy or have significant risk factors for diabetes (obesity, family history, twins, hispanic, native american, East Indian, PCO) that you have an extra early test to catch diabetes early.
Group B strep
This is a simple swab that you will do in the bathroom or your provider will do for you. It tests for the presence of Group B strep. This is a common bacteria that normally lives on about 1/3 of adults. It does not cause illness in adults. But, it does have the potential to make babies sick. So, we identify the people that are positive and treat them with antibiotics during labor to decrease the chance of the baby getting the infection.
HIV and RPR (syphilis)-we recheck these blood tests close to delivery
NST (Non Stress Test)-this an observation of the pattern of the fetal heart rate. We place a monitor on your abdomen and monitor the baby’s heart rate over 20-40 minutes. By looking at the pattern of the heart rate we can generally assess if the baby is doing well.
AFI (Amniotic Fluid Index)-this is an ultrasound to measure the amount of amniotic fluid around the baby.