Prenatal Exams, Tests, and Procedures
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 he or she can detect any problems 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:
- 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. He or she will look for:
- Symptoms of early pregnancy such as morning sickness, breast enlargement and tenderness, and frequent urination
- An embryo, viewed with ultrasound
- Enlarged uterus (6-8 weeks)
- Enlarged abdomen (14 weeks)
- Fetal heartbeat (8-12 weeks)
- Movement of the baby (18 weeks)
- 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
- Pap smear, very early in the pregnancy
- Weight measurement and blood pressure
- 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, and hepatitis
- Exam of your lower legs and ankles for swelling
- Possibly an HIV test and tests for other sexually transmitted diseases (routinely recommended)
- 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, need regular prenatal testing. 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?
Your doctor may order the following tests if he or she thinks they are medically necessary:
- 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.
- Serum alpha-fetoprotein—This screening is used to detect certain birth defects.
- 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.
- Nonstress tests—These tests check the baby as it moves.
- First-trimester ultrasound—The ultrasound is used for dating of pregnancy or detecting chromosome abnormalities.
- Genetic testing—Preconceptional or prenatal gene carrier screening is recommended for genetic diseases in individuals of Eastern European Jewish descent.
What Tests Are Given to Women With High Risk Factors?
If you have high risk factors for complications, you may undergo additional tests and procedures. These may include:
- Amniocentesis to determine fetal lung development
- Blood tests to assess clotting and liver function
- Biophysical profile—to check fetal health with ultrasound
- Rh antibody screening—repeated at 28-30 weeks if you are Rh negative
- A shot of Rhogam 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
American College of Obstetricians and Gynecologists
March of Dimes
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
First-trimester screening for aneuploidy [committee opinion]. American College of Obstetricians and Gynecologists. 2004 July;296.
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.
Prevention of early-onset group B streptococcal disease in newborns [committee opinion]. American College of Obstetricians and Gynecologists. 2002 Dec;279.
Ultrasonography in pregnancy [practice bulletin]. American College of Obstetricians and Gynecologists. 2004 Dec;58.
Last reviewed July 2007 by Ganson Purcell Jr., MD, FACOG, FACPE
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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