All those pee cups and needle sticks starting to blur together? This guide to the most common first trimester tests should help you keep things straight. You’ll definitely receive these screenings, and should discuss those marked optional with your doctor.
• Initial Blood work
At your first prenatal appointment, your doctor will take blood for a long list of screenings. First, she’ll determine your blood type, in case you need a transfusion (very unlikely!) during pregnancy or delivery. She’ll test your blood for Rh, a protein present in about 85 percent of the population. If you prove negative, you’ll need injections of a medication called RhoGAM at 28 or 29 weeks and 72 hours before delivery to prevent problems. (Without these injections, there’s a risk of complications if baby is Rh positive.) Your OB will measure your levels of human chorionic gonadotropin, a hormone produced by the fetus that indicates whether baby is developing well. Your doctor will also look for abnormal hemoglobin levels or red or white cell counts, which can be a sign of anemia or infection. You'll also be screened for Hepatitis B, Syphilis and other STDs, HIV and immunity to German measles.
• Pap Smear
In addition to blood work, your first visit will include a pap smear to check for infections and STDs like Chlamydia, HPV and gonorrhea.
• Urine Tests
At every appointment, you’ll give a urine sample to be screened for glucose (elevated levels can be a sign of gestational diabetes) and protein (a possible indication of preeclampsia or a urinary tract infection). If either shows up in your urine, your doctor will likely order order additional testing.
You'll probably have at least two ultrasounds during your pregnancy. At about 10 weeks, an ultrasound can detect a fetal heartbeat and confirm that the pregnancy is uterine (as opposed to ectopic or tubular). A more detailed ultrasound anatomy scan (also called a level two ultrasound) is performed between weeks 18 and 22. Baby will be measured from crown to rump and around the waist and head to confirm proper growth, and the kidneys, bladder, stomach, brain, spine, sex organs and four chambers of the heart will be checked for normal development and any potential problems. The ultrasound technician will also check amniotic fluid levels, placenta location and fetal heart rate. If necessary, a late-pregnancy ultrasound can check for pre-term labor by measuring cervix length.
• Nuchal Translucency Screening (NTS) (optional)
This special ultrasound, performed between weeks 11 and 14, screens for Down syndrome and other chromosomal disorders,as well as congenital heart defects. While NTS does not provide definitive results, it can determine your risk factor and help you decide whether to pursue further testing.
• Chorionic Villus Sampling (CVS) (optional)
This optional test can detect genetic disorders such as Tay-Sachs and sickle cell anemia, and rule out chromosomal disorders like Down syndrome. It also determines baby’s gender with total accuracy. CVS is done between weeks 10 and 12, and involves analyzing genetic material from a small piece of the placenta.