Prenatal Exams, Tests, and Procedures

What are prenatal exams, tests, and procedures?

Various exams, tests, and procedures are a part of your checkups during your pregnancy. Prenatal tests can help both the baby and the mother. Some tests check for diseases that the mother may have so she can be treated. Other tests look for birth defects. Still other tests are used to confirm the age, weight and health of the baby. Some tests are routine and usually done for all pregnant women. Other tests are optional and usually done only if concerns or problems arise and you agree to having them.

At each visit your health care provider will discuss with you any problems you are having, such as headaches, swelling of your hands or feet, contractions, or bleeding. Keep all of your appointments. This allows early detection of any problems. Your health care provider can then adjust the plan for your care as needed.

What signs and symptoms of pregnancy will my health care provider check?

Your health care provider will look for various signs of pregnancy and ask about your symptoms at different stages of your pregnancy. These signs and symptoms include:

• nausea, fatigue, breast tenderness or enlargement, and urinary frequency in early pregnancy
• an embryo that can be seen in an ultrasound scan as early as 5 to 6 weeks after your last period
• enlarged uterus at about 6 to 8 weeks
• enlarged abdomen at about 14 weeks
• parts and movements of the baby that can be felt by your health care provider at about 18 weeks
• the baby's heartbeat heard by a Doppler fetoscope at 12 to 14 weeks, or by an ordinary fetoscope at about 19 weeks
• movement by the baby felt by you at about 20 weeks if this is your first pregnancy, or as early as 16 weeks if you have been pregnant before
• changes in the color of your vagina, cervix, and skin.

What are the routine tests and procedures?

The routine tests and procedures done during prenatal visits include:

• urine or blood test for pregnancy at your first visit
• pelvic exam to determine the size of your pelvis and a Pap test of the cervix (usually done only very early in the pregnancy)
• physical exam including a breast exam
• calculation of the gestational age of the baby (how long you have been pregnant)
• measurement of your height, weight, and blood pressure
• tests of a sample of your urine to look for bacteria, protein, sugar, and other chemicals in the urine
• measurement of the height of the fundus (top of your uterus)
• determination of the size and position of the baby
• test of a sample of your urine to look for bacteria in the urine (This test may be done once each trimester or when you have symptoms of a bladder infection.)
• blood tests to check for anemia (may be done each trimester)
• blood tests to check for diabetes when you are 28 weeks pregnant
• blood tests for blood type and Rh antibodies and to see if you are immune to rubella (a type of measles)
• blood test for sexually transmitted infections
• cultures of cells from your cervix to test for infection
• blood test for hepatitis
• skin test for tuberculosis (TB)
• cultures of swabs of the vagina and rectum to test for Group B streptococcus (also called beta strep) in the 35th to 37th weeks of pregnancy
• examination of your ankles and lower legs for swelling.

What other tests might my health care provider order?

Some tests are optional and are often done only if they are medically necessary. They include:

• test for infection with HIV, the virus that causes AIDS (The result of this test will be kept strictly confidential.)
• chorionic villus sampling of cells from the placenta for information about your baby's chromosomes and detection of some birth defects
• amniocentesis for testing of fluid from around the baby for chromosome information and detection of some birth defects
• serum alpha-fetoprotein (AFP) measurement to screen for certain birth defects
• other blood tests that check for genetic problems or birth defects, such as the triple or quad screen tests
• ultrasound scans as needed to look at the baby and your uterus, amniotic sac, placenta, ovaries, and pelvis
• nonstress tests to check the health of the baby (checks the baby's heart rate when the baby moves).

Women with high risk factors may have additional tests and procedures, such as:

• test for herpes
• repeated Rh antibody screening at 28 to 30 weeks and a shot of Rho(D) immune globulin if you are Rh negative and the father is Rh positive
• amniocentesis to see how mature the baby's lungs are near the end of the pregnancy
• blood tests for clotting studies or liver function
• nonstress tests once or twice a week
• biophysical profile (checks the health of the baby with a nonstress test and ultrasound)
• contraction stress tests to check the baby's health (check the baby's heart rate during uterine contractions).