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Prenatal Care and Testing
Every mother-to-be needs prenatal care. Prenatal care is the regular healthcare you will receive during pregnancy from your doctor, midwife, or other healthcare professional. Prenatal care should begin as early as possible, ideally even before you become pregnant. You may hear this called a preconception visit. At this visit, your doctor will talk about any chronic medical problems and medications. Additional testing may be recommended. Your doctor will discuss your weight gain and exercise. You will also learn about nutrition, which will likely including taking prenatal vitamins and folic acid.
The goal of prenatal care is to monitor the progress of your pregnancy and check for any problems that may occur. Women who get prenatal care have healthier babies and are less likely to have pregnancy-related problems.
Routine Prenatal Care: Your First Pregnancy Visit
You should call to schedule a prenatal visit with your doctor as soon as you realize you are pregnant. After speaking with you, the doctor’s office may suggest seeing you soon, or may suggest a first visit around 8 weeks after your last menstrual period.
This first visit will include a physical examination. You will be weighed and have your blood pressure checked. You will also have a pelvic exam, and a Pap smear to check for cervical cancer and infections. You will provide blood and urine samples for a variety of tests, including tests for infections and anemia.
Your due date will be estimated. You will be advised to start taking prenatal vitamins and folic acid, if you are not already taking them.
Routine Prenatal Care: Subsequent Visits
After your first prenatal visit, you will schedule 1 prenatal visit every 4 weeks until about 28 weeks in your pregnancy. During weeks 28-36, you will schedule visits about every 2-3 weeks. After week 36, you will probably see your doctor every week. Sometimes, there are alternate visits with a clinical provider and with a nurse. The visits are more frequent if you have a high-risk pregnancy.
At these visits, your doctor will weigh you, check your blood pressure, measure and feel your growing abdomen, and check for swelling. After week 12, your doctor will listen to your baby’s heartbeat. You will also have blood tests, urine tests, and ultrasounds. A screening for gestational diabetes will be done in the second trimester. A screening for group B streptococcal disease will be done at 35-27 weeks.
At each prenatal visit, you should discuss any questions or concerns you have with your doctor.
|Ultrasound During Pregnancy|
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Prenatal Diagnostic and Screening Tests
The following table describes the most common prenatal tests used to monitor your pregnancy and identify problems.
|Blood type and antibody screen||Blood tests used to determine your blood type (A, B, AB, or O), and whether you are Rh positive (your blood has the Rh antigen) or Rh negative (your blood lacks the Rh antigen); if your blood type and Rh status are incompatible with your baby’s, you may need special care during pregnancy|
|Hematocrit and hemoglobin||Blood tests that check for anemia|
|Syphilis||A blood test that checks for the sexually transmitted disease (STD), syphilis, which can be treated so that it will not be transmitted to your baby|
|Rubella||A blood test to see if you have had rubella (German measles) or a rubella vaccination; if you have not, you will be advised to avoid being exposed to the disease while pregnant|
|Hepatitis B virus||A blood test to determine if you have hepatitis B, a viral disease that infects the liver; it can be treated with medications, which must also be given to your baby, along with a vaccine, after birth|
|Human immunodeficiency virus (HIV)||A blood test to determine if you have been infected with the HIV virus, which causes AIDS; if you have, you will be given medications during pregnancy to reduce the risk that you will pass the infection on to your baby. This test is valuable because of the power of medications to protect the baby.|
|Varicella zoster virus||Chickenpox (also called varicella) is an infection that can be harmful to your unborn baby or newborn. Your healthcare provider can test for this by taking a swab of a rash.|
|Gestational diabetes||A blood test to determine if you have gestational diabetes will be done in the second trimester.|
|Urine tests||A laboratory test to check the levels of sugar and protein in your urine, which can help identify gestational diabetes and preeclampsia; urine tests can also check for bladder and kidney infections|
|Cervical tests||A Pap test to check for precancerous cells in your cervix, and swabs to test for the STDs gonorrhea and chlamydia .|
|Multiple marker screening||The multiple marker screening measures the levels of the hormones estriol, human chorionic gonadotropin (hCG), and alpha-fetoprotein (AFP), in your blood. Abnormal results can indicate an increased risk of some chromosomal abnormalities. A fourth test, PAPP-A (pregnancy-associated plasma protein-A), is sometimes added to multiple marker screening to improve the ability to detect abnormalities in the fetus (Quad Screen).|
|Ultrasound||An imaging test that uses sound waves to view your fetus; ultrasounds can help confirm pregnancy, determine the age and sex of the fetus, and possibly identify abnormalities.|
|Group B streptococcal disease||Group B streptococcal disease is a bacterial infection that can cause illness in newborn babies and pregnant women. This test is done with a cervical swab one month before the baby is due (at 35-37 weeks)|
|Other tests||Other tests that may be performed include testing the amniotic fluid, examining cells from the placenta, testing your fetus’ genetics, and testing for tuberculosis|
Cervical cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 21, 2016. Accessed April 27, 2016.
Parmet S, Lynn C, et al. Prenatal Care. JAMA. 2004;291(1):146.
Prenatal care and tests. US Department of Health and Human Services Women's Health website. Available at: http://womenshealth.gov/pregnancy/you-are-pregnant/prenatal-care-tests.html. Updated September 27, 2010. Accessed April 26, 2016.
Prenatal testing. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/prenataltesting. Accessed April 26, 2016.
Prenatal tests. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/system/medical/prenatal%5Ftests.html. Updated June 2013. Accessed April 26, 2016.
Routine tests in pregnancy. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq133.pdf?dmc=1&ts=20121227T1019449259. Published January 2016. Accessed April 26, 2016.
- Reviewer: Andrea Chisholm, MD
- Review Date: 04/2016
- Update Date: 05/20/2015