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Routine Testing
All pregnant women undergo a battery
of tests early in pregnancy. These tests include blood
tests (blood count, blood type, rubella immunity,
hepatitis, and a state-required test for syphilis), a urine
culture, a Pap test, a state-required cervical culture for
gonorrhea and a chlamydia culture.
Rh-negative women are tested for RH antibodies around
28 weeks of pregnancy and receive a RhoGam injection.
We routinely test for gestational diabetes at 28 weeks.
We offer an enhanced serum alpha-fetal protein test
(AFP) at 16-18 weeks, which screens for head and
spinal defects and Down’s syndrome.
Ultrasound
You may be asked to have an ultrasound,
also known as an echogram or a sonogram. The most
common reason for an ultrasound scan is to date a
pregnancy, since menstrual dates may be unreliable in
up to 40 percent of all pregnant women.
It is extremely important to have an accurate estimation
of your due date for several reasons. If you should
develop complications, the management of your
problem is highly dependent on your gestational age.
The earlier in pregnancy an ultrasound scan is
performed, the more accurate it is for dating.
Ultrasound scans may also be used to detect multiple
fetuses, to find many (but not all) types of congenital
malformations, to determine the cause of vaginal
bleeding, and to detect fetal growth retardation. All
high-risk patients should be scanned at least once, and
sometimes serially, during their pregnancy.
Most patients are reassured by seeing their unborn baby
move on the ultrasound screen, and some preliminary
studies indicate the ultrasound scans may help start the
bonding process even before birth.
Amniocentesis and CVS
You should inquire about
genetic counseling and amniocentesis if you:
- Are in your mid-thirties or older.
- Have a personal or family history of a spinal, head or chromosomal defect.
- Have a low maternal serum AFP.
This test involves carefully inserting a needle into the
amniotic sac to withdraw a sample of amniotic fluid. A
number of malformations can be diagnosed using
amniocentesis, including Down’s syndrome, other
chromosomal defects, and some spinal and brain
malformations. Amniocentesis carries with it a small
risk of miscarriage or fetal damage (1-in-200
to 1-in-300).
CVS is helpful in the early detection of chromosomal
problems. CVS carries with it a 1-in-100 risk of
miscarriage or fetal damage. Information about
amniocentesis and CVS is available through the office.
All of these tests are optional.
Biophysical Profile and/or Fetal Monitor Tests
If you have certain complications of pregnancy, or if
you are at least one week overdue, you undergo these
simple and non-invasive tests once or twice each week
during the latter part of your pregnancy. These tests are
not used in normal, uncomplicated pregnancies.
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