“Testing, testing…1,2,3.” Know what prenatal testing is all about

What Is All This Testing?

Prenatal care is important. We all know that. It helps to ensure a healthy pregnancy, baby, and birth. That’s the goal, right?At your prenatal visits, you generally undergo routine exams and testing that vary depending on where you are at in your pregnancy.

Testing that throughout your pregnancy is sometimes overwhelming and confusing. This is certainly the case if the tests are ordered but not discussed in detail.

So what are all those tests? What are the benefits, risks, and are there alternatives? What will happen if I decide to opt out of these tests? This post will give you some information into some of the tests that are offered, why they are, and what you can do.
Tests performed at each prenatal visitThere are two critical and simple tests performed at every prenatal visit. These two can alone communicate a great deal about your health and your baby’s health to your care provider. Your urine is tested and your blood pressure is taken. Monitoring simply these two things can go a long way toward ensuring mom and baby’s safety.

The urine test is done to look for signs of diabetes, dehydration, bladder or kidney infections and preeclampsia by screening for levels of sugars, ketones, bacteria, and proteins. High levels of sugars may indicate gestational diabetes, which may develop around the 20th week of pregnancy. Higher protein levels may suggest a possible urinary tract infection or kidney disease. Preeclampsia may be a concern if higher levels of protein are found later in pregnancy when with high blood pressure.

Your blood pressure can tell your provider about several things about the state of your health during pregnancy. It is normal for a woman’s blood pressure to rise slightly throughout pregnancy because her blood volume is also rising. Blood pressure monitoring is important because it is a primary symptom of pre-eclampsia.

Periodic Tests
What about all the rest of those tests that they are ordering? What are they looking for in the blood tests? Glucose test? Amniocentesis?

Here is a quick list of some of the standard prenatal tests that are recommended in pregnancy:

Pap smear: 
This is sometimes, though not always, done early in pregnancy, then repeated at the 6-week postpartum checkup. Its purpose in pregnancy is the same as any other time that the test is performed. Pap smears are recommended to look for abnormal cell growth on the cervix that would indicate cancer.

Gonorrhea culture (GC):
The GC is usually done at the same time as the Pap smear. The presence of gonorrhea in the vagina during birth can seriously infect the baby’s eyes. Whether or not mothers have a positive GC, eye drops administered to the baby after delivery to prevent them from becoming colonized. Gonorrhea is often asymptomatic, so as a result, every woman is tested.

Blood tests
This is what your provider is watching when they get your blood tested:

A.) Complete blood count (CBC) to check for anemia, or iron deficiency. Hemoglobin (HGB) values should be above 11.0 and the hematocrit (HCT) should be 33 or more. This test is usually repeated between the 28 and the 32 weeks of pregnancy.

B.) Blood samples are also drawn to check your blood type and rhesus group (Rh factor), which will be either positive or negative. If the mom’s Rh is negative, the baby’s father should also be tested.

C.) Antibody test to check your immunity to infectious diseases: rubella, measles, cytomegaly virus, toxoplasmosis, hepatitis, and AIDS.

D.) RPR is the test for syphilis.

E.) Afp Screening. This is a blood test to detect neural tube defects only. This includes anencephaly, microcephaly, hydrocephaly and spina bifida.

Amniocentesis:
This test is usually recommended between 15-17 weeks, though not every woman will be advised to have it. Amniocentesis can identify down syndrome, trisomy 18, and other chromosomal defects, so most women over age 35 are advised of their options for genetic testing, including amniocentesis. It is performed by inserting a needle through the abdomen into the amniotic sac to withdraw a sample of amniotic fluid for testing. It is a common procedure, but it carries several risks, Rh sensitization, infection, leaking amniotic fluid, and in a small number of cases, miscarriage.

Glucose Tolerance Test:
This is a test that is usually done between 26-28 weeks to rule out gestational diabetes. Protocols vary for this test, but usually, it involves fasting, drinking glucola (a very sweet, sugary drink), then checking blood sugars after the test. There is little evidence to support the Glucose Test, yet it is recommended for all women in pregnancy.

Ultrasound:
Ultrasounds can be performed for many reasons. In early pregnancy, ultrasounds can be recommended to check the gestational age of the baby and establish a due date. Around 18-22 weeks, ultrasound can reveal the sex of the baby. Many physicians are now ordering late term ultrasounds to measure the baby’s growth, though these are very inaccurate measurements.


What you should know about prenatal testing
Before taking or refusing any test, you should ask your provider, “How will the results of this test change your plan of care for me?”

For instance, if you choose to opt out of the glucose test, will your provider then be anxious and wanting to induce you early? Or if you choose to have amniocentesis, and the test comes back with a positive for down syndrome, will the provider recommend termination?

If your decision to have the baby will not be affected by the results of the test in any way, is there a reason to have it done?
Much prenatal testing is done to monitor the health of you and your baby. However if for any reason you feel that a particular test or screen is not right for you, you have the right to opt out of any test.

Being aware puts you in the fulfilling position of taking responsibility for your care. The more active you are in your personal care, the more empowering the whole pregnancy experience becomes.

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