Your body undergoes many changes when you become pregnant. Prenatal testing helps your healthcare provider track the health and safety of you and your baby throughout the pregnancy. If any issues arise, they can be detected and addressed as early as possible.
Some tests are repeated during your pregnancy, while others are scheduled for certain developmental stages. Most of these tests are optional, but New York State requires some tests such as those that detect hepatitis C, HIV, and syphilis. Here’s an overview of some of the standard screenings we recommend before, during, and after your pregnancy’s three trimesters.
Before You Get Pregnant
If you’re trying to get pregnant, consider getting bloodwork done. Addressing any deficiencies helps your body prepare for the hard work of growing a baby - along with good nutrition, regular exercise, healthy sleep, and abstaining from alcohol and recreational drugs. No amount of alcohol or any recreational drugs are safe for your developing baby. Check with your provider about any prescription medications you may use during your pregnancy.
First Trimester
During the first 12 weeks, you will begin regular testing that will continue throughout your pregnancy. Your healthcare provider will note your blood pressure, weight and check your urine for signs of gestational diabetes, preeclampsia (pregnancy-related high blood pressure), or a urinary tract infection. Many women have asymptomatic bacteria in the urinary tract, and pregnancy puts you at a higher risk of kidney infection and pregnancy loss. If you are at high risk for preeclampsia, we recommend low-dose aspirin starting around 12 weeks.
You will also be offered screenings for HIV and syphilis (to be repeated in the third trimester), gonorrhea, chlamydia, a Pap smear, and a test for high lead levels that can have a significant impact on the baby’s brain development.
Around 10 to 12 weeks, non-invasive prenatal testing can be done using fetal cells to detect certain possible genetic issues in the baby. Risks for such chromosomal abnormalities increase after a mother is 35 years old.
We can also test whether you are a carrier for certain genetic disorders and assess the chances of having a child with conditions such as cystic fibrosis, spinal muscular atrophy, or blood abnormalities, including sickle cell disease.
Second Trimester
If you are older than 35, have a family history of genetic conditions, or anomalies that showed up in your first-trimester screening, you may decide to have an amniocentesis after 15 weeks of pregnancy. This test examines the amniotic fluid that surrounds your baby to find chromosomal abnormalities that can lead to health problems.
Around 16 to 18 weeks, we recommend a blood test for levels of alpha-fetoprotein that can indicate certain disorders, such as neural tube defects. This is followed by an anatomy screen between 18 to 22 weeks. Should we find any issues, such as malformations of the baby’s heart, you will be referred to a physician who specializes in high-risk pregnancies.
Third Trimester
During the final months of pregnancy, you will undergo a test for gestational diabetes. Factors such as family history and obesity put you at a higher risk of gestational diabetes.
Late in the third trimester, we give you another ultrasound to see if the baby is growing normally. We also check your blood count to make sure you are not anemic, as the baby uses a lot of iron from your body.
With certain risk factors, such as gestational diabetes or preeclampsia, you will receive weekly nonstress tests until the baby is born. These monitor your baby’s heart rate and how it responds to contractions and movement.
Finally, we test for group B strep. About one in every three women is a carrier, but in newborns the bacteria can cause sepsis and death. If you carry strep B, you will be given an IV antibiotic during labor to reduce the transmission risk to the baby.
Postpartum
Once your baby is born, you will receive mental health questionnaires at the hospital and pediatrician’s office. These screen for issues such as postpartum depression or anxiety and help ensure that you receive the support you need.
Getting Informed
As you plan for and navigate your pregnancy, speak to your trusted provider to decide which screenings are right for you. You can also find more information on the website of the American College of Obstetricians and Gynecologists.
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Dr. Kathleen Gardner is an OB-GYN and has been practicing for more than 30 years. She can be reached at Ob-Gyn & Midwifery Associates of Ithaca, (607) 266-7800.
