Pregnancy CHECKS & TESTS
Routine antenatal visits with your health practitioner are important in your pregnancy
DURING YOUR PREGNANCY, you’ll be offered a range of tests, including blood tests and ultrasound baby scans. These tests are designed to help make your pregnancy safer, to check and assess the development and wellbeing of you and your baby, or to screen for particular conditions. You don’t have to have any tests. However, it’s important to understand the purpose of all tests so that you can make an informed decision about whether to have them. Discuss this with your maternity team.
FIRST VISIT AT 6-8 WEEKS
The first visit to the doctor will involve a thorough history taking and clinical examination to establish your current and past health status, as well as estimating the due birth date for your baby. You are likely to have a vaginal ultrasound scan at your first visit. The earliest ultrasound scans are usually the most accurate for determining the estimated due date of the pregnancy and are used in preference to later ultrasound scans for dating the pregnancy. Most women in private care have a scan at every doctor visit during pregnancy. A pap smear will be done if you have not had one in the previous year. This is to check for any abnormal cells in your cervix (mouth of the womb). ROUTINE OBSERVATIONS ■ URINE TESTING You’ll be asked to give a urine sample at your antenatal appointments. Your urine is checked for several things, including protein or albumin. If this is found in your urine, it may mean that
you have an infection that needs to be treated. It may also be a sign of preeclampsia. Pre-eclampsia affects ten percent of pregnancies, and can become a serious complication. This usually only occurs after 20 weeks of pregnancy. ■ BLOOD PRESSURE The reading from the first visit will establish a baseline to work from. One to two percent of pregnant women develop raised blood pressure. If this is associated with headaches, blurred vision, and protein in the urine, it may indicate the presence of pre-eclampsia, which requires immediate treatment. Your blood pressure will be taken at every antenatal visit. It’s very common for your blood pressure to be lower in the middle of your pregnancy than at other times. This isn’t a problem, but it may make you feel light-headed if you get up quickly. Talk to your midwife if you’re concerned. ■ WEIGHT This is taken to establish a baseline and ensure an adequate amount of weight gain is achieved through the pregnancy. Most women put on 10-12.5kg in pregnancy, most of it after they are 20 weeks pregnant. Much of the extra weight is due to the baby growing, but your body also stores fat for making breastmilk after the birth. During your pregnancy, it’s important to eat the right foods and do regular exercise. ■ GENERAL OBSERVATION This will include a general assessment to establish the well-being of the mother but will also include observations of the extremities for certain signs such as swelling and presence of varicose veins, among many others. ■ ABDOMINAL PALPATION This is done to assess the size of the uterus and later to assess the position of the baby in the uterus (after 12 weeks). BLOOD TESTS As part of your antenatal care you’ll be offered several blood tests. These will be done to establish your blood group, your immunity to rubella, whether or not you are anaemic and whether you have been exposed to any sexually transmitted diseases including HIV. Some are offered to all women, and some are offered only if you might be at risk of a particular infection or inherited condition. All the tests are done to make your pregnancy safer or to check that the baby is healthy. BLOOD TESTS DURING THE FIRST TRIMESTER USUALLY INCLUDE: Full blood count and iron levels. Blood group and blood group antibodies (to check whether your blood type is compatible with your baby’s). Immunity to rubella. Tests for infectious diseases such as syphilis, hepatitis B, hepatitis C and HIV. BLOOD TESTS LIKELY TO BE PERFORMED IN THE SECOND OR THIRD TRIMESTERS MAY INCLUDE: Repeat blood count and iron levels. Repeat screening for Rh antibodies in women who are Rh negative. Screening for gestational diabetes. 12 WEEKS ROUTINE OBSERVATIONS At 12 weeks your caregiver will do a scan to check for “soft signs” of Down syndrome and this will be followed by a blood test on the same day. This is to determine what the likelihood is of your baby having Down syndrome. The result comes back as a ratio. VISITS TO YOUR CAREGIVER WILL BE MONTHLY UNTIL 28 WEEKS GESTATION 16 WEEKS ROUTINE OBSERVATIONS AS ABOVE Amniocentesis – if indicated by the 12-week scan. 20 WEEKS ROUTINE OBSERVATIONS At 20 weeks your caregiver will do a full anatomical scan, checking your baby’s development and growth and anatomy very carefully. 28 WEEKS ROUTINE OBSERVATIONS Fortnightly visits are done from 28 weeks to 36 weeks. 34 WEEKS ROUTINE OBSERVATIONS If you are seeing a midwife you will see your gynae at this visit just to check that you are on track for the birth. WEEKLY VISITS FROM 36 WEEKS UNTIL BIRTH Vaginal examination and pelvic assessment may be carried out by some caregivers to assess the size of the pelvis and the condition of the cervix. This is usually done at 38 weeks. ROUTINE OBSERVATIONS A swab of your vagina and rectum may be taken if you are delivering vaginally to test for the presence of group B streptococcus bacteria, which, if untreated, can cause infections in newborns. If you test positive for this bacterium, you will be given antibiotics in labour to prevent any problems.
YOU WILL BE WEIGHED IN ORDER TO ESTABLISH A BASELINE FOR YOUR GAIN THROUGHOUT THE PREGNANCY