Routine Tests During Pregnancy

A range of tests are recommended during pregnancy to make your pregnancy safe, check and assess the development and well-being of you and your baby, as well as screen for particular conditions.

Other Tests are done only at certain times during pregnancy, or if you have certain indications or problems. Blood tests and urine tests are two routine tests conducted during pregnancy.

Screening tests help to know about a pregnant woman's risk of having a baby with certain birth defects. These are done during the first and second trimesters of pregnancy.

First Trimester Tests (1 - 12 Weeks)

8-10 Weeks

Ultrasound on all our patients to help establish your baby's due date and to check on the health of the pregnancy.
Blood tests are done to know your blood type (A, B, AB, or O; Rh positive or Rh negative),
Imunity to German measles (rubella), and haemoglobin levels, Iron and Vit D levels, Thyroid function and fasting sugar levels
infectious disease conditions such as hepatitis B, syphilis, HIV and Syphilis

11-14 Weeks

Blood tests to measure papp-A and B Hcg ( these are placental hormones ) together with a Nuchal translucency scan can give the woman a risk ratio of having a baby with Trisomy 21, 18 and 13.
Recently there has been some advances in screening and a new test is being used and available in Brisbane, it is called NIPT ( non-invasive prenatal testing ). It involves a simple blood test from you to determine the percentage of fetal cells circulating in your blood. They can then check these fetal cells for genetic abnormalities like trisomy 21, 18 and 13. They can also check the sex of your baby.

Second Trimester Tests (13 - 28 Weeks)

Morphology ultrasound scan is routinely done between 18 to 21 weeks. The baby would have formed all its organs by now and a detailed ultrasound scan would study in detail all organ structure.

The tests of the first and second trimester screenings can be combined to confirm birth defects such as Down syndrome in a relatively larger number (90-95%) of the cases. Positive screening tests are usually followed by diagnostic tests for further information.

Genetic Tests

You will be asked to give a Genetic Testing. Genetic testing is performed to identify changes or abnormalities in the genetic makeup (DNA, chromosomes, genes and proteins) of humans.

The tests can be performed at any stage of life, but is recommended in certain cases before conception, during pregnancy or after birth.

Genetic Tests can help detect

Check for the presence of genetic abnormalities in the unborn (embryo or fetus) or newborn
Chronic villus (ability to absorb nutrients from mother) Test for genetic conditions in adults before symptoms surface
Check for inheritance or transmission of a certain condition to your family members (carrier testing)

Prenatal genetic studies may be performed during pregnancy to check the genetic makeup of the offspring. In cases of uterine abnormality, you may be recommended for surgery.

Samples for testing can be taken from blood, cheek swabs, and amniotic fluid (protective liquid in which the unborn child develops).

Genetic testing provides vital information for the diagnosis, treatment and prevention of various diseases.

Types Of Genetic Tests

Molecular genetic testing, used to study short lengths of DNA to identify mutations, chromosomal genetic testing, to study changes in chromosomes like duplication or reduction in number, and
Biochemical genetic testing, which is used to study the amount of protein activity. Although genetic testing may give you an insight into the diseases you may develop, it is not always that you will develop a certain condition if your genetic test is positive.

Prenatal Screening And Diagnosis

Prenatal screening tests are safe procedures used to determine if an expectant mother is likely to have a baby with a particular birth defect.

Prenatal tests can include

Cystic Fibrosis

Cystic Fibrosis (CF) is a genetically inherited disorder affecting children and young adults. This disorder leads to problems with digestion and respiration, and can shorten the lifespan of an individual. Symptoms of CF include build-up of thick mucus in the lungs causing congestion and associated respiratory problems. Mucus build-up is also seen in the digestive tract leading to difficulty in the absorption of nutrients.

Chorionic Villus Sampling

Chorionic villus sampling (CVS): Prenatal test done in weeks 10 and 12 of pregnancy in which a sample of chorionic villus - wispy projections in the placenta (structure that develops in the uterus during pregnancy to provide oxygen and nutrients to the growing baby) is removed and tested to confirm or rule out CF in the baby.

Amniocentesis

Amniocentesis: Prenatal procedure in which a sample of amniotic fluid (fluid that surrounds and protects a baby in the uterus) is removed and tested to check if the baby has CF.

Common Risks Associated With Prenatal Testing

Certain risks are common to both the prenatal tests. They include

Miscarriage,
Rh sensitization (occurs in women with Rh negative blood), and
Uterine infection.

Amniocentesis carries additional risks, although rare, such as needle injury, which may occur if the baby moves in the path of the needle used during the procedure.

Also, the baby might develop orthopaedic problems if there is chronic leakage of the amniotic fluid after the procedure.

Fetal Monitoring

Fetal monitoring is the procedure used to assess the rate and rhythm of the fetal heart and determine the fetus’s health. It is generally recommended during late pregnancy and labour.

CTG is useful to detect fetal distress during pregnancy and or during labour.

fetal distress can occur for many reasons:

-during pregnancy if there is evidence of growth restriction, or if there is history of trauma ( fall or car accident), or if placental abruption occurred.

-during labour, fetal distress can occur if there is a cord around the neck, or if there is compression of cord against the uterine wall, or silent placental abruption, or in cases of long labour and poor placenta oxygenation.

The average heart rate of the fetus lies between 110 and 160 beats per minute, which can vary up to 5-25 beats per minute. The heart rate may vary as the fetus responds to the uterine conditions, but an abnormal pattern may indicate problems such as the lack of oxygen supplied to the fetus.

Methods

The fetal heart and uterine activity ( CTG ) can be monitored by two methods:

External monitoring: by placement of a device on the mothers’ abdomen so that the fetal heartbeat can be heard and recorded. External monitoring can be done to:

Track the baby's heart rate during rest and movement
Measure the frequency and duration of contractions during labour and delivery
Detect premature labour
Monitor the baby's health if certain problems are suspected
Monitor the placenta (membrane lining the womb and enveloping the fetus) and ensure that the baby gets enough oxygen
Monitor for delayed fetal growth, if you have hypertension, diabetes or you have been pregnant for more than 41 weeks

Internal monitoring: placing an electronic device directly on the scalp of the fetus monitors fetal heart rate.

Once the doctor determines the head of the fetus with a gloved hand, a plastic electrode will be inserted into your vagina which will guide a spiral wire, which will be placed on the fetal scalp.
The wires of the electrode will be held around your thigh with a band and will be connected to the monitor.
The electrode will be removed after the birth of the baby.