Routine Pregnancy Tests

• To confirm pregnancy
• To correlate size of uterus with date of last menstrual period
• To estimate size and shape of pelvis
• To obtain vaginal secretions to detect infection or cervical cancer (Pap smear)

Late pregnancy:

• To assess condition of cervix and station of baby
• To obtain vaginal secretions to detect infection, if indicated

• Exam may cause dark brown or reddish vaginal discharge.
• Exam may increase risk of infection or premature rupture of membranes

• To confirm pregnancy

Each prenatal visit:

• To detect infection
• To check for sugar and acetone, which might indicate diabetes
• To check for protein, which might indicate preeclampsia or infection

• Urine test may be less accurate than blood tests to confirm pregnancy.
• Urine tests are less accurate than blood tests to confirm diabetes.

• To confirm pregnancy
• To determine blood type, Rh type
• To test for anemia (hematocrit and hemoglobin)
• To test for German measles immunity
• To test for syphilis
• To test for antibodies to human immunodeficiency virus (HIV)
• To test for antibodies to hepatitis B virus

• Some tests will be repeated.
• Some caregivers do not perform all these tests.
• Anemia may be treated with iron supplements or diet changes.

• To detect pregnancy-induced hypertension (PIH) or preeclampsia

• To detect sudden weight gain that could be due to preeclampsia
• To help monitor mother’s nutritional status

• To measure the growth of the uterus (fundal height) which indicates fetal growth and gestational age

Last weeks of pregnancy:

• To estimate size and position of the fetus (Leopold’s maneuvers)
• To estimate amniotic fluid volume
• To detect breech presentation

• If a problem is suspected, ultrasound visualization is usually recommended.

• If breech, mother may use self-help measures to turn fetus; medical professional may perform external version.

• To assess the well-being of the fetus

• Hearing the FHR increases the expectant parent’s feelings of attachment for their baby and makes the baby seem more real.

• To check for flat or inverted nipples
• To assess condition of breasts for ability to breastfeed
• To detect any breast abnormalities including screening for breast cancer

• If her nipples are flat or inverted, the mother can use methods to draw them out.
• Breast self-exams should be performed regularly throughout pregnancy.

• To screen for a baby with a neural tube defect (spina bifida, anencephaly), the presence of twins, or fetal death (high level of AFP)
• To screen for Down’s syndrome (low level of AFP)

• If AFP test results are outside the normal range, then further testing includes a repeat blood test to confirm findings, ultrasound, genetic counseling, and possible amniocentesis.
• The test will not detect all cases of neural tube defects or Down’s syndrome.
• There is a high rate of false positives (the test indicated a problem when there is none).
• The test’s accuracy is questionable if the due date is unclear.
• The risk of neural tube defects is about 1 to 2 per 1,000 births.
• Insulin-dependent diabetics usually show an AFP level lower than others.
• The test helps parents plan management of pregnancy or birth (they could terminate the pregnancy, plan a cesarean if spina bifida is detected, or prepare of a child with a disability).

• To screen for Down’s syndrome (low levels of estriol and AFP combined with high levels of hCG)

• Initial studies indicate that the Triple Screen is more accurate than AFP screening alone in detecting Down’s syndrome (2 to 3 times more accurate in women under 35; 50 percent more accurate in women over 35).
• It is useful those who do not have amniocentesis, although it does not detect the hundreds of other possible inherited disorders that can be detected by amniocentesis or chorionic villus sampling.
• It is a screening procedure only; this test may miss 20 to 30 percent of Down’s syndrome pregnancies in women over 35, and 40 percent in women under 35.

• To screen for gestational diabetes, which, if untreated, may cause problems for mother and baby

• If the mother’s blood sugar is elevated, a longer and more sensitive glucose tolerance test (GTT) is planned.
• Approximately 85 percent of those with an elevated blood sugar in the screening test will be found to have normal blood sugar levels in the GTT.
• Detection of diabetes enables treatment to avoid problems for the mother of baby.