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Pregnancy (cont.)

Exams and Tests

Several tests may be conducted while a woman is pregnant.

Pregnancy tests: The woman's urine or blood may be tested.
- Women may choose to use a home pregnancy test. This is a urine test kit that can be purchased at a pharmacy or grocery store. The test can indicate whether a woman is pregnant. This type of test is known as a qualitative test. It can only test yes or no for the pregnancy hormone, beta-hCG. If a doctor is considering prescribing a medication that might not be appropriate to take during pregnancy, one of these simple tests may be performed in the office to determine if a woman is pregnant or to make sure she is not pregnant. If the test is performed very early in a pregnancy, the hormone level may still be negative. Some home pregnancy tests might not show positive results until 7-10 days after a missed period.
- More sophisticated tests are called quantitative because they measure hCG levels in the blood. This type of testing is completed by drawing blood for testing at a hospital or doctor's office. These levels indicate how far along a woman is in her pregnancy. If levels of hCG do not rise as she progresses in her pregnancy, it could indicate something is wrong (such as an ectopic pregnancy with low levels) or surprising (high levels may indicate twins).
Ultrasound: A doctor may use sound waves to examine the internal structures such as the uterus, ovaries, and the embryo or fetus.
- Transabdominal ultrasound: A jelly is put on the abdomen, and a hand-held sound-wave wand is moved around to look at the internal structures. The woman's bladder must be full to help transmit the sound waves, so she may be asked to drink two to three glasses of water starting an hour before the test. This method works best later in pregnancy when the fetus is well developed. The doctor may have a scan performed during the first trimester to make sure the pregnancy is in the uterus and not outside it (ectopic pregnancy) and to assess the woman's risk for having a miscarriage. The scan can also tell if more than one fetus is developing. During the remainder of the pregnancy, scans may be used to look for problems, assess the age and development of the fetus, check out its position, and, by 17 weeks, determine the sex. There is no risk to the woman or her developing fetus with ultrasound, and it is not uncomfortable. Ultrasounds help doctors establish the due date. Due dates can now be predicted within two to four days if the ultrasound is performed early enough.
- Endovaginal or transvaginal ultrasound: A long, thin, sound-wave wand is covered with a condom and put inside the vagina. This type of ultrasound is usually performed early in pregnancy to make sure that the embryo or fetus is inside the uterus where it belongs. This type of ultrasound also gives more detail, for instance, about the structure of the woman's cervix and the early embryonic anatomy.
- Targeted Ultrasound Tests: A targeted or level II ultrasound exam provides a detailed assessment of fetal anatomy. It is recommended if there are concerns for fetal problems based on other tests or history.
- Nuchal Fold Translucency Tests: A non-invasive screening for genetic defects. A certified ultrasound technologist measures the fold at the back of the neck. Measurements are then formulated to calculate the risk factor for certain birth defects. It is usually done at 10-14 weeks gestation and offered with a blood test that also screens for birth defects.
Blood tests
- Complete Blood Count
- Blood type, Rh status, and antibody test
- Thyroid test (optional)
- Urine culture
- Sickle cell screening if of African American heritage
- Syphilis tests, HIV test, and tests for hepatitis B
- Alpha fetoprotein tests or Quad Screen Test: A Quad Screen looks for four specific substances, Alpha fetoprotein, human chorionic gonadotropin, Estriol (an estrogen), and Inhibin-A (a protein produced by the placenta and ovaries).
Culture tests
- Gonorrhea culture (GC) and chlamydia culture
- Group B streptococcal test by 35 weeks
- Test for bacterial vaginosis (BV), an infection in the vagina, if the woman has vaginal discharge, burning during urination, or itching around the outside of the vagina.