9 Must-Know Facts About Pregnancy Tests You Can’t Ignore

Embarking on the journey of pregnancy can be a wonderful experience. However, it can also be pretty daunting to a first-time mother-to-be who has no idea what to expect now that her annual gynecologist visits have become far more frequent, filled with tests, monitors, and ultrasounds.

The process does not need to be frightening. Instead, with a bit of study and preparation, new moms can be aware of the importance of various tests that will be done, the benefits of those tests, and any potential risks that would make them not worth taking.

Each visit to the OB will begin the same way, except for the initial visit. Each visit will require the mom-to-be to provide a urine sample, stand on the scale for a weight check, and then sit calmly while the nurse does blood pressure and temperature checks.

All of these help document your vitals throughout the pregnancy and allow the doctor to pinpoint if any serious issues are developing, like gestational diabetes or pre-eclampsia.

It is very important to catch these conditions early on, which is why monitoring weight gain and blood pressure can help a doctor catch these conditions as soon as possible.

Other than these regular tests, various other blood draws and ultrasounds will be done periodically. These tests are typically administered with very little to no pain, and they help ensure the safe growth and development of the fetus.

First Trimester

There is always an element of suspense and perhaps some anxiety around the first visit to the OB/GYN’s office. In order to confirm your at-home pregnancy test results, the doctor will also give you a pregnancy test. They will also do an exam and even a PAP smear if you are due for one and have not had it completed recently.

Most doctors will perform an ultrasound or schedule one to determine your due date. Prior to the ultrasound, they will base your due date on the dates of your last period, so be prepared for that question when you head in for the appointment.

Once your pregnancy is confirmed, the next step is a blood draw for some pregnancy-related tests. Those tests include testing for your blood type, Rh factor, anemia, sexually transmitted infections, and cystic fibrosis.

The doctor or a nurse will also ask if you want to be tested for HIV, and if you do, that test will be performed at the same time as those previously listed.

If the initial ultrasound is not done while you are at the office, it is typically done within a week to 10 days after your first appointment. This depends on the OB’s personal preferences and routines.

During that ultrasound, measurements are taken to see what stage of development the fetus has reached and whether a heartbeat can be found. That can help determine the accuracy of the initial due date assigned based on the mother-to-be’s last known period.

Here is a fact that is not widely shared: the first ultrasound is typically done vaginally, compared to those ultrasounds you see on tv where there is a gel applied to the abdomen and the wand is simply moved over the stomach area.

Those ultrasounds happen later in the pregnancy when the baby grows bigger and easier to find with the wand. However, the first ultrasound to determine the level of development of the fetus is completed through the vagina, similar to a Pap smear.

This can be slightly uncomfortable, but that discomfort is far overshadowed by the initial view of the life growing inside you.

First Trimester Screen

The next step on your testing journey is the “First Trimester Screen,” completed between the 11th and 14th weeks of pregnancy.

This test involves having blood drawn and an ultrasound completed. Both are done on the same day, and the ultrasound is done after the initial one to determine how far along the pregnancy you are.

The screening looks for markers for birth defects and chromosomal abnormalities, including Trisomy 18, Down Syndrome, and others.

These issues can be determined by testing for high protein levels in the blood, hence the blood test. They can also be determined by measuring the fluid levels in the back of the baby’s neck.

A high fluid level in this area can indicate these issues are present. However, your OB/GYN may not necessarily require or even offer an ultrasound. It is good to check with your doctor and see what tests they prefer to run.

Second Trimester

The Second Trimester starts with a significant test. This test is known as the Multiple Marker test, also called the triple or quadruple marker screening. It is administered to evaluate levels of a certain protein, alpha-fetoprotein, and two pregnancy hormones, estriol and human chorionic gonadotropin (hCG), in the blood.

For the quad marker, the additional inhibin-A substance is also measured. These measurements help doctors screen for Down Syndrome and neural tube defects. They are used in conjunction with the woman’s age, weight, race, the number of fetuses being carried, and whether the woman is diabetic.

It can also be combined with the results of the first-trimester screen. This test is typically administered between the 15th and 20th weeks of pregnancy, although different doctors prefer different forms of it—hence the triple or quadruple marker labels.

Ultrasound

The fun test for the pregnancy, if you want to find out the gender, is administered during the second trimester. Another ultrasound is completed sometime around the 18th to 20th weeks of pregnancy.

This ultrasound measures the chambers of the baby’s heart and the levels of amniotic fluid. It also evaluates the umbilical cord and other elements of the womb and the growing fetus. That is not the fun part, though.

The fun part is, this ultrasound can determine the gender of your growing baby, allowing your plans to focus more on blue or pink, should you so choose. This makes numerous elements of the preparation more fun, although being surprised at the birth is definitely worthwhile for those with the patience and the belief that the surprise is part of the fun.

Glucose Test

This test is usually administered between the 24^th and 28^th weeks of pregnancy. It requires the mother-to-be to drink a sugary beverage and have her blood drawn one hour after the drink is consumed. The drink must also be consumed within a specific time frame (a matter of minutes) to ensure the accuracy of the test.

Those who do not get a number within a certain frame are considered at risk for gestational diabetes, and further tests are required to determine the precautions to be taken going forward.

Those who have gestational diabetes have a risk for higher-weight babies at birth, as well as other risks. This test helps the medical professionals catch the issue so the mum-to-be’s diet can be monitored and altered as necessary. In severe cases, the mother must also have insulin administered.

Third Trimester

As the final trimester begins and progresses, visits to the OB’s office become more frequent. As mentioned before, they continue to do urine tests, weight checks, and blood pressure checks at every visit. However, the need for blood draws and tests in that manner decreases.

The fetus’s heartbeat is typically checked at every visit, and some doctors like to measure the growth of the fundus—or the top portion of the uterus. This is done using measuring tape that is stretched from the hips to the top of the stomach as it grows to accommodate the fetus growing within.

Another ultrasound may or may not be done during this trimester, depending on your doctor’s preference or the coverage allowances of your insurance.

If an ultrasound is done, it can be done in both 3D and 4D, providing great shots of your developing baby that warm your heart and heighten your excitement to meet the newest family member.

However, if another ultrasound is not performed, the excitement is not in any way lessened as you count down to the finish line of this drawn-out waiting period. 40 weeks is nothing to sniff at, as all women who have carried children to full term – and beyond – can tell you.

No-Stress Test

As your pregnancy is winding down to the moment of birth, some mothers are given regular no-stress tests to make sure the baby is not experiencing any discomfort or distress.

These tests typically involve a visit to the hospital’s maternity ward, where a fetal monitor is strapped to the abdomen and left there until the attached machine has received a detailed printout of the baby’s movement. For some moms, this requires the consumption of a snack and some juice to get the baby moving.

For others, the babies are not fans of the monitor. Once they discovered the pressure and sound associated with the monitor, those babies expressed their displeasure with the situation. Sometimes, it seems like they are trying to dislodge the monitor with eerily accurate kicks.

This is good news, however, since it means the machine registers the required amount of movement, and mom and baby can escape the monitors and head home. Don’t worry; the baby is not harmed or caused distress by this monitoring experience.

Further Testing For At-Risk Pregnancies

For moms-to-be who are older (age 35 and above), have had multiple miscarriages, a child born with a birth defect or previous pregnancies where chromosomal abnormalities were present, or have a family history of medical issues like heart problems or other serious concerns like genetic disorders, the pregnancy can be considered high-risk.

If this label is applied to your pregnancy, it simply means more care and attention is taken to attempt to ensure a healthy pregnancy and the delivery of a healthy child. For this reason, additional tests may be administered.

Amniocentesis

This test is administered if the doctor must diagnose certain disorders or issues. This test not only has a risk of miscarriage (1 in 300 to 1 in 500), but it can cause uterine infection, which endangers the baby. This is because the test involves extracting amniotic fluid to be tested.

The risks of this test need to be weighed against the potential knowledge that can be gained from testing the amniotic fluid.

Percutaneous Umbilical Blood Sampling

This test involves extracting the infant’s blood from the umbilical cord to perform further testing to diagnose chromosomal abnormalities. It is quick and usually used with an ultrasound and amniocentesis.

This is done to confirm when an abnormality is found via ultrasound. If the amniocentesis is inconclusive, this test may also be administered. This test is usually done after the 18^th week of pregnancy.

Certain other screenings can be offered to prospective parents who have families with complex medical histories. These include screenings for Sickle Cell Disease, spinal muscular atrophy, Tay-Sachs Disease, hepatitis C, toxoplasmosis, Fragile X Syndrome, and Canavan Disease.

Research and Take Confidence in Your Knowledge

Not every test the OB offers is necessary to have done. This is something that not every first-time mom-to-be realizes. However, it is very true. If you have any concerns about the test, any potential harm to the fetus, or discomfort for yourself, simply do some research and discuss the possibilities with the doctor.

For example, if the glucose test is failed, the one-hour test involving a sugary drink becomes a three-hour test where a drink containing more sugar is consumed and must be kept down while blood is drawn every hour. No food can be consumed during or before the test after midnight of the previous day.

This can cause significant discomfort for a pregnant woman. If this is an issue, other tests can be administered. Also, the glucose test is not the most accurate indication that a mother-to-be has gestational diabetes. Therefore, it will not significantly impact your health if you choose to pursue an alternate test path.

Consider this Checklist to help you understand the tests your OB may offer you. These tests are not all mandatory and may be something you should consider skipping. Being informed can also cut down on potential misunderstandings that can increase stress. Stress during pregnancy is something to avoid.

Therefore, knowing all of your options and the potential alternatives can go a long way to keeping you and the growing baby healthy during your navigation of a first pregnancy – or one in a line of pregnancies when you may not have realized you had alternatives to the testing your doctor made to sound necessary.

Parenting is a tricky road to navigate, from the point of conception until your death. You are a parent beyond your child’s high school graduation or introduction to adulthood. Even as your child becomes a parent in his or her own right, you still are there to help, guide, and worry—that is the gift of parenting that keeps on giving.

Being prepared by researching the various tests and understanding the options can be very calming and helpful to you as a prospective parent.

While the medical field has come a long way, that does not mean doctors know everything. Nor does it mean that everything a particular doctor says or recommends must be done to have a healthy pregnancy and ensure the baby’s health.

Final Thoughts

You will spend a lot of time visiting your OB’s office, conversing with the doctor and the nurses, and discussing your options and concerns. Do not hesitate to ask the doctor questions to understand everything happening better.

They may have done this numerous times, but this is your pregnancy, and their job is to make sure you understand and are comfortable every step of the way.

Also, remember that every pregnancy is different, so your opinions on your situation and the potential issues in your pregnancy are valid because this pregnancy is a once-in-a-lifetime experience.

If you choose to carry other children, your future pregnancies will differ from this journey.

Therefore, be comfortable with the current testing and screenings. If new screenings are offered, ask why they are being offered now, if they are safe, and what the doctor thinks based on your pregnancy’s progress. Then, weigh the options and your feelings along with the recommendations and find a decision that makes you happy.

Resources:

http://kidshealth.org/parent/system/medical/tests-first-trimester.html#

http://www.parents.com/pregnancy/stages/1st-trimester-tests/prenatal-test-checklist/