What kind of tests are recommended?
ACOG’s recommendations on prenatal testing are to receive routine laboratory/diagnostic tests during the first prenatal visit such as: blood type and screen, CBC for H&H.MCV, platelet count, Hepatitis B surface antigen, syphilis screening, screening for gestational diabetes, HIV testing, cervical cancer screening, urine C&S and urine drip for protein and glucose.
Cystic fibrosis screening, hemoglobinopathy screening, chlamydia testing, and gonorrhea testing are also offered if certain criteria are met.
Subsequent prenatal visits include fetal assessments, vital signs, urine dips for protein and glucose, pelvic exam if fetal heart tones are not heard with amplification, aneuploidy screening, anatomic survey ultrasound, neural tube defect screening, amniocentesis for women with increased risk for aneuploidy, neural tube defect screening offered to women who elect first trimester screening or invasive testing for aneuploidy, screening for gestational diabetes, repeat testing for sexually transmitted diseases for at-risk women, Group B Strep screening, baseline non-stress test, contraction stress test, ultrasonography, and biophysical profile.
The testing done between 11-14 weeks of gestation is nuchal translucency screening/combined screen for fetal aneuploidy, which detects most major chromosome abnormalities.
This is accomplished through appropriate counselling, measurement of nuchal translucency by appropriately trained sonographers, and measurement of maternal serum ß-hCG and PAPP-A by laboratories that can demonstrate good quality assurance performance.
Women may choose to have this test because there are good detection rates and it will give the mother time to figure out what her next step will be, such as having a diagnostic test or ending the pregnancy. Women may decline this test because of the possibility of a false positive or because the test would not alter their decision to continue with the pregnancy anyway.
These tests all aid the primary care provider and the expectant individual make informed decisions regarding care, support, and treatment during the course of the pregnancy and birth.