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Prenatal Tests
 
Throughout your pregnancy, you will be offered a variety of routine medical tests as part of prenatal care. These tests help you and your health care provider know how you and your baby are doing.

There is a LOT to learn...


With the help of the American Pregnancy Association website, we
are able to offer complete information on the available laboratory
and diagnostic tests.






Urinalysis with Culture & Sensitivity


... used to assess bladder or kidney infections, diabetes, dehydration and pre-eclampsia by screening for
high levels of sugars, proteins, ketones and bacteria. HBMS in-office urinalysis screens for 10 parameters:
  • Glucose
  • Protein
  • pH
  • Blood
  • Ketones
  • Bilirubin
  • Nitrites
  • Urobilinogen
  • Specific Gravity
  • Leukocyte


... used to evaluate woman's health status in early pregnancy; evaluate for anemia, leukemia, reaction to inflammation and infections, peripheral blood cellular characteristics, state of hydration and dehydration, polycythemia, hemolytic disease of the newborn, and ABO incompatibilities.
  • ABO grouping and Rh typing;
  • Antibody screen & titre;
  • CBC (complete blood count) with differential;
  • HBsAg (Hepatitis B);
  • Hepatitis C
  • Rubella antibodies, IgG;
  • Syphilis serology (RPR/VDRL)


... used to determine if a mother is infected with HIV. HIV transmission from mother to child during pregnancy, labor, delivery or breastfeeding is called perinatal transmission. If infected with HIV, the mother's risk of transmitting the virus to her baby is reduced if she stays as healthy as possible. According to the March of Dimes, new treatments can reduce the risk of a treated mother passing HIV to her baby to a < 2% chance.



Gonorrhea
and Chlamydia Cultures/Urinalysis

... used to determine the presence of Gonorrhea and Chlamydia bacterial infections by assessing the secretions from infected areas: cervix, urethra, anus, or throat. Vaginal cultures and/or urine are the most common specimen samples taken for laboratory analysis.







... used to detect premalignant and malignant processes in the cervix. A vaginal speculum is used to take cells from the outer opening of the cervix and the endocervix. The cells are examined under a microscope to look for abnormalities. The test aims to detect potentially pre-cancerous changes (cervical intraepithelial neoplasia [CIN] or dysplasia), which are usually caused by sexually transmitted human papilloma viruses (HPVs). The test may also detect infections/abnormalities in the endocervix & endometrium.


... used to identify chromosome abnormalities and other inherited disorders. CVS is a diagnostic procedure which involves removing some chorionic villi cells from the placenta at the point where it attaches to the uterine wall.
There are two ways that samples are collected.
  • Transcervical: An ultrasound guides a thin catheter through the cervix to your placenta. The chorionic villi cells are gently suctioned into the catheter. This is the most common method.
  • Transabdominal: An ultrasound guides a long thin needle through the abdomen to your placenta. The needle draws a sample of tissue and then is removed. This procedure is similar to that of amniocentesis.


... used as a screening test for open neural tube defects, Down syndrome and trisomy 18. Performed at 16 to 19 weeks. Screening tests do not look only at results from the blood test.  They compare a number of different factors (age, ethnicity, results from blood tests, etc...) and then estimate what a person’s chances are of having an abnormality. These tests DO NOT diagnose a problem; they only signal that further testing should be done.

The test includes:
  • α-Fetoprotein (AFP);
  • human chorionic gonadotropin (hCG);
  • unconjugated estriol (uE3)



... used to identify gestational diabetes in pregnant women. A preliminary screening test is performed @ 26-28 weeks: Glucose Challenge Screening. A positive result indicates the need for a second test: Glucose Tolerance Test. This test will diagnose whether diabetes exists or not by indicating whether or not the body is using glucose effectively.

    The testing medium options are:50g Glucola drink, or


    ... used to detect a type of bacterial infection that can be found in a pregnant woman’s vagina or rectum. This bacteria is normally found in the vagina and/or rectum of 15-25% of all healthy, adult women. Those women who test positive for GBS are said to be "colonized". A mother can pass GBS to her baby during delivery. GBS is responsible for affecting about 1 in every 2,000 babies in the United States. Without treatment, statistics show that just under two babies for every 1,000 will become infected. In lay terminology, not every baby who is born to a mother who tests positive for GBS will become ill. Primarily because of advances in NICU care, >3% of sick, term babies will die of invasive GBS disease.



    ... used to assess the health and well-being of the fetus. A NST may be performed if:
    • the baby is not moving as frequently as usual,
    • pregnancy is past the known/estimated due date,
    • there is any reason to suspect the placenta is not functioning adequately,
    • there are high risks for any other reason(s).



    ... used early in pregnancy to diagnose potential ectopic or molar pregnancies and calculate due date. Used throughout pregnancy, as medically indicated, to detect or aid in the detection of abnormalities and conditions related to pregnancy. Ultrasounds are usually combined with other tests, such as triple screen, amniocentesis,or chorionic villus sampling (CVS)to validate a diagnosis. Ultrasound should ONLY be performed when "medically indicated." As noted above, ultrasound enables your healthcare provider to evaluate the baby’s well being as well as diagnose potential problems. For women with an uncomplicated pregnancy, ultrasound is not a necessary part of prenatal care, with the exception of women planning to give birth outside of a hospital. In this case, one mid-term ultrasound is "medically indicated" to rule-out abnormalities of the fetus or placenta, and/or identify any at-risk conditions which may make out-of-hospital birth unsafe.

    An ultrasound exam is medically indicated throughout pregnancy for the following reasons:  
    First Trimester:

    Confirm viable pregnancy

    Confirm heartbeat
    Measure the crown-rump length or gestational age
    Verify dates
    Confirm molar or ectopic pregnancies
    Assess abnormal gestation


    Second Trimester:

    Diagnose fetal malformation
    Weeks 13-14 for characteristics of potential Down syndrome
    Weeks 18-20 for congenital malformations
    Structural/Placental abnormalities
    Confirm multiple pregnancy
    Verify dates and growth
    Identify hydramnios or oligohydramnios – excessive or reduced levels of amniotic fluid
    Evaluation of fetal well-being
    Confirm intrauterine death
    Third Trimester:

    Identify placental location
    Identify hydramnios or oligohydramnios – excessive or reduced levels of amniotic fluid
    Evaluation of fetal well-being
    Observe fetal presentation
    Observe fetal movements
    Identify uterine and pelvic abnormalities of the mother
    Confirm intrauterine death





    Download this document:   HBMS Prenatal Testing Schedule and Informed Consent




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