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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Prenatal Exams, Tests, and Procedures
What are prenatal exams, tests, and procedures?
Various exams, tests, and procedures are a part of your
checkups during your pregnancy. Some tests are routine and
done for all pregnant women. Other tests are optional or
may be ordered by your health care provider in certain
situations, particularly if concerns or problems arise.
At each visit your health care provider will discuss with
you any problems you are having, such as headaches, swelling
of your hands or feet, contractions, or bleeding. Keep all
of your appointments. This allows early detection of any
problems. Your health care provider can then adjust the
plan for your care as needed.
What signs and symptoms of pregnancy will my health care
provider check?
Your health care provider will look for various signs of
pregnancy and ask about your symptoms at different stages of
your pregnancy. These signs and symptoms include:
- nausea, fatigue, breast tenderness or enlargement, and
urinary frequency in early pregnancy
- an embryo that can be seen in an ultrasound scan as early
as 5 to 6 weeks after your last period
- enlarged uterus at about 6 to 8 weeks
- enlarged abdomen at about 14 weeks
- parts and movements of the baby that can be felt by
your health care provider at about 18 weeks
- the baby's heartbeat heard by a Doppler fetoscope at 12
to 14 weeks, or by an ordinary fetoscope at about
19 weeks
- movement by the baby felt by you at about 20 weeks if
this is your first pregnancy, or as early as 16 weeks if
you have been pregnant before
- changes in the color of your vagina, cervix, and skin.
What are the routine tests and procedures?
The routine tests and procedures done during prenatal visits
include:
- pelvic exam to determine the size of your pelvis and a
Pap smear of the cervix (usually done only very early in
the pregnancy)
- calculation of the gestational age of the baby (how long
you have been pregnant)
- measurement of your weight and blood pressure
- tests of a sample of your urine to look for protein,
sugar, and other chemicals in the urine
- measurement of the height of the fundus (top of your
uterus)
- determination of the size and position of the baby
- test of a sample of your urine to look for bacteria in
the urine (This test may be done once each trimester or
when you have symptoms of a bladder infection.)
- blood tests to check for anemia (may be done each
trimester)
- blood tests to check for diabetes when you are 28 weeks
pregnant
- blood tests for blood type and Rh antibodies and to see
if you are immune to rubella (a type of measles)
- blood test to check for syphilis
- cultures of cells from your cervix to test for infection
- blood test for hepatitis
- examination of your ankles and lower legs for swelling.
Your health care provider will offer to test you for HIV
infection (the virus that causes AIDS) and may counsel you
about AIDS. The result of this test will be kept strictly
confidential.
What other tests might my health care provider order?
Some tests are optional and are often done only if they are
medically necessary. They include:
- chorionic villus sampling from the placenta for
information about your baby's chromosomes and detection
of some birth defects
- amniocentesis for chromosome information and detection of
some birth defects
- serum alpha-fetoprotein measurement to screen for certain
birth defects
- ultrasound scans as needed to look at the baby and your
uterus, amniotic sac, placenta, ovaries, and pelvis
- nonstress tests to check the health of the baby (checks
the baby's heart rate when the baby moves)
- diabetes screening
- triple test, which provides more accurate screening for
birth defects and includes tests for alpha-fetoprotein
(AFP), human chorionic gonadotropin (HCG), and
unconjugated estradiol (uE).
Women with high risk factors may have additional tests and
procedures, such as:
- test for herpes
- repeated Rh antibody screening at 28 to 30 weeks and a
shot of Rho(D) immune globulin if you are Rh negative
- amniocentesis to see how mature the baby's lungs are
- blood tests for clotting studies or liver function
- nonstress tests once or twice a week
- biophysical profile (checks the health of the baby with
a nonstress test and ultrasound)
- contraction stress tests to check the baby's health
(check the baby's heart rate during uterine
contractions).
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