Pregnancy: regular checkups

If you suspect you are pregnant, you can use a home pregnancy test, which should be done one day after the expected missed period. Pregnancy is measured in weeks from the first day of your last menstrual period. There are several ways to calculate the weeks of pregnancy.

As soon as you know that you are indeed pregnant, make an appointment with your doctor. Your first visit will help him/her to fully obtain all the necessary information that can be used throughout the pregnancy.

Good pregnancy care includes regular prenatal checkups. At each visit, you will be weighed, have your abdominal circumference measured, have a urine test, and have your blood pressure checked. Be sure to ask your doctor any questions you may have. At certain stages of your pregnancy, you will have several additional checkups and tests. Some are routine, and some are ordered if certain risk factors arise.

The first prenatal checkup and tests include a medical history, physical examination, and blood and urine tests.

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Deciding whether to test a child for birth defects

Discuss with your doctor the possibility of testing for birth defects in your fetus. There are several types of tests. If you have concerns, get tested early in your pregnancy. If the risk of having a baby with birth defects is low, you may choose not to have the test. On the other hand, if the results will not affect your decision to have a baby, you may choose not to have it at all.

Para-aminobenzoic acid screening test (test for detecting latent forms of the disease): a blood test and ultrasound show the presence of pathology in the fetus. Some medical centers perform screening for Down syndrome at the end of the first trimester using a blood test and ultrasound measurement of the thickness of the fetal occipital folds. This diagnostic can also be performed at the beginning of the second trimester of pregnancy and is considered quite safe for the mother and fetus.

Diagnostic testing identifies fetal defects if screening results show a high risk of fetal abnormalities. In this case, chorionic villus sampling or amniocentesis is performed. If you have a family history of fetal abnormalities, you can immediately undergo diagnostic testing without prior screening testing. You just need to remember that amniocentesis and chorionic villus sampling slightly increase the risk of miscarriage.

First trimester examination and tests

Includes ultrasound examination of the fetus, which can determine the condition of the baby and placenta. At the end of the first trimester, non-invasive screening for Down syndrome is performed using a blood test and ultrasound measurement of the thickness of the fetal occipital folds. Chorionic villus sampling is performed earlier than amniocentesis (in the second trimester).

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Examination and tests of the second trimester of pregnancy

They may include fetal ultrasound and electronic fetal monitoring. At the very beginning, you may be given a triple or quadruple analysis. It shows the level in the blood of:

• alpha-fetoprotein;
• human chorionic gonodotropin;
• estrogen (estriol);
• inhibin A (quadruple assay only).

If you are at risk for developing fetal defects or the triple or quadruple screening suggests a problem, you will need to have an amniocentesis. Later in the second trimester, you will need to be tested for gestational diabetes (an oral glucose tolerance test). If you are Rh negative, a blood test will detect the presence of antibodies, after which you will likely be given immunoglobulin.

Third trimester examination and tests

Includes ultrasound of the fetus, tests for hepatitis B and streptococcal infection. All pregnant women should be tested for HIV. But sometimes this test is done only at the woman's request.

What should you think about?

When you want to do genetic testing, you need to keep in mind the appropriate time for it.

• Chorionic villus sampling is performed in the first trimester of pregnancy (usually at 10-12 weeks), while amniocentesis is performed at 15-20 weeks. The test results will influence a woman's decision to have a baby or terminate the pregnancy. Biopsy results are known within a few days, but amniocentesis results are known after 2 weeks.
• Chorionic villus biopsy does not detect neural tube defects, so the alpha-fetoprotonin test, which is part of triple screening, is also recommended.
• Chorionic villus sampling and amniocentesis pose a low risk to pregnancy because the membranes of the fetus are disrupted. One in 400 pregnancies are reported to have miscarried as a result of this testing. The risk is lower if the procedure is performed by highly trained professionals.