If you suspect you are pregnant, it is important that you know for sure as soon as possible. There are many home pregnancy tests available at local drug stores that deliver fast, accurate results. You can use one of these tests as early as one day after your first missed period. Make an appointment with your obstetrician as soon as you know you are pregnant.
The Initial Visit
During this first prenatal visit to your local OB/GYN clinic, your doctor will perform a thorough physical examination, obtain a complete medical history, and ask for blood and urine samples. The nurse will ask you the date of the first day of your last period. Doctors measure pregnancy across 40 weeks beginning from this date. Before leaving the office, you will make the appointment for your next visit. As your pregnancy progresses, you will undergo several routine tests and exams. Depending on your health and the baby’s development, your physician may order additional, more detailed tests along the way.
The First Trimester
In addition to recording your weight, blood pressure, and abdominal measurements, the nurse or physician will listen to the baby’s heartbeat at every visit, using a special device called a fetal Doppler. If you are under the age of 35, have no health issues, and the baby’s development seems normal based on your abdominal measurements, you may not receive a fetal ultrasound during the first trimester. However, some physicians may order an ultrasound if you request it.
Prior Health Issues
If you had diabetes, high blood pressure, or other health complications before pregnancy, or are over the age of 35, the doctor may order additional screenings. Women with pre-pregnancy diabetes or high blood pressure are at higher risk of developing health problems later in pregnancy. Because of this, your doctor may schedule more frequent visits as well as further lab tests as your pregnancy progresses.
Over Age Thirty-Five
Women who become pregnant after age 35 have and increased risk of delivering a baby with chromosomal abnormalities, such as Down syndrome. For this reason, he may order a late first trimester screening involving a blood test and a specialized ultrasound procedure that measures the baby’s neck or nuchal fold. Another test available during the late first trimester is called chorionic villus sampling (CVS). With this test, a sampling of chorionic villi, located on the placenta is taken for genetic testing. A highly trained technician will take the sample by inserting a tube made of thin, flexible material into the vagina and through the cervix or by inserting a long needle into the abdomen, guided by ultrasound.
The Second Trimester
In the second trimester, physicians routinely order a triple of quadruple screen to check for possible indications of birth defects. The screen requires a blood sample and measures the levels of alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), estrogen, and the hormone inhibin A (quadruple screen only). If you are at risk for having a baby with genetic abnormalities due to age or other factors or if the triple or quadruple screen indicates a possible problem, your physician may order an amniocentesis. Amniocentesis tests involve sampling the amniotic fluid around your baby by inserting a long needle, guided by ultrasound, into the amniotic sac via the abdomen. Late in the second trimester, you will take an oral glucose test to screen for gestational diabetes.
The Third Trimester
During the third trimester, your OB/GYN doctor will test you for hepatitis B and group B strep. A positive test for hepatitis B will require that your baby receive a hepatitis B vaccination and hepatitis B immune globlulin within 12 hours after delivery. Strep B can cause severe illness in your baby. If you test positive for this organism, the physician will order treatment with intravenous antibiotics during labor.
Your Obstetrician – Your Partner in a Healthy Pregnancy
Your obstetrician may not order all of these tests, or he may order all of them. He will decide which tests to order based on your health history, current health status, and pregnancy progression. Discuss any concerns and questions you have with your doctor, keep all prenatal visits, and practice healthy lifestyle habits to ensure the most uncomplicated, satisfying pregnancy possible.
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