Your pregnancy weeks are counted from the first day of your last period. If you are pregnant, the first thing you will notice is that your period has not arrived. Taking a pregnancy test is the most reliable way to find out if you’re pregnant.
Do you have a positive pregnancy test? Just by getting up from the couch, you’re wiped out? Trying to figure out where the best places to puke in the office are? Congratulations on your pregnancy, and welcome to the first trimester!
If you’ve already had your first prenatal visit and seen that thumping heartbeat, you’re ready for the next step: testing. So many tests. You’ll pee into a cup several times, have your blood drawn a few times, and have an ultrasound performed on your baby by a complete stranger.
Do you want to know what tests your doctor is performing to ensure that you and your baby have a safe and healthy pregnancy? Continue reading to learn more about the tests.
These tests fall into two broad categories:
The first set of procedures are standard, but they may necessitate additional doctor and lab visits. You will have options and decisions to make regarding prenatal genetic testing, particularly during the first trimester.
Types of Prenatal Tests and Screenings
Some of the tests you’ll undergo during your pregnancy will assist your doctor in monitoring your health, while others will provide you with more information about your baby’s health.
The following are the various types of prenatal tests that can provide you with additional information about your child, including their risk of having a genetic or chromosomal condition:
Screenings
Prenatal screenings, such as blood tests, can help you determine the likelihood of a baby having a genetic or chromosomal disorder, but they cannot diagnose the disorder. If the results of these tests show that you are at a high risk for an abnormality, your doctor may recommend a diagnostic test to confirm or rule out the finding.
Diagnostic tests
Prenatal screenings, such as blood tests, can help you determine whether a baby has a genetic or chromosomal disorder, but they cannot diagnose the disease. Suppose the results of these tests indicate that you are at high risk for an abnormality. In that case, your doctor may advise you to have a diagnostic test to confirm or rule out the finding.
You started your pregnancy by peeing on an at-home pregnancy test, so it’s only natural that you’ll pee in a cup at nearly every prenatal visit. Why? Urinalysis assists your doctor or midwife detect two potentially dangerous pregnancy complications: high blood pressure (preeclampsia) and gestational diabetes. Both are treatable, but if they are not identified, they can be hazardous.
The good news is that providing a urine sample is risk-free, so drink plenty of water before each appointment!
Initial blood work
You’ll roll up your sleeve for a blood sample at your first prenatal visit, which will be tested for conditions that could affect your pregnancy and delivery. Your provider will specifically look for:
If you were not screened before conception, you might be screened for cystic fibrosis, Tay-Sachs, sickle cell anemia, spinal muscular atrophy, thalassemia, and other genetic conditions.
Pap smear
At your first prenatal appointment, your midwife or doctor may perform a Pap smear (or Pap test) to screen for abnormal cervical cells. You’ll also be tested for sexually transmitted infections (STIs), such as gonorrhea, syphilis, hepatitis B, HIV, and chlamydia.
Suppose you test positive for a bacterial infection during pregnancy. In that case, your doctor will prescribe pregnancy-safe antibiotics for you and possibly your partner because if you give birth with an untreated infection, your baby is at risk of dangerous infections such as pneumonia.
Genetic carrier screening
A carrier screening can determine whether you have a gene for (or are a “carrier” for) genetic conditions like cystic fibrosis or spinal muscular atrophy. Your doctor will most likely draw blood or swab saliva from the inside of your cheek and send it to a lab. The results will be either “positive” (you are a carrier for the condition) or “negative” (you are not a carrier for the condition). While the test can be performed before becoming pregnant, some women prefer to perform it during pregnancy.
It is carried out between 10 and 13 weeks of pregnancy. Your medical history and demographic information (e.g., height, weight, ethnicity, and smoking status) are required to provide an accurate risk assessment for early-onset preeclampsia. A maternal blood sample is analyzed for three biochemical markers: PAPP-A, alpha-fetoprotein (AFP), and placental growth factor (PlGF).
Your doctor may also perform one or both of the following biophysical measurements: a) mean arterial pressure (MAP) involves taking exact blood pressure measurements from both arms; b) uterine artery Doppler pulsatility index (UtAD-PI) uses a particular type of sonogram to examine the uterine artery (ultrasound).
First Trimester Genetic Screening and Diagnostic Testing
Pregnant women can begin receiving first-trimester screening and tests for certain chromosomal conditions around week 10. Suppose the screening results indicate that your baby has an abnormality. In that case, you can receive additional diagnostic testing to confirm or rule out the diagnosis.
If you choose early screening and testing, you will have more time to make medical decisions during your pregnancy and after delivery.
Noninvasive prenatal testing
Noninvasive prenatal testing (NIPT) or noninvasive prenatal screening (NIPS) is a blood test that analyzes DNA fragments in a woman’s bloodstream (also called cell-free DNA, or cfNDA). The test, which can be performed around week 10 of pregnancy, can detect chromosomal abnormalities such as Down Syndrome, trisomy 18, and trisomy 13.
Nuchal translucency screening (NT)
An ultrasound is used to screen for nuchal translucency (NT) between weeks 10 and 13. The nuchal fold, a pocket of fluid behind the baby’s developing neck, is measured in this routine test. Babies who have increased fluid and swelling in this area are more likely to have chromosome abnormalities such as Down syndrome. Hormonal levels drawn during the NT can also indicate an increased risk of preeclampsia.
Chorionic villus sampling (CVS)
Suppose a NIPT or NT reveals that your baby is at a higher-than-usual risk for particular congenital conditions. In that case, your doctor may advise you to undergo a diagnostic test known as chorionic villus sampling (CVS). This test will take a small sample of the placenta, which contains the baby’s genes. It will either confirm or rule out the presence of the chromosomal condition in your child. CVS is typically performed between weeks 10 and 13 of pregnancy.
First Trimester Ultrasound
An early ultrasound is typically performed as part of routine prenatal care between weeks 6 and 9. However, it can occur at any time before week 14. On the other hand, a first-trimester ultrasound isn’t a common practice because it’s still too early for your practitioner to see your baby in detail.
Most practitioners will not perform the first pregnancy ultrasound until the patient is at least 6 weeks pregnant. On the other hand, a gestational sac can be seen as early as 4 1/2 weeks after your last period.
A fetal heartbeat can be detected as early as 5 to 6 weeks (though this is not always the case). If your doctor decides to perform an early ultrasound, you will get your first glimpse of your baby. This sneak peek is used to:
During pregnancy, two types of ultrasounds are used: transvaginal ultrasounds and transabdominal ultrasounds. Both types of scans are painless and typically last about 20 minutes. The type of ultrasound you will receive is determined by how far along you are in your pregnancy.
You’ll be able to watch along with your practitioner during your first ultrasound (though you’ll probably need help understanding what you’re seeing). You’ll almost certainly take home a tiny printout as a souvenir.
Transvaginal ultrasound
If you have your first pregnancy ultrasound before week 6 or 7, it will most likely be a transvaginal ultrasound. A small, long transducer (or wand) is inserted into the vagina and wrapped in a sterile cover.
The wand will then be moved within the vaginal cavity to scan your uterus. There will be pressure, but it should be painless.
The transducer sends out sound waves that bounce off of structures (such as your baby) to produce an image that you can see on a computer or video screen.
Transabdominal ultrasound
If your first ultrasound occurs after week 6 or 7, it will undoubtedly be a transabdominal ultrasound. A gel is applied to your belly to aid in the movement of sound waves, and the wand is then rubbed over your stomach to generate images of your baby.
This exam should not be painful, but it may be slightly uncomfortable if the sonographer needs to press hard on your abdomen to see a specific part of your baby more clearly (especially with a full bladder).
What’s the bottom line?
While testing can be stressful, information can be handy, especially when it comes to your or your child’s health. The results of all of these tests will enable you to make better healthcare decisions and, in many cases, to receive treatment to solve or manage unexpected conditions.
An early ultrasound is typically performed as part of routine prenatal care between weeks 6 and 9. However, it can occur at any time before week 14. On the other hand, a first-trimester ultrasound isn’t a common practice because it’s still too early for your practitioner to see your baby in detail.
