Here's what you should expect from prenatal tests and screenings.
Getting pregnant can throw even the savviest mom into an unfamiliar world of medical and technical jargon. With so many tests, doctors poking and prodding at you, and strangers groping your belly, it can be very disorienting. Here’s a pocket guide to prenatal testing, so you know what to expect, what to watch out for, and which questions to ask.
1. Urine test: Get ready to pee in lots and lots of cups, ladies. You’ll be doing a sample at just about every exam from here on out. The first one is to confirm your pregnancy by measuring your hCG levels. The subsequent tests are to check for urinary tract infections, preeclampsia, and gestational diabetes.
2. Sequenom/MaterniT 21 test: The MaterniT 21 PLUS is a non-invasive prenatal test that screens the expectant mom’s blood for specific irregularities, such as trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome) and trisomy 13 (Patau syndrome). As a fun plus, the test will also be able to tell you if you’re having a boy or a girl, and can be performed as early as nine weeks.
3. Chorionic villus sampling (CVS): This test can diagnose chromosomal and genetic disorders by removing a small amount of cells from the placenta. You can also determine the child’s paternity via CVS. This test does carry a small risk of miscarriage and infection. It’s typically performed at 10 to 13 weeks.
4. First trimester screen (also known as a sequential screening): A standard exam offered at 11 to 14 weeks. It’s a non-invasive way to pinpoint potential disorders. The mother submits a blood sample, and an ultrasound is used to measure the back of the fetus’ neck. If anything abnormal is detected, your doctor may recommend another test (such as an amniocentesis or CVS screening).
5. Amniocentesis: Performed at 14 to 20 weeks, the amnio can diagnose a wide range of birth defects, such as down syndrome, cystic fibrosis and spina bifida by testing a small amount of amniotic fluid. Many mothers are hesistant to get this test done because of the risk of miscarriage. Your doctor may recommend it if you are higher risk, or if your sequential screening indicates an abnormality.
6. Maternal serum (aka quad screen or triple test): A blood test to detect chromosomal disorders and neural tube defects between 15 to 20 weeks.
7. Ultrasound: Although an ultrasound can be done at any point, most doctors order one between 18 and 20 weeks to ensure that baby is growing well. It’s noninvasive and not painful. The sex of the child can usually be told at this point.
8. Glucose challenge screening: My stepdaughters accompanied me for this test. As we sat around the lab, they asked what we were doing. I explained that I had drank some juice, and now we were going to see what happened to it. That’s pretty much it: drink the juice and get your blood drawn to check your blood sugar levels. It’s done between 26 and 28 weeks to determine the risk of gestational diabetes.
9. Glucose tolerance test: Depending on the results of the above-mentioned “juice test,” your doctor may request the glucose tolerance test to diagnose gestational diabetes. Before you drink the juice, you’ll have to fast for fourteen hours.
10. Nonstress test: This test uses a belt placed around the expectant mother’s abdomen to indicate possible signs of fetal distress. It can be done any time after 28 weeks.
11. Group B streptococcus: Your OB takes a swab of your vagina and rectum (yeah, I know…fun) to look for bacteria that may pose a risk of infection to the baby. You should include this information in your birth plan (if you have one). This test happens around 36 weeks.
12. Biophysical profile: This is an ultrasound along with a nonstress test to determine if the baby is ready to be delivered. Once you hit your due date, you’ll be getting one of these just about every other day (literally).
13. APGAR scale: A quick assessment of how your newborn baby is doing. It stands for appearance, pulse, grimace (reflex irritability), activity and respiration. The higher the score the better, with 7-9 being ideal. Most newborns lose a point or two for blue hands and lips, which is generally not a reason for concern.
14. Six-week checkup: Your OB or midwife will want to see you six weeks after delivery to make sure you’re healing well, that any tears or incisions haven’t been infected, and that you’re emotionally healthy. You’ll generally get your birth control and your clearance to start working on the next baby at this appointment as well.