When you visit your doctor during pregnancy, your health and your pregnancy is monitored and for this purpose, the doctor may advise you the following investigations during the pregnancy: Complete blood count. Blood group including Rh typing. If your blood group is Rh negative, your husband’s blood group will be tested. If his blood is Rh positive than your anti body titres are tested by indirect Coombs test (ICT). Screening for infections: HIV 1 and 2, hepatitis B, syphilis (VDRL), HCV. Rubella IgG Screening for thalassemia: Haemoglobin electrophoresis Blood sugar: fasting and two hours after meals. To diagnose if there is any fetal abnormality, following blood tests are done:
(a) dual test,
(b) triple-marker test, and
(c) quadruple test.
Screening for thyroid problems: Serum TSH may be done. If the report shows that you are hypothyroid or hyperthyroid you must consult an endocrinologist and follow the treatment advised by them. You need to get serum TSH done every six weeks for monitoring your thyroid level (If you are diagnosed as hypo/hyperthyroid).
Urine routine and microscopic examination to rule out any bacterial infection, if needed urine culture is done to rule out any infection in urine. Ultrasound examination during pregnancy Nowadays with the development in the technology, the growth of your foetus (i.e., your unborn baby) is monitored with frequent ultrasound examinations during antenatal period.
1. Ultrasound in the early pregnancy is done: To confirm foetal viability To confirm, if the pregnancy is in the uterus To know the exact duration of pregnancy For early diagnosis of multiple pregnancies and its chorionicity. If there is an episode of bleeding in the current pregnancy If there is history of missed abortion / spontaneous abortion in previous pregnancy.
2. Once cardiac activity has been detected by first ultrasound another ultrasound is done for nuchal translucency (NT) between 11 weeks and 13 weeks six days. NT is an important component of the first trimester test for Down syndrome.
3. Level II ultrasound is done between 19 to 20 weeks to rule out any congenital anomalies in the foetus. During level II scan each and every organ of the foetal body is examined in detail so as to exclude any abnormality.
4. In high risk pregnancy foetal echo is done between 24 and 26 weeks of pregnancy. Foetal echo is also done if level II scan detects any abnormality in the foetal heart.
5. Ultrasound between 32 to 34 weeks of pregnancy is done to know the fetal weight, position of placenta, amount of amniotic fluid and fetal well-being.
6. In high-risk pregnancies few more ultrasounds are done for Doppler study.
How often various blood tests are required during pregnancy:
In addition to the blood tests done during the first antenatal visit, following blood tests are repeated according to the duration of pregnancy:
Haemoglobin estimation is repeated at: around 20 to 24 weeks pregnancy around 32 to 34 weeks pregnancy near-term i.e., around 38 weeks Screening for gestational diabetes is done between 24 to 28 weeks pregnancy by 75 g glucose challenge test. The blood are taken fasting, one-hour and two hours after taking 75 g glucose. Gestational diabetes is diagnosed if any of the result is abnormal. You will be advised to consult an endocrinologist, follow his advice regarding diet and medicines, if that is required to maintain your blood sugar levels within prescribed limits. You need to test your blood for glucose levels from time to time, as you need to maintain your blood glucose level within normal range. If you are Rh negative ICT is repeated at around 20 weeks, 28 weeks and if ICT is negative than injection Anti-D is given at around 28 weeks in all Rh negative pregnant women. ICT is advised in all pregnant ladies at around 32- 34 weeks of pregnancy irrespective of their Rh status. Urine examination is done during early pregnancy at around 24 to 28 weeks pregnancy at around 34 to 36 weeks pregnancy. At around 38 weeks of pregnancy complete blood count, prothrombin time, APTT and INR tests are advised. At around 37th week of pregnancy digital pelvic examination is done to exclude disproportion between the pelvic size and fetal head.