Dr Olga Sambolska. Family Medical Practice
Dr Olga Sambolska*
From the beginning of the pregnancy to the delivery of the baby, a pregnant woman has to do a lot of tests. These tests help healthcare providers find possibly latent conditions that may affect the foetus and the newborn if left untreated. But what tests are needed and when?
Blood test
Blood type and Rhesus factor, negative or positive, are important to know in case a blood transfusion is needed during pregnancy or birth.
Rhesus-negative patients need anti-D injections at 28 weeks and 36 weeks to prevent antibody production.
A full blood count will detect anaemia and iron deficiency that can lead to complications such as preterm labour, low birth weight and increased risks of inflammatory diseases. This is quite common for pregnant women, and early treatment with iron-rich food and iron supplements may prevent complications.
The blood can also detect congenital physical defects such as Down, Patau or Edwards syndrome. Together with ultrasound measurement for NT (Nuchal translucency) it’s called the prenatal genetic screening test. This test is the most accurate between 11 and 14 weeks.
STI screening
Blood tests for HIV, Syphilis, Hepatitis B and C are recommended for all pregnant women. These infections can be acquired long before pregnancy, and while they may remain asymptomatic for the mother, they can harm the foetus. Timely detected infection reduces transmission to neonates, and proper treatment significantly increases the chances of good outcomes.
Chlamydia and Gonorrhoea screening is advised only for high-risk women and is not needed for all pregnant women.
Rubella test (‘German Measles’ or 3-day measles) for pregnant women who have never been vaccinated against Rubella and haven't had this disease in childhood. This blood test looks for antibodies, and in case they are high, the women should be monitored as they are at high risk of congenital rubella syndrome (severe birth syndrome).
Thyroid function
The thyroid is hyperstimulated during pregnancy, and thyroid symptoms can start during pregnancy or worsen. A thyroid test should be done at 12 weeks to evaluate thyroid function.
Gestational diabetes
Glucose intolerance provoked by pregnancy affects 10 per cent of all pregnant women who haven't been diagnosed with diabetes before pregnancy.
The test should be done between the 24th and 28th weeks.
Urine analysis
This is important during pregnancy to assess the level of proteins, sugar, ketones, and bacteria and helps to detect in early stage UTIs, dehydration, diabetes, and preeclampsia. As urinalysis is an easy and quick test which indicates many pregnancy complications, it is commonly performed during each pregnancy appointment.
Urine culture
All pregnant women should be tested for asymptomatic bacteriuria between 12 and 16 weeks. Urine test shows bacteria in urine (if it exists) and sensitivity of infection to specific antibiotics for proper treatment.
Vaginal swabs
Vaginal mount (vaginal microscopy) can be done once during pregnancy to detect Candida or BV. Vaginal swabs should be repeated in case abnormal vaginal discharge or vaginal symptoms appear later during pregnancy. All kinds of vaginal infections should be treated after 12 weeks to prevent pregnancy complications.
A vaginal swab for GBS (Streptococcus Group B) is recommended at 35-36 weeks to detect streptococcal infection, which is asymptomatic and harmless for pregnant women but can seriously affect newborns. Streptococcus can be transmitted from the mother to the foetus during vaginal birth. GBS infection is a leading cause of meningitis and sepsis in neonates. Timely testing and proper treatment usually prevent complications from this infection.
Generally, three ultrasounds are recommended during pregnancy; an early pregnancy (dating scan) to confirm intrauterine pregnancy with an alive embryo; in the first trimester (11-14 weeks) to detect congenital diseases; and a second-trimester foetal anomaly scan (18-24 weeks) for a detailed baby anomaly scan.
More can be done in case of complications or twin pregnancy.
From the beginning of the pregnancy to the delivery of the baby, a pregnant woman has to do a lot of tests. — Photo shutterstock.com
Lastly, CTG (antenatal cardiotocography) is a continuous recording of foetal heartbeat to monitor signs of foetal distress and is usually performed after 34 weeks.
*Dr Olga Sambolska graduated from Lviv National Medical University in 1996 and commenced her medical career at the Volyn Regional Maternity Hospital in Ukraine. Since 1998 she has been a registered obstetrics and gynaecology doctor, providing healthcare to women regarding pregnancy, birth control, menopausal issues, contraception, menstrual cycle diseases and sexually transmitted diseases. She is fluent in Ukrainian, Russian, Polish and English.
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