Blood (or Saliva) Tests
In a blood test, blood is drawn from your arm using a syringe and sent to a lab for evaluation. Blood tests check for:
Blood Type and Rh Factor
There are four major blood types: A, B, AB, and O. Each of these blood types is also classified by the types of antigens present. Antigens are proteins on the surface of blood cells, one of which is called the Rh factor. If you carry this protein, you are Rh positive. If you do not carry this protein, you are Rh negative. About 85% of people are Rh positive.
When the mother is Rh negative and the father is Rh positive, the fetus has at least a 50% chance of being Rh positive. Potential
result. The mother may develop antibodies to the Rh antigens in the baby’s blood if a small amount of the baby’s Rh-positive blood mixes with the mother’s blood. This rarely occurs in a woman’s first pregnancy, because fetal blood cells usually only gain access to the mother’s circulation very late in the pregnancy or during childbirth. The woman can also become sensitized to the Rh factor during a
Symptoms and complications of Rh incompatibility only affect the fetus or newborn. The mother’s health is not affected. If the mother’s antibodies cross the placenta and attack the fetus’s blood, the fetus’s red blood cells will be broken down and fetal
will result. This can cause swelling of the baby’s body, brain damage, heart failure, or even death of the fetus or newborn.
Rh incompatibility can be prevented in most cases by giving mothers Rh immunoglobulin (RhIg). This prevents sensitization of an Rh-negative mother’s blood. The first injection is given at week 28 of the pregnancy. The second injection is given within 72 hours of delivery, and after miscarriage or abortion to desensitize the mother’s blood for future pregnancies.
When an Rh-negative woman develops antibodies to an Rh-positive baby, RhIg treatment does not help. Therefore,
Rh incompatibility prenatal testing
and preventative measures are extremely important. The fetus will be closely monitored during the pregnancy. The baby may need a
after delivery. In severe cases, the fetus may be given a
while in the uterus.
If you are
anemic, you have low levels of iron in your blood. A
serum ferritin screening test
may be done to determine if you are anemic. A mild level of anemia is expected. It is normal in later pregnancy due to the mother’s expanded plasma volume. But, severe or early onset anemia can lead to extreme tiredness and increase your risk of
and low birth weight. You may be prescribed iron tablets or injections.
Sexually Transmitted Diseases (STDs)
Many STDs can harm your developing baby. Doctors routinely test for
gonorrhea, which are done by culture. Blood tests are done for:
- Hepatitis B
- Human immunodeficiency virus (HIV)
It is important to know if you have any of these conditions. There are things that you can do to help prevent the STDs from spreading to your baby.
Risks of Certain Diseases
are usually mild diseases in nonpregnant women. However, they can cause birth defects if a mother is infected for the first time during pregnancy.
is a genetic disease. Both parents must be CF gene carriers for the baby to get the condition. There is no cure for CF, although treatment has greatly advanced in recent years. CF is most likely to occur if the parents are Caucasians of Northern European descent.
Some pregnant women develop high blood sugar levels during pregnancy. This is called
gestational diabetes. It is due to hormonal changes in the body that affect insulin absorption. You may be asked to take an oral glucose tolerance test around the 24th to 28th week of pregnancy. This includes a special sugar-loaded drink and repeated
blood tests. Women at high risk should be screened sooner.
If you have symptoms or a history of thyroid disease, you may undergo
to confirm it. It is usually treated with the medication
to bring thyroid-stimulating hormone (TSH) back to normal levels. This reduces the risk of complications for the baby and mother.
Serum Screening Tests
At 15-20 weeks, a mother’s blood components can be tested to find out if the baby is at increased risk for
abdominal wall defect,
Down syndrome, and trisomy 18 (another type of genetic disorder). At 10-14 weeks, these blood serum tests can be combined with a special ultrasound, called nuchal translucency, to identify signs of Down syndrome, trisomy 18, and other birth defects.
Triple Screen or Multiple Marker Screening
The triple screen is a maternal blood test that measures the levels of three substances normally produced by the fetus or placenta. The test is used to identify pregnancies that have a higher-than-average risk of certain birth defects, such as Down syndrome and neural tube defects.
The triple screen can be done between the 15th and the 20th week of pregnancy. However, it is most accurate when done between the 16th and 18th week. The screening is done through a normal blood draw and poses no risk to the mother or fetus.
The triple screen test is available for all pregnant women, but is recommended for those who are 35 years or older. It may also be recommended for pregnant women with:
- Birth defect history
- History of illicit drug or harmful substance use
- Viral infection
- Radiation exposure
The three substances the triple test measures are:
- Alpha-fetoprotein (AFP)—protein normally produced by the fetus
- Estriol—estrogen produced by both the fetus and placenta
- Human chorionic gonadotropin (hCG)—hormone produced within the placenta
The triple screen is a screening test, not a diagnostic test. This means the test can only assess risk. It cannot diagnose a condition. A woman’s individual risk of having a child with birth defects is calculated using the levels of AFP, estriol, and hCG combined with the mother’s age, weight, and race.
The test results are expressed as odds. For example, “the odds this baby has Down syndrome are now greater than, less than, or equal to” what was expected based on the mother’s age and medical history.
If the triple screen shows increased risk, additional testing is done, as well as a referral to a genetic specialist. It is important to remember that the test only indicates the likelihood of an outcome—it is not diagnostic. Many women with a positive screening test do not have a child with a birth defect. This is considered a false positive result.
AFP is sometimes tested alone, without hCG and estriol. Also, an additional marker can be added to the test, making the triple screen a quadruple screen. The substance is inhibin A, which is a glycoprotein. Studies have found that a greater number of markers increases the accuracy of the screening test.
A swab of your vagina or rectum may be taken by your doctor to check for signs of infection or changes in cell structure. A swab or smear may be taken for:
or other conditions—A cervical or
is often done at the beginning of pregnancy to check for abnormalities in cells or other conditions, such as
- Group B streptococcal infection
Group B Streptococcal Infection (GBS)
Group B streptococcus (GBS) is a bacterium that can cause life-threatening infections in newborns. Many people carry GBS but do not become ill. One of every four to five pregnant women carry GBS in the rectum or vagina. During birth, a newborn may come in contact with this bacterium.
Occasionally babies born to a mother who carries GBS will develop signs and symptoms of the disease. Most cases occur within the first week of life and most cases are apparent a few hours after birth. GBS infection can lead to severe infection,
meningitis. Once diagnosed, GBS infections can be treated through intravenous antibiotics.
A woman can be checked for GBS during pregnancy. The test should be done late in pregnancy, during weeks 35-37. The doctor takes a swab of both the vagina and rectum, which is sent to a lab and grown in culture.
If the result of the test is positive, then you are considered a carrier of GBS. If you test positive for GBS or are at high risk, your doctor will recommend giving you IV antibiotics during labor and delivery.