First trimester tests during pregnancy
Keep your diary or smartphone calendar handy, as the first trimester of pregnancy, from week zero to week 13, will soon fill up with tests, screenings and other antenatal appointments.
This list looks at common tests for healthy women having uncomplicated pregnancies. Additional tests or screening more often may be recommended based on individual circumstances.
During one of your initial examinations, your doctor or midwife will identify your blood type and Rh (rhesus) factor, screen for anaemia and test for hepatitis B, syphilis, and HIV. Depending on racial, ethnic, or family background, you may be offered tests and genetic counselling to assess risks for diseases such as Tay-Sachs, cystic fibrosis, and sickle cell anaemia (if these weren't done at a preconception visit). Tests for exposure to diseases such as toxoplasmosis and varicella (the virus that causes chickenpox) may also be done if needed. Your health care provider may also want to check your levels of hCG, a hormone secreted by the placenta, and/or progesterone, a hormone that helps maintain the pregnancy. In April 2016 it was announced that women in England would no longer be routinely screened for immunity to rubella (German measles).
You will also be asked early on for a urine sample so that your doctor or midwife can look for signs of kidney infection and, if necessary, to confirm your pregnancy by measuring the level of hCG. (A blood hCG test to confirm pregnancy may be used instead.) Urine samples will then be collected regularly to detect glucose (a sign of diabetes) and albumin (a protein that may indicate pre- eclampsia, which is associated with high blood pressure).
Chorionic villus sampling (CVS)
If you're 35 or older or have a family history of certain diseases, you will be offered this optional, invasive test usually between 11 and 14 weeks of pregnancy. CVS can detect many genetic defects, such as Down’s syndrome, sickle cell anaemia, cystic fibrosis, haemophilia, and muscular dystrophy. The procedure involves either threading a tiny catheter through your cervix or inserting a needle into your abdomen to obtain a tissue sample from the placenta. The procedure carries a 2% risk of inducing miscarriage and is about 98% accurate in ruling out certain chromosomal birth defects. But, in contrast to amniocentesis, it does not help in detecting neural tube disorders, such as spina bifida and anencephaly, or abdominal wall defects.
A procedure that combines a blood test with an ultrasound to screen for Down’s syndrome may be available between 11 and 14 weeks of pregnancy. The results of a blood test that measures hCG and/or PAPP-A (pregnancy-associated plasma protein A) in maternal blood are used with an ultrasound measurement of the skin at the back of the foetus’ neck (called nuchal translucency). The procedure may be able to pick up a substantial portion of Down’s syndrome cases and other genetic conditions. However, as with all screening methods, a more invasive diagnostic technique like CVS is used to follow up a positive screen.