Routine Visits and Tests During Pregnancy
During pregnancy, there are a number of tests that are performed to check the health of you and your baby. Below outlines the most common schedule of visits and routine tests we perform as part of your overall obstetric care.
- First Visit - 26 weeks: Visits usually every 4 weeks
- 26 weeks - 32 weeks: Visits usually every 3 weeks
- 32 weeks - 36 weeks: Visits usually every 2 weeks
- 36 weeks and beyond: Weekly visits until you deliver
Each visit will include a urine dipstick, blood pressure and weight check. After 20 weeks, your belly will be measured to determine the appropriate growth of the baby. The doctor or midwife will listen to your baby's heartbeat with a Doppler at each visit after 12-14 weeks.
If you have a high-risk pregnancy or complications during pregnancy, your schedule and tests will be different from those outlined below. Make sure you follow the schedule as determined by your doctor or midwife.
First Prenatal Visit
Your doctor or midwife will perform the following:
- Obtaining a full medical history including past medical problems, surgeries, previous pregnancies and medications.
- Full physical exam, including a pap smear (if needed) and STD testing (for chlamydia and gonorrhea)
- Urine dipstick to check for protein and/or glucose in urine
- Urine culture to check for urinary infections
- Blood work to test for Hepatitis B, HIV, Rubella immunity and Syphilis
- Complete blood count to check for anemia and platelets
- Blood type (A, B, O blood types) and RH status (positive or negative), antibody screen
- Ultrasound to confirm estimated due date and heartbeat (may be delayed if you are very early - usually done after 8 weeks)
First trimester screening for birth defects is available. The screening test includes a ultrasound to measure the thickness of a pocket of fluid on the back of the baby's neck (called "Nuchal Translucency") and a blood test.
See the link on our website about screening tests for birth defects to learn more.
This is usually when the anatomy ultrasound is scheduled. Many women ask that their ultrasound be earlier, however, the heart is best visualized after 19-20 weeks. This ultrasound looks at basic anatomy, including the brain, heart, bladder, kidneys, face and limbs and overall growth and fluid. It can also determine the sex of your baby by looking directly at the genitals, however, this is not considered essential to the evaluation.
This is usually the time for your diabetes screen in pregnancy. All women are screened using the one-hour glucose tolerance test. You do not have to fast for this test, but you should not eat for 1-2 hours before drinking the glucose drink.
A blood test will be performed exactly one hour after drinking the glucose drink - we check for a blood sugar level below 140 and also perform a screen for anemia. If your blood sugar is above 140, you will need to do additional testing to see if you have gestational diabetes.
If you have Rh Negative blood, we will usually repeat your antibody screen and give your first shot of RhoGAM to prevent complications from blood type mismatch. See our website for more information about Rh status and Iso-immunization
Your doctor or midwife may elect to retest for anemia or certain STDs in high-risk populations.
Screening for Group B Strep (GBS) usually occurs at this visit. Group B Strep is a bacteria that is present in the vaginal area about 30% of the time. GBS IS NOT AN INFECTION, however, having GBS present in the vagina at any point during the 5 weeks before delivery puts babies at increased risk for infection after birth. If you are positive for GBS, you will be given antibiotics during labor to help prevent infection in your baby.
36-37 weeks and beyond
Your doctor or midwife will often perform an internal exam on you to determine if your cervix is changing, especially if you are experiencing contractions or pressure.