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Your Guide to Prenatal Appointments

Prenatal Testing 101

BLOOD TESTS: During your pregnancy, you’ll be amazed by how much blood you can part with at a time. A battery of prenatal blood tests identify your blood group, hemoglobin level, iron, immunity to infectious diseases, such as German measles, and whether you are Rhesus (Rh) positive or negative.

Most people (85 percent) are Rh-positive, but if you’re Rh-negative, your blood may be incompatible with your baby’s. “If an Rh-negative mother is pregnant with an Rh-positive baby and any of the baby’s blood cells enter the mother’s blood stream, her body will produce antibodies to break down the baby’s red blood cells,” says Georgoussis.

The Rh blood test is typically done around 28 weeks because there’s a greater chance of bleeding in the later stages of pregnancy, she says. “If the test shows that you’re Rh-negative, you’ll be given an injection of Rh immunoglobulin, which protects your baby by preventing antibodies from forming.”

URINE TESTS: At every prenatal visit you’ll have to do a urine test to measure levels of sugar, protein or bacteria in your urine. The test is used to determine whether you might have diabetes, kidney disease or a urinary tract infection (UTI).

Although you may not notice any symptoms, being pregnant makes you more susceptible to UTIs that can put you at risk of developing a kidney infection, which can cause premature labor. If you test positive for a UTI, you’ll be given a course of antibiotics to clear up the infection.

ULTRASOUNDS: Ultrasound images are created by sound waves as they bounce off organs inside the body. (You’re asked to have a full bladder because it helps the sound waves travel through skin and tissues.) Depending on your care provider, you may have an ultrasound early on (between 11 and 14 weeks) to date the pregnancy. You may already be able to see your baby’s heartbeat at this point.

At around 18 weeks, you’ll have a lengthy anatomy scan in which an ultrasound is used to check your baby from head to toe to assess his size and growth and to look for any abnormalities. Depending how your baby is positioned, this is when you may also be able to find out the sex.

GLUCOSE SCREENING: This test is done between 24 and 28 weeks. Gestational diabetes is one of the most common health problems during pregnancy and a glucose screening test is necessary because the condition seldom causes symptoms.

You’ll be given a large sugary drink that tastes like pop and, an hour later, your blood is drawn and tested for elevated sugar levels. If you test positive, you will be retested with a longer, glucose tolerance test (but don’t panic–only about a third of women who test positive during glucose screening actually have gestational diabetes).

If you are diagnosed with gestational diabetes, your doctor will help you come up with a plan to help you manage the condition, which may mean altering your diet and routinely monitoring your glucose levels with an at-home kit. Most of the time, gestational diabetes goes away after you have your baby, although you may be given another glucose test at your six-week checkup, just to be sure.

GROUP B STREP: At around 36 weeks, you’ll be given a test to determine whether you have group B streptococci. “We do it as late as possible because it’s a normal body flora so the swab can be positive or negative at any time,” says Georgoussis. About 20 percent of women carry the bacteria normally on their skin, but it can cause severe infections in newborns and can be passed on to them during a vaginal birth.

The test involves swabbing the outside of the vagina and rectum with a Q-tip. “If you test positive, it doesn’t mean you have an infection,” says Georgoussis. “It just changes how we manage your labor.” If you have the bacteria, you will receive intravenous antibiotics when your water breaks or when you go into labor, whichever comes first.

Meet our expert:

Susan Georgoussis is the co-founder of Becoming Maternity and Parenting Centres and a mother of four. She is a certified perinatal nurse specialist (PNC), lactation consultant (IBCLC) and Lamaze childbirth educator (LCCE). For more than 25 years, Susan has focused her career on women’s health issues related to birth and parenting.