Early in your pregnancy you will visit the G.P. or midwife who will ask various questions about your general health, your
family history, social history, and about any previous pregnancies which you have had. This is not a test but it is very important
as it can raise issues which may result in you needing special attention during the pregnancy. At this check you will be weighed
and your height will be taken, this is to see if you are significantly underweight or overweight which may increase the
risks during pregnancy. You will then undergo regular checks where the midwife will check
- the growth of the baby.
This is done by a midwife or doctor during routine antenatal checks. They use a tape to measure
from the top of the growing uterus (womb) to the pubic bone (the bone at the bottom of your abdomen).
- your blood pressure.
to ensure that it is normal as raised blood pressure can indicate problems such as
pre-eclampsia
the baby's position. The midwife will examine your abdomen to feel the baby to detect if the baby is lying in breech
position (bottom down). If so, treatment to turn the baby to a head down position may be considered.
your urine. Urine is checked at antenatal checks using a simple dipstick test to detect protein in the urine this
may indicate early
pre-eclampsia or high blood pressure. During pregnancy you can have an infection of the urine without symptoms so bacteria
is checked for. Your sugar levels are also checked, pregnant have sugar in their urine sometimes but if it is present regularly
then it may indicate gestational diabetes, which can be controlled by a change in diet or possible insulin injections
Blood tests
A sample is taken and sent to the labs to check for:
- Anaemia.
The common reason for anaemia is lack of iron which can usually be treated easily with iron tablets.
- Blood group.
If you are rhesus D negative and your baby is rhesus positive then you may form anti-D antibodies in
your bloodstream. These are not dangerous in the first pregnancy, but can attack the blood cells of a baby who is rhesus D
positive in any future pregnancy. To prevent this you will usually be offered anti-D injections later in the pregnancy. Various
other antibodies sometimes develop against red cells. Their significance varies and a doctor or midwife will explain if any
action should be taken if they are detected.
Certain infections
Some uncommon but serious infections are checked for. These are:
- HIV.
This is the virus that causes AIDS. You can be infected with HIV for years before it causes symptoms. The risk
of passing this virus on to your baby can be greatly reduced with treatment during pregnancy and delivery by caesarean section.
- Hepatitis B.
Many people are carriers of this virus but have no symptoms. In some cases it can cause serious liver
damage. If you have this virus, it may be prevented from affecting your baby if the baby is immunised at birth.
- Syphilis.
This is a sexually transmitted infection. Again, you can be infected with these bacteria without realising
and pass it on to your baby. It can develop into a serious illness. It can be treated with antibiotics.
- Rubella status.
This test checks for antibodies to the rubella virus (German measles). If antibodies are present it
means that you are immune to this infection. If you are not immune, when you are pregnant you should keep away from anyone
who may have rubella.
A repeat blood test at about 28 weeks is usually offered to re-check for anaemia and red cell antibodies.
Early in the pregnancy you will be offered a test for sickle cell and thalassaemia disorders which are commonly inherited
conditions.
Inherited conditions
If you have a family history of Cystic Fibrosis, Tay Sachs or Duchenne muscular dystrophy then extra testing is offered
to detect these conditions
Routine ultrasound scans
An ultrasound scan is a safe and painless test which uses sound waves to show you a picture of your child in the womb.
A routine ultrasound scan is usually offered at:
At the scan it can be established the delivery date, a check is made to ensure that the baby is developing normally
and the position of the placenta is also checked. The scan will also establish if you are carrying one or more children.
And by far the most important thing once you establish that everything is ok is the baby's first portrait.
Screening for Down's syndrome
Down's syndrome is a condition which is caused by an abnormal chromosome. Children with Down's syndrome have learning disabilities
and often have other medical problems. There are different screening tests for Down's syndrome and so different tests may
be used in different areas. The initial blood test usually picks up 2 out of 3 babies who are affected. Your doctor
or midwife will explain the type of test performed in your area, and the implications of the results. For more information
read
Down's syndrome
Screening for Edward's Syndrome
Edward's syndrome is caused by a chromosomal abnormality. Many babies who are affected by it have severe heart problems
and often learning difficulties, many die young. It is not as common as Down's syndrome
Screening for placenta previa Placenta previa means that the placenta is covering the opening from the
uterus to the cervix. This can cause serious problems during childbirth. If an earlier ultrasound scan indicates that you
may have a placenta previa, a repeat scan at 36 weeks pregnancy may be advised to clarify the position of the placenta before
delivery. Your midwife or GP will be able to advise you further on this issue. Or to read more on placenta previa
click here
If it is found that you have a high level risk of Down's or Edward's syndrome you will be offered an amniocentesis. An
amniocentesis is a diagnostic test where a small amount of fluid from around the baby is collected by passing a needle guided
by a scan into the abdomen and into the uterus. The sample is then sent for chromosomal analysis and the results usually
return within 3 days. The test carries a 0.5 to 1% risk of miscarriage so it is up to you whether you choose to do it
or not.
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