Tests That Need to Be Performed During Pregnancy

In order for mothers to have a healthy pregnancy and give birth to a healthy baby, they need to have certain tests done at certain times during their pregnancy. Then, what are these tests?
The tests that should be performed during pregnancy help both the baby and the mother to go through this process healthily and provide timely treatment when necessary. Yeditepe University Kozyatağı Hospital  Gynecology and Obstetrics Specialist Prof. Dr. Rukset Attar talked about the tests that should be performed during pregnancy and their importance.

The First Step Is Beta HCG

The first test to be performed during pregnancy is the blood pregnancy test, which we call beta hCG. This test is important both to show whether the pregnancy really exists and to distinguish between ectopic pregnancy and intrauterine pregnancy. For this purpose, ultrasonography should be performed together with beta hCG. Apart from this, blood group determination, complete blood count, free T4, TSH, and biochemistry tests should be performed. Determination of blood group is important for the determination of blood incompatibility, while blood count and biochemistry tests are important to show whether the expectant mother has anemia and to evaluate her current health status. Free T4 and TSH tests are important because thyroid disease affects the development of the baby as well as the mother. In cases where the mother-to-be is Rh-negative and the father-to-be is Rh-positive, an indirect Coombs test called the blood incompatibility test should be performed.

It is necessary to perform a screening test for infections called perinatal infections during pregnancy that can affect both the mother and the baby. These tests include Hepatitis B, Hepatitis C, HIV, VDRL, syphilis, Toxoplasma, CMV, and Rubella. The common feature of these infections is that they can result in miscarriage, stillbirth, prematurity, intrauterine growth retardation, congenital malformations, acute illness at birth or immediately after birth, or a normal-term baby. In addition to these tests, a complete urinalysis should be performed, because occult urinary tract infections during pregnancy can cause early miscarriage, premature birth threat, and early water breaking.

As The Second Trimester Begins

Between 11-14 weeks, a blood test called the double screening test, which shows the risk status for some chromosomal disorders, especially Down Syndrome, is performed. An ultrasound is performed the day before this test will be performed. In ultrasound, the neck thickness of the baby is measured, and it is checked whether there is a nasal bone or if there is a cardiac or another anomaly.
In risky pregnancies, a free fetal DNA test can be performed in the mother's blood starting from the 10th week. In the Free Fetal DNA test, fetal chromosomes are examined by obtaining free fetal DNA from the blood of the expectant mother. Although it is not a definitive diagnostic test, it is considered a reliable screening test. This test is recommended for patients with high risk in the double or triple screening test, if the expectant mother is 35 years of age or older at the time of birth, and for mothers with increased risk of aneuploidy (chromosomal anomaly) detected by fetal ultrasound, those who have a history of giving birth to a baby with trisomy (Down Syndrome) or who have a risk of a chromosomal anomaly in detailed ultrasound.
16-20 weeks, a triple or quadruple test can be performed for the screening of chromosomal anomaly and spina bifida. Double, triple, and quadruple screening tests and free fetal DNA tests in the mother's blood are screening tests. Therefore, in cases where there is a high risk in these tests, chorionic villus biopsy, amniocentesis or cordocentesis should be performed according to the gestational week in order to make a definitive diagnosis.
Between 20-22 weeks, detailed ultrasonography is performed to evaluate parameters such as the condition of the baby's organs, the condition of the placenta, called the baby's partner, the length of the cervix, and the blood flow in the vessels feeding the uterus.
With the effect of pregnancy hormones during pregnancy, diabetes of pregnancy called gestational diabetes can be seen in women who do not have diabetes. If gestational diabetes is not diagnosed and treated, it may cause problems in the baby in the intrauterine period, during delivery, and in the postnatal period. Therefore, it is important to diagnose it. For this purpose, a 75-gram sugar loading test is performed between 24-28 weeks. Another test is the 50-gram sugar test, and in case of a high value, a 100-gram sugar load test is performed for diagnosis. In addition, complete blood count, urinalysis, and urine culture are repeated. In pregnant women with Rh incompatibility, an indirect Coombs test should be repeated at 28 weeks and a blood incompatibility injection should be done according to the result. 

Last Weeks

In the last months of pregnancy, NST is performed to evaluate both the mother's pain and the baby's heartbeat. NST is started at 32-34 weeks of pregnancy. However, in the presence of pregnancy-related risk factors such as the threat of preterm birth, it can be started in earlier weeks. Cultures are taken from the vagina and anus for group B streptococcus between 35-37 weeks. Complete blood count and urinalysis are repeated according to the complaints of the expectant mother throughout the entire pregnancy.