Pregnancy is a splendid journey that every woman wishes to experience. From carrying a tiny peanut to a fully grown baby, that is what pregnancy is all about. Oh, and let’s not forget the part of bringing that tiny person in this world. Sometimes there is even more than one bun in there! Wink! And though being pregnant is a blissful feeling, the period of nine months comes with its own challenges. To make sure that your pregnancy goes smoothly, you need to go through several tests. Let’s find out All About Pregnancy Tests and What to Expect?

During your pregnancy, you will be going through several tests of a list a mile long. But don’t let panic creep in. Carrying a tiny human inside for nine long months affects the normal functioning of your body. From your hormones to your emotions and body, everything will be changing and then changing again. To ensure that these changes are within the healthy parameters, you need to take these tests. A healthy baby will come from a healthy mama. And these tests will monitor your health and ensure you have a happy pregnancy.

All About Pregnancy Tests and What to Expect?

The First Pregnancy Test

The very first pregnancy test that you have to take is not in a maternal clinic but right in your bathroom. You can have it in a clinic as well but most women these days prefer to use a home kit and then move things from there to the clinic. Yup, we are talking about those sticks on which you have to pee and then wait a few minutes to know whether you are pregnant or not. Now how would you know that using only a stick? There is a hormone called HCG (Human Chorionic Gonadotropin) which is produced in your body only when you are pregnant. This urine pregnancy test checks if this hormone is present or not. Generally, if you have missed a period then you should take this test. Other symptoms like tender breasts, fatigue, nausea or a feeling of bloated abdomen could also be a sign for you to take a test.

Once you have taken a blood test and got a confirmation of pregnancy, your doctor would order a number of tests and screenings for you. while some of these tests would be common, there would be some additional tests in case of a high risk pregnancy.

COMMON TESTS DURING LOW-RISK PREGNANCY

Genetic Screening

If either you or your partner has a history of genetic disorders, chances are there that your baby could inherit those. With genetic screening, genetic abnormalities can be diagnosed. Either you can ask for this test or your doctor could recommend this.

Blood Tests

Blood tests will happen at different stages of your pregnancy. This is done to find out your blood group, blood sugar level, iron levels, Rh factor, and infection.

Thyroid

Produced by your pituitary gland, TSH (Thyroid Stimulating Hormone) is responsible for the regulation of hormone production and metabolism throughout your body. Your TSH levels will also be checked throughout your pregnancy at different stages. The normal TSH levels are:

• During the first trimester, it should be about 0.6 to 3.4 mU/L
• During the second trimester, it should be about 0.37 to 3.6 mU/L
• During the third trimester, it should be about 0.38 to 4.0  mU/

Sugar [Fasting, Post-Prandial, OGTT]

The blood sugar level is one of the key players during pregnancy. Good control over blood glucose level ensures a smooth pregnancy free of complications for both the mother and the baby. Generally, your blood sugar is 100 mg/dL but pregnant women have low sugar levels. These are the normal blood glucose level for a pregnant woman.

• For a fasting blood test (no food within eight hours), blood sugar should be under 95 mg/dL.
• For a post-prandial blood test (after a meal), blood sugar should be less than 120 mg/dL.
• An Oral Glucose Tolerance Test (OGTT) will also be done to find gestational diabetes which women develop temporarily during pregnancy.

Haemoglobin

Your haemoglobin level is checked to diagnose anaemia which is a result of decreased haemoglobin and red blood cells. Due to pregnancy, your haemoglobin level is dropped to 10.5g/dl which is completely normal. This happens because of the increase in blood plasma levels. Following is the range of normal haemoglobin level during pregnancy.

• 1st trimester of pregnancy: 11.6 to 13.9 g/dl or 116 to 139 g/L
• 2^nd trimester of pregnancy: 9.7 to 14.8 g/dl or 97 to 148 g/L
• 3^rd trimester of pregnancy: 9.5 to 15 g/dl or 95 to 150 g/L

HIV, Syphilis, Hepatitis B

A screening for sexually transmitted diseases (STDs) such as HIV/AIDS, syphilis, herpes, hepatitis B and C, gonorrhea, and Chlamydia is done as early as possible so as to prevent these diseases from being transmitted to the baby. Your immunity to rubella will also be tested since it can cause multiple birth defects.

Uric Acid

High uric acid levels in pregnancy can create complications such as pre-eclampsia, high blood pressure or gestational diabetes. Normal levels of uric acid during pregnancy are:

• First trimester: 2-4.2 mg/dL or 119-250 µmol/L
• Second trimester: 2.4-4.9 mg/dL or 143-292 µmol/L
• Third trimester: 3.1-6.3 mg/dL  or 184-375 µmol/L

NT Scan

In a Nuchal Translucency (NT) scan, an ultrasound is used to examine the area at the back of the baby’s neck for increased fluid or thickening. Too much clear space in this area can indicate Down syndrome or some other chromosome abnormalities.

Anomaly Scan

Also known as mid-pregnancy scan or 20-week scan, the anomaly scan is done to check your baby’s health. During this scan, several parts of the baby’s body are examined such as heart, brain, limbs, spinal cord and other organs as well as the position of placenta and amount of amniotic fluid. They will check for any abnormalities in this scan which you shouldn’t really worry about.

Color Doppler Scan [28 weeks]

Color Doppler scan is a Doppler sonography, a technique which is used to measure movements such as speed and direction of blood flow as well as heartbeat. This scan will show whether your baby’s growth is normal and whether all the tissues with enough blood and nutrients are supplied.  

TESTS FOR HIGH RISK PREGNANCY

Mothers of age above 35 years have higher chances of a high-risk pregnancy. Besides that, an unhealthy lifestyle including smoking, drinking and substance use can also cause a high-risk pregnancy. There are some tests which are recommended in such circumstances.

Double Marker Screening Test

Generally done in the first trimester, between 9 and 14 weeks, a double marker screen test involves blood test. This test is used to diagnose any chromosomal irregularities or neurological defects in the baby and detects conditions like Edward’s syndrome or Down’s syndrome.

Triple And Quadruple Marker Screening Test

The triple and quadruple marker screening tests are the types of multiple markers which measures different substances of a pregnant woman’s blood and see if your baby has any chances of having birth defects.  A triple screening test measures the three substances that are:

• Alpha-fetoprotein screening (AFP): a protein made by the baby’s liver.
• hCG: the human chorionic gonadotropin hormone made by the placenta.
• Estriol: a form of estrogen hormone made by the placenta.

Add another substance to be measured and the marker test becomes a quad screening test. This substance is:

• Inhibin: a hormone made by the baby and the placenta.

Lupus Anticoagulant

Lupus is a chronic condition in which your immune system attacks different healthy tissues of your body. This malfunctioning of the immune system can cause complications in pregnancy and may even induce miscarriage. Your doctor would order multiple blood tests to diagnose LAs in case you have unexplained blood clots or have had multiple miscarriages.  

APLA

Similar to LA, APLA test is done to diagnose Antiphospholipid syndrome (APS) which produces antibodies known as antiphospholipid antibodies (aPL) that attacks the person’s own body. APS is mostly associated with pregnancy complications such as pre-eclampsia, thrombosis, autoimmune thrombocytopenia, fetal growth restriction, and miscarriage.

Cell-Free Fetal DNA

Cell-free fetal DNA (cffDNA) is a genetic material released by the placenta. It is extracted from the mother’s blood and screened to see if the baby has any risk of having chromosome problems. Another name of this test is Non-invasive prenatal testing (NIPT).

Amniocentesis

An amniocentesis test is done in which a small sample of amniotic fluid is taken to determine genetic abnormalities or chromosome problems and open neural tube defects (ONTDs) like spina bifida. It takes place somewhere between 14 to 18 weeks. There is a slight risk of miscarriage in doing an amniocentesis test.

Chorionic Villus Sampling

In Chorionic Villus Sampling (CVS), your doctor will take a sample of placental tissue to diagnose any chromosomal abnormalities such as Down syndrome, sickle cell, cystic fibrosis, haemophilia, etc. This test is done between 10 and 12 weeks. A CVS also carries a risk of miscarriage.

LFT

Liver Function Test is done to check the changes in the liver functions during pregnancy. However, severe changes can cause complications such as pre-eclampsia and eclampsia, acute fatty liver of pregnancy (AFLP), elevated liver enzyme and low platelets (HELLP) syndrome, etc. An early assessment of LFT can ensure the reduction of complications for both the mother and the baby.

Glycosylated Haemoglobin

When a person’s blood sugar level is higher, it causes haemoglobin of the person to be glycosylated. It means that the glucose molecules in the blood get stuck to the haemoglobin molecules. Also referred as haemoglobin A1c or HbA1c, the Glycosylated haemoglobin test will show how well diabetes is being controlled during pregnancy. The target HbA1c for mothers before and during pregnancy is 6.1% (or 43 mmol/mol).

Vitamin D3 Serum

Vitamin D is important for bone growth and ossification and your baby gets vitamin D from you. In this test, your vitamin D level is tested and if found lacking, extra supplements are added to improve the vitamin D levels.

TSH [Extra Sensitive]

Untreated thyroid conditions can either reduce chances of getting pregnant or cause miscarriage. It is important to maintain a normal range of thyroid-stimulating hormone during pregnancy. The TSH test will help your doctor to see if there are any chances of complications due to lack or excess of TSH.

FT4

This test is used to find the concentrations of free thyroxine (FT4) during pregnancy. Due to changes in the thyroid axis, doctors need to have access to an accurate number of thyroxine concentrations to monitor the baby’s IQ and psychomotor development.

Fetal Blood Sampling And Intrauterine Transfusion

This test is done by extracting a small amount of blood of your baby from the umbilical cord to check if your baby has anaemia or lack of blood cells which can lead to the baby’s heart failure. If the baby has anaemia, your doctor would replace the destroyed blood cells by performing several intrauterine transfusions throughout the pregnancy.

Fetal Echocardiography

This test is done to see the development of your baby’s tiny heart. If any defect is found, the doctors could take proper measures to care for your baby throughout the whole pregnancy.

Color Doppler Scan [again at 32 Weeks]

This scan turns sound waves into images that help to find any issue regarding blood flow. It will show if there are any blocked or narrowed arteries. It will also help find problems of blood flow in the liver, kidneys, pancreas or spleen. This scan is generally done in the third semester on women with high-risk pregnancies and reduces the risk.

Now you know the different tests that you would have to go through. So don’t worry about them and don’t stress much. Talk to your doctor and prepare yourself for all the tests which will help you to monitor your baby’s development. Have a happy and amazing pregnancy!