Pregnancy: Antenatal Checks and Tests

Antenatal Checks and Tests

During your pregnancy you will be offered a variety of tests. These tests are designed to help make your pregnancy safer, check and assess the development and well being of you and your baby and screen for different conditions.

You don’t have to have these tests, however it is important to understand the reasons for the tests so that you can make an informed decision about whether to have them. Discuss these with you midwife or doctor.

 

Weight and height checks in pregnancy

 

You will be weighed at your booking appointment, but you won’t be weighed regularly during your pregnancy. Your weight and height are used to calculate your body mass index (BMI). Women who are overweight for their height are at an increased risk of problems during pregnancy for example gestational diabetes and high blood pressure. But it is very much dependent on how much overweight you are.

Most women put on 10-12.5 kg (22-28 lbs) in pregnancy. Most of this weight is after the 20 weeks of pregnancy. Most of this weight is due to the baby growing but your body also stores fat for making breast milk after birth.

During your pregnancy it is important to eat the right foods and do regular exercises.

 

Antenatal Urine Tests

When you attend for your antenatal appointment you will be asked to bring a sample of urine with you. This urine sample is checked for many things for example protein and glucose (sugar).

If you have protein in your urine it can sometimes mean an infection and you may need to have a sample of urine sent to the laboratory for further testing or you may need treatment depending on your symptoms.

Protein can also show in your urine when screening for pre-eclampsia. It is important to screen for pre-eclampsia as it can lead to a variety of problems for you and for your baby.

If you have glucose in your urine you may need further tests for example glucose tolerance test.

 

Blood Pressure Test

At every antenatal check you will have your blood pressure taken. It is very common for your blood pressure to be lower in the middle of your pregnancy than at other times. This is not a concern but it may make you feel lightheaded if you get up too quickly. Talk to your midwife or doctor if you are concerned. A rise in blood pressure later in pregnancy could be a sign of pregnancy induced hypertension or pre-eclampsia and you would require regular checks.

 

Blood Tests in Pregnancy

There are several blood tests you can be offered during your pregnancy. All tests are done to make your pregnancy safer or to check that the baby is healthy.

Once you have had a discussion with your midwife or doctor take your time in deciding what tests to have, the following is an outline of tests that can be offered:

Blood group

Rhesus disease

Anaemia

Diabetes

 

Blood Group

It is very important to know your blood group in case you need to be given blood. If you have a bleed (haemorrhage) following delivery you may require a blood transfusion. The test will also tell you if you are rhesus negative or rhesus positive. Women who are rhesus negative will require extra tests in pregnancy to reduce the risk of rhesus disease.

 

Rhesus Disease

People who are rhesus positive have a substance known as D Antigen on the surface of their red blood cells. Rhesus negative people do not. A rhesus negative woman can carry a baby who is rhesus positive if baby’s dad is rhesus positive. If a small amount of the baby’s blood enters the mother’s bloodstream during pregnancy or birth the mother can produce antibodies against the rhesus positive cells (also known as anti D antibodies).

This usually doesn’t affect the current pregnancy however when the woman has another pregnancy with a rhesus positive baby, her immune response will be greater and she may produce a lot more antibodies. These antibodies can cross the placenta and destroy the baby’s blood cells resulting in a condition called rhesus disease or haemolytic disease of the new born. This can lead to anaemia and jaundice in the baby.

Anti D is an injection that can prevent rhesus negative women from producing antibodies against the baby. Rhesus negative women who have not developed antibodies are offered an injection of Anti D between 28 and 32 weeks pregnant as well as after the birth of the baby.

Anaemia

Anaemia can make you feel very tired and less able to cope if you lose blood at the time of your delivery. If your blood tests show you have anaemia you will be given diet advice which is rich in iron and an iron supplement.

 

Diabetes

Some women are at an increased risk of developing gestational diabetes in pregnancy for example; if you are over-weight, have a close relative with diabetes or had diabetes in a previous pregnancy.

If you are high risk for gestational diabetes you may be offered a glucose challenge/tolerance test in pregnancy.

 

Infections

You may be offered tests for infections in pregnancy for example:

Rubella

Syphilis

Hepatitis B

HIV

Rubella (German measles)

A blood test will be taken from your arm in early pregnancy to check it you are immune to rubella. If you get rubella in early pregnancy it can be serious for you baby. If your test result shows you are low or no immunity your midwife or doctor will discuss your result with you.

Syphilis

In early pregnancy you will be tested for syphilis which is a sexually transmitted infection. If you test positive you will require treatment as left untreated can lead to miscarriage.

Hepatitis B

You can be immunised as a baby to prevent you getting Hepatitis B which causes liver disease.

You will be offered a blood test to test for Hepatitis B. If you are a carrier or infected during pregnancy your baby won’t usually be ill but has a high chance of developing long term infection and liver disease later in life. If you have hepatitis B you will be referred to a specialist.

HIV (human immunodeficiency virus)

This is the virus that causes AIDS. HIV infection can be passed on to baby during pregnancy, at delivery or after birth by breastfeeding.

You will be offered a blood test and if you are HIV positive both you and your baby can have treatment and care that reduces the risk of your baby becoming infected.