Your doctor will probably order several tests at the first or second visit. These may include:
 | complete blood count (CBC) |
| urinalysis and urine culture |
| test for syphilis |
| cervical cultures |
| rubella titers (for immunity against rubella) |
| blood type |
| Rh-factor |
| test for hepatitis-B antibodies |
| alpha-fetoprotein test |
| ultrasound |
| Pap smear |
| mammogram (if you are at least 35 and a mammogram has not been done before); many doctors will not do this test during pregnancy |
Results of these tests give your doctor information he or she needs to provide the best care for you. For example, if testing shows you have never had rubella (German measles) or rubella vaccine, you will know you need to avoid exposure during pregnancy and you should receive the vaccine before your next pregnancy. Rubella can be responsible for miscarriage or birth defects if a woman contracts the disease during pregnancy.
Questions to Ask Your Doctor
Some tests are fairly routine, and you probably won't ask many questions about those. But for procedures that are more involved, you will want more information. Your goal in asking these questions about any test procedure is to ensure the benefits of the test outweigh any risks. You may want to ask your doctor some of the following questions before any test.
| Will my insurance cover the test? |
| Why are you doing this test? |
| How will the test be performed? |
| What risk does this test pose to me or the baby? |
| How experienced is the person doing the test? |
| How experienced is the lab doing the test? |
| How dependable are the results? |
| When will I get the results? |
| What happens after I get the results? |
| What is the possibility of false-positive or false-negative results? |
| What will happen if we don't do the test? |
| How will the results affect my pregnancy? |
| Is there any other way to get the same information? |
| What is the cost of the test? |
Tests Given or Repeated Later
Many doctors repeat some tests or perform new tests at other times during pregnancy. For example, the 28th week of pregnancy is the best time to uncover blood-sugar problems. Also at this point in your pregnancy, RhoGAM is given to an Rh-negative woman to protect her from becoming sensitized.
| Test | How It Is Done | What You and Your Doctor Can Learn |
|---|
| Alpha-fetoprotein | Blood sample drawn from mother | May indicate neural-tube defects (spina bifida) or risk of Down syndrome |
| Amniocentesis | Sample of amniotic fluid drawn by needle from uterus | Early in pregnancy, indicates chromosomal problems (Down syndrome), neural-tube defects (spina bifida), genetic disorders (cystic fibrosis), sex of fetus; late in pregnancy, indicates whether baby's lungs are developed |
| Biophysical profile | Variety of tests, including ultrasound for monitoring and observation | Used to show fetal well-being or to look for signs of fetal stress |
| Chorionic villus sampling | Sample of placental tissue drawn from placenta through abdomen or vagina | Used to determine many diseases, such as Down syndrome; some biochemical diseases, such as Tay-Sachs disease; and other fetal conditions, such as cystic fibrosis |
| Stress/nonstress test | Fetal activity is monitored by expectant mother and fetal monitor | Used to show fetal well-being or to look for signs of fetal stress |
| Ultrasound | Sound waves produce picture of uterus, placenta and fetus on screen | Age of fetal growth, fetal position, heart rate, movement, number of fetuses, some birth defects, fetal sex (sometimes) |
What about Genetic Counseling?
Not everyone needs genetic counseling. Those who do usually have had an infant with abnormalities, have a family history of inherited diseases, have had recurrent miscarriages (usually three or more) or will be 35 or older at the time of their baby's birth.
If you are a candidate for genetic counseling, you and your partner participate together. Detailed questions are asked about your medical history, other pregnancies, medication usage and the medical history of your family and your partner's family. If chromosome tests are necessary, blood samples are taken from both of you. You are advised about the potential or possibility for problems in a pregnancy.
