Pregnancy - Investigations

Antenatal checkups help gravida to give birth to healthy baby.  The aim of antenatal checkups is to evaluate the health of woman and recognise any medical or surgical

condition that can have adverse effect on the outcome of pregnancy.

In the first visit obstetrician not only confirms pregnancy but also evaluates the woman by taking her personal, family history and appropriate blood and urine examinations.  General health checkup includes total physical examination and recording height and weight of the gravida.  Common investigations in the first visit are,

Blood examination:  most importantly to know the hemoglobin percent, blood grouping and Rh typing, also for any sexually transmitted diseases, and serum hepatitis. In regions where hypothyroidism is endemic thyroid hormone test is done.  Few more tests are done depending on the gravida’s medical history.

Urine examination:   for any infection.

If the gravida is having Rh negative blood group, husband’s blood grouping and Rh typing is done to take appropriate precautions if the husband is Rh positive.  If the gravida is positive for any sexually transmitted diseases, spouse also evaluated for the same and the couple treated to prevent any complications to the fetus.

First visit:  confirmation of pregnancy, height and weight, blood pressure recording, blood and urine examination, if necessary ultrasound scanning. 

In developed countries Pap smear test is done as a screening procedure for cancer cervix.

In consecutive visits and every visit

Weight, blood pressure, fetal growth (height of uterus) is noted.  Any complaints by the gravida are addressed to.  The total weight gain in pregnancy in a normal healthy woman, with a healthy pregnancy is 10-12 Kg.  Increase in weight by 1/2 Kg a week after 16 weeks of pregnancy is expected.  Underweight woman is encouraged to gain more weight and obese to restrict total pregnancy weight gain to 6-8 Kg only.  

Blood test for hemoglobin percent and urine for any sugar and proteins is done.

If family history of diabetes mellitus is present the gravida needs to undergo test for blood sugar at 20 weeks, 28 weeks and repeated at appropriate intervals if necessary.

Rh negative group woman with Rh positive husband will have to undergo blood test (Coomb’s test) at 20 weeks, 28 weeks and 36 weeks to note any changes in the blood that may adversely affect the fetus.

Woman with hypothyroidism may have to undergo repeat test for thyroid evaluation for adjusting the dose of thyroxin hormone.

Ultrasound scanning is done early in pregnancy to confirm viable pregnancy and for dating, between 12-14^th week and around 18 - 22 weeks to rule out any fetal anomalies.   Scanning may be repeated if there are any problems affecting the growth of the fetus and evaluation of fetal growth.

Any illnesses occurring during the pregnancy will need appropriate tests.

In India gravida is given all the reports of investigations.  She has to carry all these when she visits the obstetrician.  If the clinic or hospital gives a record of all the investigations with the history and examination of woman she should carry this to her consultant at every visit to record findings.  This will help in early identification of any risk arising during the course of pregnancy.

Good antenatal care will ensure healthy mother and healthy baby.