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Routine Tests
Special Tests for
Invasive Tests
In - utero tests





During pregnancy profound changes occur in your body. Every aspect of your body shows marked changes.In a healthy lady these changes are easily accommodated in her body without really dipping into her reserves. For those who start pregnancy with a physical or medical problems the body will put pressure on these limited reserves. As a result there will be evidence of adverse effects on the body.Your doctor’s job is to assess the state of your body and among the measurements that will be done is to have your blood and urine examined. Both these investigations can give clues as to the state of your body as it adapts to your growing pregnancy.

The doctor will ask for common laboratory tests during your pregnancy by drawing some blood from your arm and obtain a urine sample.

Pregnancy places a heavy load on the urinary tract ,cardiovascular(heart andblood vessels),respiratory systems, which is easily adapted by most women. Hence it is very important to ensure that these systems are functioning normally before the start of your pregnancy.
Urine is excreted by your urinary tract. The urinary tract comprises of the following:

  • Urine test (Urine analysis)

The urine comprises the end products of your body’s metabolism, which is filtered out in the kidneys and excreted through the ‘water works’ to the outside.
Hence if there is any damage to any or both of the kidneys, these end products would accumulate in the body causing undesirable effects. The kidneys could also be damaged due to infection from bacteria causing inefficient functioning. Also the collecting tubes or the bladder may be damaged or blocked, or damaged due to infection.
In the clinic when you are given a jar and told to pass urine in it, to ensure a ‘clean catch’ it is advisable to first wash yourself, pass a little urine in the toilet and then pass urine in the jar- a midstream specimen.
Urine will be tested for
Confirming Pregnancy (hCG hormone)
pus cells

The routine blood tests that are done are:-

  • Test for confirming pregnancy (hCG assay)
  • Hemoglobin content
  • Complete Blood Count
  • Blood Group and Rh factor
  • VDRL Tests for syphillis (sexually transmitted disease)
  • HIV Factor for AIDS
  • Hepatitis B Screening.
  • Blood sugar at 24-28 weeks.
  • Blood sugar

If there is a family history of diabetes or if you are over weight or if your growing baby is assesed to be larger than expected, there is a chance of developing gestational diabetis.    

  • Ultrasound Scan

Ultrasound was adapted to medical use in the early 1960's when it was first used in Obstetrics to locate the position of the foetus and the placenta or afterbirth.

Today, because of advances made in instruments, it is possible to learn important information about the foetus and its surroundings.



Purpose of test

The common reasons of asking for a Ultrasound are :-

  1. Confirm an early pregnancy. .
  2. Rule out ectopic pregnancy. This is usually necessary in early pregnancy.
  3. Determine due date.
  4. Determine foetal position.
  5. Identify location of the placenta
  6. Verify the diagnosis of twins/multiple pregnancy.
  7. Evaluate foetal growth.
  8. Determine the amount of amniotic fluid around the baby.
  9. Assess fetal well-being.
  10. Accompaniment to special procedures.

The test is normally performed in the doctor’s clinic or a hospital.In India the test is usually done by a Doctor who is a specialist in Radiology or is also done by the Obstetrician.

  • Risks

There are no risks or precautions to be taken.A commonly asked question is if the procedure of ultrasound harms the baby. Thus far, from all the information gathered and studied in human beings, there has been no good data published that indicate that ultrasound used during obstetrical diagnosis has any ill effect on the growth and development of the baby.

Trans Abdominal

The test requires a full bladder to help define pelvic organs. Drink several glasses of water about 1 hour before the test. Do not urinate until the test is finished.
Follow the doctor’s instructions for positioning your body. Oil or jelly is applied to your abdomen to improve sound wave transmission. The doctor guides a transducer, which may feel cold on your skin, over the area examined. Transducer sends an ultrasound beam, composed of very high-frequency sound wave, inaudible to the human ear. Ultrasound waves travel at varying speeds, depending on the thickness of the material they travel through. After passing through the tissue, reflected sound waves are converted into electrical impulses and displayed on a video screen for interpretation or photographing for later interpretation.

Abdominal USG(Ultrasound; Sonogram)

You will want to urinate as soon as the test is finished. The time before results are reported to patient varies from a few minutes to a few days.


In certain cases, an internal ultrasound may be required, particularly in early pregnancy. This is called ‘trans-vaginal sonography’ and can define pelvic structures and early pregnancy better, as it is done by a probe placed inside the vagina (like an internal examination with a picture of your inner organs being taken). Your doctor will specify if such procedure is necessary. A full bladder is not required for this procedure. pic of trans vaginalUSG

The ultrasound can be used to calculate the due date of delivery. This is particularly helpful when the exact date of the last menstrual period is not known or if the periods have been very irregular.
The parts used in the measurement are the bi-parietal diameter of the baby’s head, the length of the femur and the circumference of the abdomen. The accuracy of the procedure can determine within one to one and a half weeks of pregnancy.

It is possible to determine the sex of the baby. This is possible with the machine getting sophisticated. If the foetal position permits visualization of the genital area, it has been possible to make a guess of the sex of the baby. You will not be told the sex of your baby unless you want to know. Sometimes, under certain conditions it is necessary to find the sex of the baby, especially with a genetic inherited condition. If that is the case, then a effort would be made to identify the sex. Although ultrasound is able to identify many abnormalities, so-called "normal" results do not guarantee that your foetus is without abnormalities.

Rubella Test
Done for German Measles-(Rubella). If there is history of exposure to an infected individual, ideally, rubella status should be determined prior to getting pregnant – if not immune, you should be immunized. Most people are immunized in childhood now by MMR vaccine.

Blood test for Alpha feto- protein (AFP)
This test can be done on mother’s blood (MSAFP or Maternal Serum AFP) around the 14th – 16th week of pregnancy. It is a screening test i.e. an abnormal result is found in certain conditions. High levels make the doctor suspect defects in the development of spinal cord or brain (neural tube defects) in the baby.Gastrointestinal tract or in kidneys (congenital nephrosis) Low levels may be seen in genetic defects such as Down syndrome. An abnormal result needs to be verified by additional tests, which will be advised by your doctor. MSAFP is not done for all pregnancies. The doctor usually will suggest it to you if it is necessary.This blood test is done when there is a suspicion of a Neural Tube Defect in the unborn baby- Spina bifida, anencephaly.

Triple Marker Test
This specialized test may be recommended if you or your doctor is worried that the baby may not have developed normally. It tests a pregnant woman’s blood around 14 – 16 weeks for AFP (as above) hCG (human chronic gonadotrophin), and estiol.
A computerized program will give your risk, taking into account variables like your age, medical history and other factors. This new test is not yet available everywhere but is being done by some centers. If abnormal detailed testing may be recommended by your doctor.

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Invasive Tests for Special Cases

In certain cases when screening tests like AFP or Triple Marker are abnormal, or there is a past history of child with genetic defects (haemophilia, thalessemia, Down’s, sickle cell major, cystic fibrosis etc) it may be necessary to take out some foetal tissue for genetic testing. This may be done by:

This test is done around 16 weeks,but may be done earlier or later in special cases.This is a procedure where under the guidance of an ultrasound a needle is passed into the uterine cavity and some amniotic fluid is sucked out. This test is done on suspicion of genetic defects.For details of special tests your doctor is the right person to guide you.

A test done in early pregnancy. The procedure involves inserting a needle into the uterus cavity into the placental site to suck out a very small bit of tissue. This test is done to determine certain genetic disorders like Tay -Sach’s Disease, Sickle Cell Anemia. Thalassemia, Down’s Syndrome. The risk involved in this procedure is risk of abortion and damage to fetal limb.

  • Tests for your baby's health in-Uterus

These are usually recommended in advanced pregnancy (after 32 weeks) and are to be done if your doctor advices it.

  • Daily Foetal Movement Count (DFMC)

Changes in fetal movement may reflect changes in fetal well-being. By keeping a record of the number of times your baby moves during the day, you can provide useful information on fetal well-being. Some babies are more active than others.
There are various methods to evaluate the movement count. The easiest way is during the evening hours to record the time that has elapsed to feel the baby kick 10 times. The average time taken to feel 10 movements is 21 minutes. If you have taken 2 hours or more to feel 10 movements, contact your doctor.

This is a test to assess the well being of your baby. It is a non- invasive test and carries no risk of the procedure. The duration of the test is approximately 20 minutes.
In this test , movements of the baby are monitored along with the heart rate with each movement. The baby needs to be awake during this test.
With the movement of the baby, there is a corresponding increase in the heart rate.
The NST is done in a high risk pregnancy and is usually done after the 36 th week and repeated weekly.

  • Biophysical Profile

In late pregnancy, to assess the baby’s health in utero, the gynecologist studies the foetus to know the movements, posture and one, and assesses the placenta and amniotic fluid. The overall result tells you how well the baby is doing. If the result is not good, further tests or some intercention may be needed. Some intercention may be needed. This is usually done if there is some problem complicating the pregnancy, such as hypertension, diabetes, IUGR, etc.   

Cartoon of a dr. using a doppler

This is a special addition to the routine ultrasound machine, which enables study of blood flow to the baby and in the feto-placental circulation. It is done to assess feotal health in complicated pregnancies, and may be used in deciding when to deliver the baby.

  • Vitro-acoustic stimulation test (VAST)

Here a vibrating and sound stimulation is given through the mother’s abdomen to the foetus and its reaction in terms of increase in heart rate and movements is seen

Recommended:  book
"The new parent"
by author Martha


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